The safety and effectiveness of mind body interventions for women with pregnancy induced hypertension and or preeclampsia: A systematic review and meta-analysis

C A Smith; A Tuson; Charlene Thornton; Hannah G Dahlen

doi:10.1016/j.ctim.2020.102469

The safety and effectiveness of mind body interventions for women with pregnancy induced hypertension and or preeclampsia: A systematic review and meta-analysis

Complement Ther Med. 2020 Aug:52:102469. doi: 10.1016/j.ctim.2020.102469. Epub 2020 Jun 6.

Authors

C A Smith¹, A Tuson², Charlene Thornton³, Hannah G Dahlen⁴

Affiliations

¹ NICM Health Research Institute, Western Sydney University, Penrith, 2751, Australia. Electronic address: caroline.smith@westernsydney.edu.au.
² Registered Midwife and Western Sydney University Summer Scholar, Western Sydney University Penrith, 2751, Australia. Electronic address: Alice.Tuson@health.nsw.gov.au.
³ College of Nursing and Health Sciences, Flinders University, Bedford Park, 5042, Australia. Electronic address: c.thornton@flinders.edu.au.
⁴ School of Nursing and Midwifery, Western Sydney University, Penrith, 2751, Australia. Electronic address: h.dahlen@westernsydney.edu.au.

PMID: 32951719
DOI: 10.1016/j.ctim.2020.102469

Abstract

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.

Keywords: Pregnancy; complementary therpies; mind body interventions; preeclampsia; pregnancy induced hyptertension; systematic review; womens health.

Publication types

Meta-Analysis
Systematic Review

MeSH terms

Blood Pressure / physiology
Female
Humans
Hypertension, Pregnancy-Induced / therapy*
Mind-Body Therapies / methods*
Patient Safety
Pre-Eclampsia / therapy*
Pregnancy
Pregnancy Complications / therapy*
Randomized Controlled Trials as Topic