Effectiveness of mindfulness training on pregnancy stress and the hypothalamic-pituitary-adrenal axis in women in China: A multicenter randomized controlled trial

Shulei Wang; Chen Zhang; Mengyun Sun; Daming Zhang; Ying Luo; Kairu Liang; Tao Xu; XiaoPing Pan; Ruimin Zheng; Fangfang Shangguan; Jia Wang

doi:10.3389/fpsyg.2023.1073494

Effectiveness of mindfulness training on pregnancy stress and the hypothalamic-pituitary-adrenal axis in women in China: A multicenter randomized controlled trial

Front Psychol. 2023 Mar 2:14:1073494. doi: 10.3389/fpsyg.2023.1073494. eCollection 2023.

Authors

Shulei Wang^{1

2}, Chen Zhang^{3

4}, Mengyun Sun¹, Daming Zhang⁵, Ying Luo⁶, Kairu Liang⁷, Tao Xu¹, XiaoPing Pan¹, Ruimin Zheng¹, Fangfang Shangguan⁴, Jia Wang⁸

Affiliations

¹ National Center for Women and Children's Health, China CDC, Beijing, China.
² Yantai Center for Disease Control and Prevention, Yantai, Shandong, China.
³ Fengtai Mental Health Center, Beijing, China.
⁴ School of Psychology, Capital Normal University, Beijing, China.
⁵ Shanxi Maternal and Child Health Hospital, Taiyuan, Shanxi, China.
⁶ Shandong Maternal and Child Health Hospital, Jinan, Shandong, China.
⁷ Sichuan Maternal and Child Health Hospital, Chengdu, Sichuan, China.
⁸ Shandong Provincial Hospital, Jinan, Shandong, China.

Abstract

Introduction: In the past two decades, mindfulness-based intervention programs have gradually become popular.Many studies have confirmed that these programs can effectively alleviate prenatal stress and negative emotion.The mindfulness-based stress-buffering hypothesis suggests that mindfulness training can induce changes in the levels of the cortisol secreted by the HPA axis, thereby reducing stress susceptibility. However, to date, only a few high-quality evidence-based medical studies have analyzed the effect of the mindfulness-based intervention in a maternal population.Thus, this study investigated the effects of a mindfulness-based psychosomatic intervention on pregnancy stress and the HYPERLINK "javascript:;" hypothalamic-pituitary-adrenal (HPA) axis of pregnant Chinese women.

Methods: Women experiencing first-time pregnancy (n = 117) were randomly allocated to the intervention group or parallel active control group, and data were collected at baseline and post-intervention periods. The participants completed questionnaires regarding mindfulness and pregnancy stress. Saliva samples was collected at the time of waking up, and 30, 45, and 60 min after waking up for analyzing the salivary cortisol levels. We analyzed differences between the two groups and changes within the same group before and after the intervention.

Results and discussion: A total of 95 participants completed the trial. Compared with the parallel active control group, the intervention group exhibited lower levels of stress after the intervention (P = 0.047). For HPA-axis-related indicators after the intervention, Delta value (P = 0.01) and AUCM value (P = 0.031) of the intervention group were significantly higher than that of the control group. Mindfulness-based interventions effectively reduced the level of pregnancy stress and adjusted the HPA axis function in pregnant women in China.

Clinical trial registration: https://www.chictr.org.cn, identifier ChiCTR 2000033149.

Keywords: HPA axis; mindfulness; multicenter; pregnant women; randomized controlled trial; stress.