Mind-body interventions on stress management in pregnant women: A systematic review and meta-analysis of randomized controlled trials.

Abstract

To quantify the effect of mind-body interventions on stress in pregnant women. A systematic review and meta-analysis of randomized controlled trials was performed. PubMed, Embase, CENTRAL, Web of Science and PsycINFO were searched from each database inception to January 2020. Randomized controlled trials regarding mind-body interventions for stress in pregnant women were included. Methodological quality was evaluated using the Cochrane Collaboration 'Risk of Bias' tool and meta-analysis was performed via RevMan 5.3. Subgroup analysis and publication bias assessment were conducted. Post hoc sensitivity analysis was performed to investigate the source of heterogeneity. In total, 28 studies comprising 1944 participants were included. The overall meta-analysis showed that antenatal stress of pregnant women in the mind-body interventions groups showed significant high improvements (SMD=-0.94; 95% CI [-1.25, -0.63]; p<.00001) compared with the control groups. Results of subgroup analyses indicated that all types of mind-body interventions including mindfulness intervention, cognitive behavioural therapy, relaxation techniques and yoga were beneficial to antenatal stress. Both groups and individual formats mind-body interventions were effective. 4-8weeks mind-body interventions were seemed as the optimal choice. Moreover, mind-body interventions were concomitant with reducing antenatal anxiety and depression. Mind-body interventions are promising approaches for stress reduction in pregnant women. Nevertheless, the results should be interpreted with caution because of high heterogeneity and publication bias. Further high-quality studies are needed to verify the findings. Mind-body interventions have been widely implemented to ameliorate antenatal stress, but conflicting results were found across studies. This systematic review and meta-analysis suggested that mind-body interventions are relatively safe and convenient and can successfully promote antenatal stress. The suggestions proposed in this review may be useful for developing a scientific mind-body interventions regimen and encouraging the application of mind-body interventions in pregnant women, thereby managing antenatal stress effectively.