TY - JOUR
T1 - The safety and effectiveness of mind body interventions for women with pregnancy induced hypertension and or preeclampsia
T2 - A systematic review and meta-analysis
AU - Smith, C. A.
AU - Tuson, A.
AU - Thornton, Charlene
AU - Dahlen, Hannah G.
PY - 2020/8
Y1 - 2020/8
N2 - Objectives: To undertake a systematic review of the safety and effectiveness of mind body approaches for women with hypertensive disorders in pregnancy (HDP). Design: A search was undertaken of databases from inception to 2019 for randomised and quasi randomised controlled trials. Main outcome measures: The primary outcome was a reduction in systolic and / or diastolic blood pressure for women with hypertension and or preeclampsia in pregnancy. Results: 121 studies were identified and eight studies were included in this review. These included mind body interventions examining yoga, guided imagery, relaxation, music, and acupuncture for HDP. Two studies of relaxation found a reduction in systolic (MD -11.3, 95%CI -13.23 to -9.39) and diastolic blood pressure (MD -6.59, 95%CI -9.43 to -3.75) and reduced stress (MD -11.4, 95%CI -16.5 to -6.3). In one study of yoga, the risk of developing HDP was reduced (RR 0.28, 95% CI 0.09 to 0.91, 59 women) and a second study found a reduction in stress at the end of the intervention of yoga. One trial of guided imagery found a reduction in mean arterial blood pressure compared to the control (4.35, 95% -8.04 to -0.66, p=0.02). Overall there was no effect on the development of preeclampsia, use of anti-hypertensive medication and any neonatal outcomes from the interventions evaluated. Few trials reported on safety outcomes, one trial of acupuncture reported one case of placental abruption and three cases of acupuncture related side effects.Conclusion: Few high quality trials have examined the effectiveness and safety of mind body interventions to manage HDP. Relaxation, yoga, guided imagery and music may have some potential benefit. Safety issues are completely unclear and thus the risk-benefit ratio of all interventions could not be determined. Further research is recommended.
AB - Objectives: To undertake a systematic review of the safety and effectiveness of mind body approaches for women with hypertensive disorders in pregnancy (HDP). Design: A search was undertaken of databases from inception to 2019 for randomised and quasi randomised controlled trials. Main outcome measures: The primary outcome was a reduction in systolic and / or diastolic blood pressure for women with hypertension and or preeclampsia in pregnancy. Results: 121 studies were identified and eight studies were included in this review. These included mind body interventions examining yoga, guided imagery, relaxation, music, and acupuncture for HDP. Two studies of relaxation found a reduction in systolic (MD -11.3, 95%CI -13.23 to -9.39) and diastolic blood pressure (MD -6.59, 95%CI -9.43 to -3.75) and reduced stress (MD -11.4, 95%CI -16.5 to -6.3). In one study of yoga, the risk of developing HDP was reduced (RR 0.28, 95% CI 0.09 to 0.91, 59 women) and a second study found a reduction in stress at the end of the intervention of yoga. One trial of guided imagery found a reduction in mean arterial blood pressure compared to the control (4.35, 95% -8.04 to -0.66, p=0.02). Overall there was no effect on the development of preeclampsia, use of anti-hypertensive medication and any neonatal outcomes from the interventions evaluated. Few trials reported on safety outcomes, one trial of acupuncture reported one case of placental abruption and three cases of acupuncture related side effects.Conclusion: Few high quality trials have examined the effectiveness and safety of mind body interventions to manage HDP. Relaxation, yoga, guided imagery and music may have some potential benefit. Safety issues are completely unclear and thus the risk-benefit ratio of all interventions could not be determined. Further research is recommended.
KW - complementary therpies
KW - mind body interventions
KW - preeclampsia
KW - Pregnancy
KW - pregnancy induced hyptertension
KW - systematic review
KW - womens health
UR - http://www.scopus.com/inward/record.url?scp=85086566782&partnerID=8YFLogxK
U2 - 10.1016/j.ctim.2020.102469
DO - 10.1016/j.ctim.2020.102469
M3 - Review article
C2 - 32951719
AN - SCOPUS:85086566782
VL - 52
JO - Complementary Therapies in Medicine
JF - Complementary Therapies in Medicine
SN - 0965-2299
M1 - 102469
ER -