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... Our review of the literature demonstrated that music was used in different sample groups such as older adults, premature babies, intensive care patients, patients with Alzheimer's disease, gynecological oncology patients and pregnant women [15][16][17][18][19][20]. In studies conducted with pregnant women, having them listen to music has been determined to positively affect such conditions as anxiety, labor pain, psychosocial stress, physiological health, maternal and fetal attachment [8,12,13,[21][22][23][24][25][26]. However, our search for studies in which the effect of music on sleep and comfort during pregnancy was investigated demonstrated a gap in the literature. ...
... In music intervention, music aimed at relaxation should have a regular speed (less than 80 beats per minute), and a smooth and flowing melody. It is recommended that the volume of the music should be between 60 and 70 dB and should not be excessively loud, and that if music is to provide relaxation, it should be played 20-40 min for at least three days or a maximum of two weeks [8,12,21,27,28]. Taking these recommendations into account, the sound decibels of mp3 devices to be given to pregnant women were adjusted to the volume in the range of 60-70 dB with the decibel measurement tools. ...
... In order for the music intervention to be effective, women were asked to listen to music for 30 min every other day (Mondays, Wednesdays and Fridays) for two weeks before going to sleep. In order to minimize environmental stimuli, at the beginning of the data collection process and during the monitoring periods, they were recommended to listen to the music in a semi-Fowler's position with their head and shoulders raised 30°after emptying their bladder [21]. ...
Article
Background: The mother's having good mental health during pregnancy is important for the mother's and fetus's health. Stress experienced during pregnancy can also affect prenatal attachment. In this study, it was aimed to determine the effect of the stress level of pregnant women on prenatal attachment and the factors affecting prenatal attachment. Subjects: In this descriptive cross-sectional study conducted in the obstetrics outpatient clinic of a training and research hospital, 276 healthy primiparous pregnant women whose gestational age was ≥20 weeks were included. To collect the data, the Descriptive Characteristics Form, Pregnancy Stress Rating Scale (PSRS), and Prenatal Attachment Inventory (PAI) were used. Results: The mean scores the participants obtained from the Pregnancy Stress Rating Scale and Prenatal Attachment Inventory were 40.13±31.22 and 46.87±16.62 respectively. A moderately statistically significant negative correlation was determined between pregnancy stress and prenatal attachment (r=-0.42, p=0.000). In the study, it was observed that pregnancy stress level of the participating pregnant women decreased as the age increased (r=-0.13, p=0.026), but that it increased as their education and income levels increased (χ2=8.150, p=0.043) - (χ2=6.785, p=0.034). The participants' attachment levels were not correlated with variables such as age, education, baby's sex and gestational age, but prenatal attachment levels of the participants who received social support while they did house hold chores were statistically significantly higher (U=7872.500, p=0.025). Conclusions: It was observed that as the prenatal attachment level of the participating pregnant women decreased, as their stress level increased, that their stress level decreased as their age increased, that that their stress level increased as the education and income levels increased, and that the prenatal attachment of the participants who received social support when they did household chores was higher. It is thought that health personnel can improve prenatal attachment by taking necessary steps to reduce the stress levels of pregnant women in this process.
... Our review of the literature demonstrated that music was used in different sample groups such as older adults, premature babies, intensive care patients, patients with Alzheimer's disease, gynecological oncology patients and pregnant women [15][16][17][18][19][20]. In studies conducted with pregnant women, having them listen to music has been determined to positively affect such conditions as anxiety, labor pain, psychosocial stress, physiological health, maternal and fetal attachment [8,12,13,[21][22][23][24][25][26]. However, our search for studies in which the effect of music on sleep and comfort during pregnancy was investigated demonstrated a gap in the literature. ...
... In music intervention, music aimed at relaxation should have a regular speed (less than 80 beats per minute), and a smooth and flowing melody. It is recommended that the volume of the music should be between 60 and 70 dB and should not be excessively loud, and that if music is to provide relaxation, it should be played 20-40 min for at least three days or a maximum of two weeks [8,12,21,27,28]. Taking these recommendations into account, the sound decibels of mp3 devices to be given to pregnant women were adjusted to the volume in the range of 60-70 dB with the decibel measurement tools. ...
... In order for the music intervention to be effective, women were asked to listen to music for 30 min every other day (Mondays, Wednesdays and Fridays) for two weeks before going to sleep. In order to minimize environmental stimuli, at the beginning of the data collection process and during the monitoring periods, they were recommended to listen to the music in a semi-Fowler's position with their head and shoulders raised 30°after emptying their bladder [21]. ...
Article
Objectives: This pilot randomized controlled experimental study was conducted to investigate effects of music on sleep quality and comfort levels of pregnant women. Methods: The sample of the study consisted of 70 pregnant women who met the inclusion criteria and agreed to participate in the study. The pregnant women were assigned to the music (n=35) and control groups (n=35). In the study, the musical pieces composed in Uşşak mode were played for the participants in the music group. The pregnant women in the music group were first asked to empty their bladder and then listen to music for 30 min in a semi-Fowler's position with their head and shoulders raised 30°, in a quiet and dim environment, every other day for two weeks before going to sleep. The Pregnant Information Form, Prenatal Comfort Scale (PCS) and Pittsburgh Sleep Quality Index - 1 week (PSQI-1 week) were used to collect the study data. Results: The analysis of the mean scores obtained from the overall PSQI-1 week by the pregnant women in the music and control groups by weeks demonstrated that there was a statistically significant difference between the music and control groups in the second week (p<0.05). There was no statistically significant difference between the two groups in terms of the mean scores they obtained from the overall PCS (p>0.05). Conclusions: Music increased the sleep quality of the pregnant women in the music group, but had no effect on their comfort levels.
... Based on the our research findings, we can suggest that the long-term application of therapeutic music can use as an effective method to alleviate trait anxiety during pregnancy. The study of García González et al. (2018) found that STAI-T measurement of the intervention group, who listened to music during the NST application, was found to be significantly lower than the control group (García González et al., 2018). Nwebube et al. (2017) evaluated the effects of music specially composed for pregnancy on anxiety and depression in their study. ...
... Based on the our research findings, we can suggest that the long-term application of therapeutic music can use as an effective method to alleviate trait anxiety during pregnancy. The study of García González et al. (2018) found that STAI-T measurement of the intervention group, who listened to music during the NST application, was found to be significantly lower than the control group (García González et al., 2018). Nwebube et al. (2017) evaluated the effects of music specially composed for pregnancy on anxiety and depression in their study. ...
... In the study of García González et al. (2018) the reactivity findings of the intervention group listening to music during NST were found to be statistically significantly higher than the control group. (García González et al., 2018). ...
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The researchers’ aims were to investigate the effects of music therapy applied to pregnant women on maternal, fetal, and neonatal results. Sample of the randomized controlled trial consisted of 100 (50 intervention, 50 control) primipara women. Nonstress Test was applied to women in 36th, 37th, and 38th gestational weeks. During the test, we played music to the intervention group and gave routine care to the control group. We determined that the mean scores of State Anxiety Inventory, evaluated during the Nonstress Test applications, decreased significantly after the application. Acceleration, mean number of fetal movements and reactivity findings were significantly higher in the intervention group. There was no significant difference between the groups in terms of the State Anxiety Inventory means after childbirth and neonatal findings. According to the results, we determined that the music therapy applied to pregnant women decreased maternal anxiety and had positive effects on Nonstress Test findings.
... Recently, several randomized controlled trials (RCTs) have demonstrated conflicting results on this topic. Some studies have indicated that music interventions relieve anxiety levels during pregnancy [15][16][17], but one study did not report a significant effect [18]. Our aim is to perform an updated systematic review and meta-analysis, incorporating all previously available trials to verify the reported inconsistencies, and to evaluate the relationship between music interventions and prenatal anxiety. ...
... Removing duplicates and screening by the titles and abstracts, we excluded 1519 articles (Figure 1). Subsequently, after full text assessment, 12 studies were deemed eligible for inclusion [15][16][17][18]21,22,[28][29][30][31][32][33]. Two publications by Garcia-Gonzalez et al. had the same study population [16,33], and one of that mainly focusing on newborns outcome was excluded [33]. ...
... Subsequently, after full text assessment, 12 studies were deemed eligible for inclusion [15][16][17][18]21,22,[28][29][30][31][32][33]. Two publications by Garcia-Gonzalez et al. had the same study population [16,33], and one of that mainly focusing on newborns outcome was excluded [33]. Finally, 11 trials were included in our review (Table 1). ...
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Prenatal anxiety is extremely common and may result in adverse effects on both the mother and the baby. Music interventions have been used to reduce anxiety in various medical patients and in pregnant women during childbirth. This study aims to assess the clinical efficacy of music interventions in women during pregnancy rather than during labor. Seven databases were searched from inception to September 2019 without language restrictions. We included only randomized controlled trials that compared music intervention and control groups for anxiety reduction in pregnant women. We used the revised Cochrane risk-of-bias tool (RoB 2.0) for quality assessment. Finally, 11 studies with 1482 participants were included. The pooled meta-analysis results showed that music interventions significantly decreased anxiety levels (standardized mean difference (SMD), −0.42; 95% confidence interval (CI), −0.83 to −0.02; I2 = 91%). Moreover, subgroup analysis showed that listening to music at home had significant anxiolytic benefits (SMD, −0.28; 95% CI, −0.47 to −0.08; I2 = 0%). However, meta-regression revealed a nonsignificant trend for increase in the anxiety-reducing effects of music interventions with increasing maternal age. In conclusion, music interventions may be beneficial in reducing anxiety and may be applied in pregnant women.
... This fact may be related to the proper management of the team of employees and researchers, who had a positive relationship with the animals. [37] observed that music therapy during pregnancy was positively related to the birth weight of babies, concluding that there is a direct relationship between mother's exposure to music, lower levels of anxiety, and greater newborn weight [37] (Garcia-Gonzalez et al., 2018). High levels of stress and anxiety have been linked to low birth weight of babies [38,39] (Copper et al., 1996;Bhagwanani et al., 1997). ...
... This fact may be related to the proper management of the team of employees and researchers, who had a positive relationship with the animals. [37] observed that music therapy during pregnancy was positively related to the birth weight of babies, concluding that there is a direct relationship between mother's exposure to music, lower levels of anxiety, and greater newborn weight [37] (Garcia-Gonzalez et al., 2018). High levels of stress and anxiety have been linked to low birth weight of babies [38,39] (Copper et al., 1996;Bhagwanani et al., 1997). ...
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The rearing environment of pigs can cause a high level of stress due to the lack of stimuli and the impossibility of carrying out natural behaviors. Music therapy is a way to enrich the environment and promote stress relief. Few studies in swine using environmental enrichers focus on functional benefits, such as stress resilience, improved biological functions, or mental status. The effect of environmental enrichment on neurobiological processes is particularly poorly understood in farm animals. Thus, our study sought to elucidate the influence of music in piglets exposed to music therapy in the intrauterine and extrauterine phase on neuroplasticity, evaluating the levels of brain-derived neurotrophic factor (BDNF). Behavioural responses were also evaluated using fear tests related to stress resilience. The productive performance of these piglets was analysed to relate the possible reduction in stress levels to greater productivity gains. Forty-eight sows were used at 90 days of gestation until the weaning of their piglets. In the gestation phase, the sows were divided into two treatments: control (without music therapy) and music (with music therapy). In the farrowing/lactation phase, the sows were separated into four treatments: control-control (no music in any phase); control-music (music only in farrowing/lactation); music-control (music only during pregnancy); and music-music (music in both reproductive phases). Music therapy did not cause a difference in the BDNF levels of piglets at birth. However, piglets born from sows of the music-music treatment did not show a reduction in BDNF between birth and weaning, unlike the other treatments. Exposure to music in the last 1/3 of pregnancy and farrowing/lactation improved the weight of piglets at birth and at weaning. Musical enrichment during pregnancy and lactation was able to cause changes in the piglets’ neuroplasticity and improve their productive performances.
... Consequently, the current study focused on whether trait anxiety independently affects BP, whether trait anxiety can induce BP directly or indirectly, and whether trait anxiety may lead to BP indirectly by reducing self-control. Similar to self-control, trait anxiety can also be regulated with methods such as meditation monologue [28], music therapy [29], and yoga [30]. Therefore, the results that emerge from this study are expected to help elucidate stable factors that contribute to BP and provide evidence by which to formulate interventions to address BP based on the individual's level of trait anxiety and self-control ability. ...
... It should be noted that the level of trait anxiety can also be regulated or shaped. Some interventions, such as meditation monologue [28], music therapy [29], and yoga [30], have been shown to reduce trait anxiety. Therefore, the regulation of trait anxiety may change one's susceptibility to BP and contribute to the effectiveness of self-control training on BP. ...
Article
Background: Bedtime procrastination (BP), a special type of health behavior procrastination, is considered to be a failure of self-control. Notably, self-control may mediate the effect of trait anxiety on general procrastination. However, there is no evidence demonstrating the role of self-control in the relationship between trait anxiety and BP. Moreover, the association between BP and trait anxiety has not yet been thoroughly studied. Therefore, the present study aimed to explore the direct relationship between them as well as the mediating role of self-control in this relationship. Methods: This cross-sectional survey included 718 college students enrolled in Chinese universities between October 2018 and January 2020. The Chinese versions of the Bedtime Procrastination Scale, the Self-Control Scale, and the Trait Anxiety Inventory were used to evaluate BP, self-control, and trait anxiety, respectively. Results: Multiple linear regression analysis revealed trait anxiety independently predicted BP while controlling for demographic characteristics. Correlation analyses showed that BP was positively correlated with trait anxiety, but negatively related to self-control. Structural equation modeling further revealed a mediating role of self-control in the relationship between trait anxiety and BP. Conclusions: Trait anxiety is a significant independent predictor of BP and may induce BP directly or indirectly through the effect of self-control. These findings provide a deeper understanding of the relationship between trait anxiety and BP and the underlying mechanism by exploring the mediating effect of self-control. As such, trait anxiety and self-control should be included in prevention and intervention strategies to address BP behavior in college students.
... Evidences claim that music helps in rapid recovery of symptoms of COVID-19 along with boosting immunity and helping through-out the quarantine period [19]. Studies also support the use of music therapy in reducing anxiety, stress, depression while increasing mindfulness and well being [24,8,6,9,17,16]. ...
... Music as a therapeutic approach can be dated back to the time of Hippocrates, Plato, Pythagoras and Aristotle. Music was used to eliminate pain, anxiety and sufferings from various disease and at pregnancy [9,30,23]. Although there are many studies on music therapy, very few studies are found on Indian classical music ragas as a therapy [19,23]. ...
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Raga todi, an Indian classical music raga is emerging as a therapeutic approach in mental health and well being. This study aims to assess the relationship of raga todi and state anxiety at the time of novel coronavirus spread across the globe. 30 young female adults of age 20 to 28 years were randomly assigned to experimental group and control group of 15 participants each to which a pre and post test of State Anxiety test of STAI-A was administered. Results stated that state anxiety is negatively correlated to the listening of raga todi. Thus, listening to raga todi could be useful in reducing the state anxiety level provoked by a stressful life event like the lethal coronavirus pandemic.
... Normal kalp atım hızına uyumlu bir müziğin ya da ninninin olumlu psikolojik etkileri (8-10) yanında gebelik komplikasyonlarını azaltması (11)(12)(13)(14)(15)(16), vital bulguları ve perinatal sonuçları iyileştirmesi (17,18) gibi olumlu fiziksel etkileri vardır. Ayrıca ninniler, anne ile bebeğin yakınlığını ve uyumunu sağlamaktadır. ...
... Ninnilerin müzik değeri taşıyan bir yapısı olduğundan (4) gebelikte müzik ile ilgili yapılan bazı çalışma sonuçları incelendiğinde; gebelerde müziğin kan basıncı, solunum ve nabız hızını azalttığı bildirilmiştir (27)(28)(29)(30)(31). Yine müziğin doğumun ilk evresinin daha kısa sürmesi, doğumun kendiliğinden başlaması, doğuma daha az tıbbi müdahale edilmesi, daha az anormal fetal prezentasyon, erken doğum, sezaryen doğum ve epizyotomi ihtiyacı gözlenmesi gibi perinatal sonuçlar üzerine de olumlu etkileri olduğu ifade edilmiştir (17,18,32). Müzik gebelerde pozitif duyguları artırmakta, doğum öncesi ve sonrası anne-bebek ilişkisinin gelişmesini ve gebenin kendi bakımına katılıp otonomi kazanmasını sağlamaktadır (14). ...
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Öz Ninni, genellikle kadınların hem bebeği hem de kendisi hakkındaki duygu ve düşüncelerini, bulunduğu toplumun kültürel ve ezgisel anlayışını yansıtarak şefkatle dile getirdiği bir iletişim yoludur. Ninniler, anne ile bebek arasındaki uyumu güçlendirmekte, anneden bebeğe sevgi, güven ve huzur taşımaktadır. Tarih boyunca hemen her toplumda var olmuş ve kültürel olarak kabul edilmiş olan ninnilerin gebelikte bazı olumlu fiziksel ve psikososyal etkileri vardır. Ninniler akıcı, yavaş, duygusal ve yumuşak melodisiyle ruh halini etkileyebilmektedir. Gebelerin ninni dinlemesinin ya da söylemesinin, keyifli bir egzersiz olarak maternal anksiyete ve stresi azalttığı, prenatal bağlanmayı sağladığı bildirilmiştir. Gebelerin ninni dinlemeyi diğer müzik türlerine göre daha çok tercih ettiği belirtilmiştir. Hemşireler ve diğer sağlık çalışanları gebelikte ninniyi fiziksel, duygusal ve ruhsal sağlığı destekleyerek iyileştirici bir çevre yaratmak için bakım ve tedavide kolayca kullanabilir; böylece gebelere en doğal kültürel araçlardan biri olan ninnilerle çok yönlü katkı sağlayabilir. Anahtar sözcükler: Ninni, Kültür; Gebelik, Bakım, Müzik Abstract Lullaby is a medium of communication in which the women verbalize their feelings and thoughts about both their babies and themselves affectionately by reflecting the cultural and melodic perception of the society they live in. Lullabies strengthen the harmony between the mother and the baby and convey love, trust and peace from mother to baby. Lullabies, existed and culturally accepted in almost every society throughout history, have some positive physical and psychosocial effects in pregnancy. With their fluent, slow, emotional and soft melody, lullabies might affect mood. It was reported that listening to or singing lullabies by pregnant women reduces maternal anxiety and stress and enables prenatal attachment as an enjoyable exercise. It was reported that pregnant women prefer listening to lullabies over other music genres. Nurses and other health professionals might easily use lullabies in care and treatment for creating a healing environment by supporting physical, emotional and mental health in pregnancy; thus, they can provide pregnant women with a multidirectional contribution through lullabies, which are among the most natural cultural instruments. Key words: Lullaby, Culture, Pregnancy, Care, Music
... Pregnant women with primigravida have a higher level of anxiety than pregnant women with second pregnancy (Herawati et al., 2021). The anxiety felt by mother causes the muscle tension and increases pain during the labor process, besides, excessive anxiety causes the mother feels tired quickly, so it hinders the labor process and causes prolonged labor (Garcia Gonzalez et al., 2018). Anxiety is caused by several factors, one of the factors is the lack of knowledge about childbirth, especially in primigravida, so that, health workers have an important role to provide counseling or counseling services for pregnant women to increase their knowledge. ...
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Background: the anxiety is an unclear situation having by someone. Someone who has this condition will have unpredictable feeling and feeling helpless. Moreover, someone with anxiety disorder tends to be easy to get emotional due to her mood. This condition occurs due to physical tension as well as their worries about the future they will face. Aims: to review about childbirth counseling by WhatsApp group media to reduce the anxiety of primigravida. Method: the method used is scoping review. Scoping review is used to map the literature and to obtain the information about the research activity relate to the topic researched and identify the problems in research area that will be researched, make a framework by identifying the research question through PEOs and identify the relevant study through Google Scholar, Pubmed and Science Direct, select the study article by Prisma Flow Chart, map the data charting and draw the article search flow, arrange, summary and report the result and discussion by using qualitative method which consist of four (4) articles, use qualitative method consisting five (5) articles, three (3) articles from Indonesia, one (1) article from Brazil, one (1) article from Tabriz Iran, , one (1) article from Oared
... In this context, Pia et al. also reported that there was high initial self-reported anxiety among the pregnant women and their anxiety was significantly reduced during the 3-day period after musical intervention. [18] In a randomized study, Garcia-Gonzalez et al. [19] assessed maternal anxiety among 409 women using the Spielberger state-trait anxiety inventory. The women from the experimental group showed significantly lower scores in state anxiety (odds ratio = 0.87; P < 0.001) as well as trait anxiety (P < 0.001) compare to the control group. ...
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BACKGROUND: Every pregnancy is special and each and every pregnant woman must receive special care. It was estimated, by the WHO that deaths due to hypertensive disorders of pregnancy represented 13% of all maternal deaths. The study was conducted with an aim to assess the effect of music therapy on anxiety among antenatal mothers with pregnancy-induced hypertension (PIH). MATERIALS AND METHODS: A true experimental research approach with Pretest posttest control group design was adopted for the study. Simple random sampling technique was applied to select 60 participants (30 experimental and 30 controls) but assignment of participants to the respective group was done through odd and even methods. Data was collected by using standardized Speilberger's state trait anxiety inventory and structured observation schedule for demographic data and clinical profile. RESULTS: The present study investigated that in the experiment group, mean anxiety scores in pretest and posttest were 55.23 ± 9.09 and 27.53 ± 4.56 respectively. While in control group, pretest mean anxiety score was 50.73 ± 9.34 and the posttest score was 43.53 ± 8.4. Furthermore, the obtained “t” value was 9.17 with P < 0.00001 which indicated that music therapy was significantly effective in reducing the anxiety scores among pregnant women. In addition, posttest anxiety scores have no significant association with age (P = 0.51), parity (P = 0.82), and period of gestation (P = 0.06). CONCLUSION: Music therapy is effective in reducing anxiety of antenatal mothers with PIH. The therapy can be implemented in clinical settings to decline the levels of anxiety among women with PIH.
... Music has positive effects on the psychological well-being of pregnant women (Uc¸aner and Birsen 2015; Corbijn van Willenswaard et al. 2017;Gonzalez et al. 2018;Arnon 2019). In a trial conducted by K€ uç€ ukkelepçe and Taşhan (2018), listening to music during the NST made the pregnant women feel more comfortable and happier, increased foetal heart rate and the number of accelerations, and so, it increased the rate of reactive NST results. ...
Article
This study aimed to determine the effect of motivational video stimulation and nutrition on the non-stress test (NST). The sample of the study consisted of 360 pregnant women in total, including two experimental groups and one control group (120 pregnant women in each group). After the pregnant women in the study were divided into three groups at a 1:1:1 ratio with the computer-assisted random sampling method, the draw method was used to determine the experimental and control groups. The pregnant women in the first experimental group were allowed to consume cake and juice 30 min before the NST procedure. The pregnant women in the second experimental group were also allowed to consume cake and juice, while they were also shown a video with the content of development and changes in the mother and the foetus during pregnancy, with relaxing music, for about 15–20 min. There was no intervention made in the control group. The data were collected using a Participant Information Form and an NST Findings Registry Form which were created by the researchers based on their review of the relevant literature. The data were analysed using arithmetic means, percentage distributions, ANOVA, Bonferroni and chi-squared tests. It was found that the mean number of foetal movements and the mean number of accelerations in the cake + juice and motivational video groups were higher than those in the control group (p < 0.001). Besides, the pregnant women in the experimental groups were found to have more reactive NST results. As a result, it was determined that the motivational video and cake + juice interventions improved the movement of the foetus, the number of accelerations and the ratio of reactivity in NST, but the two interventions did not have any superiority over each other. It is recommended to offer cake and juice to pregnant women before NST or have them watch a motivational video during NST, for having good NST results. • Impact statement • What is already known about the topic? The false-positive rates of the NST, which enables monitoring foetal movements and foetal heart rates, are high. These false-positive rates of the NST lead to many obstetric complications, in addition to increasing the rates of cesarean-section deliveries. Recent studies showed that there are methods and factors that increase foetal movements and shorten the application period of the NST. It was identified that food intake, music therapy, foetal vibroacoustic and halogen light stimulation before the NST increases foetal movements and shortens the application period of the NST. • What this paper adds? In the study, it was found that watching motivational videos and consuming cake and juice increased the number of foetal movements, the number of accelerations and the rate of reactive NST results, but the two interventions did not have superiority over each other. • What are the implications of these findings for clinical practice and/or further research? In order to increase reactive NST rates, it is recommended that pregnant women consume cake and fruit juice before the procedure and watch a motivational video during the NST procedure.
... The IG listened to the lullabies for 20 min per day, for 2 successive days using an MP3 player. It has been suggested that listening to music for a long time leads to discomfort, and that a duration of 15-40 min resulted in relaxation [15,22]. Accordingly, a duration of 20 min was determined, consistent with the research results and routine procedures in perinatology clinics. ...
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Background: Women with high-risk pregnancy experience anxiety and low mother-fetal attachment when faced with signs of danger and health problems. This study aimed to investigate the effects of lullaby intervention on anxiety and prenatal attachment in women with high-risk pregnancy. Materials and methods: This randomized controlled trial was conducted in the perinatology clinic of a state maternity hospital in Turkey. Seventy-six women with high-risk pregnancy were included. The intervention group listened to lullabies for 20 min once a day, and accompanied by lullabies touched their abdomen and thought about their babies, but the control group did not. Data were collected using the Pregnant Information Form, the State Anxiety Inventory, and the Prenatal Attachment Inventory. Results: Baseline anxiety did not differ in the intervention versus control group (47.83 ± 10.74 vs. 44.10 ± 8.08, mean difference 3.73 [95% Cl -1.18 to 8.64], p = 0.13), but after the 2nd day lullaby intervention anxiety was lower in the intervention group versus control group (33.66 ± 9.32 vs. 43.06 ± 8.10, mean difference -9.40 [95% Cl -13.91 to -4.88], p < 0.01). Baseline prenatal attachment did not differ in the intervention versus control group (56.03 ± 10.71 vs. 53.86 ± 9.98, mean difference 2.16 [95% Cl -3.18 to 7.51], p = 0.42), but after the 2nd day lullaby intervention prenatal attachment was higher in the intervention group versus control group (66.70 ± 7.60 vs. 54.36 ± 9.52, mean difference 12.33 [95% Cl 7.87 to 16.78], p < 0.01). In the within-group analysis the intervention group had lower anxiety and better prenatal attachment (p < 0.01), but not in the control group (p > 0.05). Conclusion: Lullaby intervention can play an effective role in reducing anxiety and improving prenatal attachment. The use of this integrative, noninvasive, non-pharmacologic, time-efficient, and natural intervention is suggested in the care of pregnant women.
... A considerable body of empirical research indicating that the early exposure of the fetus and the infant to sources of maternal stress is associated with the epigenetic status of genes related to the early caregiving environment, stress response and neuromaturation (Provenzi et al., 2020(Provenzi et al., , 2018, such as NR3C1, SLC6A4, FKBP5, BDNF, OXTR (Cicchetti et al., 2016;Craig et al., 2021;Isgut et al., 2017;Krol et al., 2019;Montirosso and Provenzi, 2015;Szyf, 2019). Moreover, when pregnant women showed a high level of anxiety, the adrenal glands in their bodies raise the secretion of glucocorticoids such as cortisol (Garcia-Gonzalez et al., 2018). These hormones pass through the placental barrier and are transmitted to the fetus; this mechanism can adversely affect the development of the fetus, leading to long-term negative effects on the child (Isgut et al., 2017). ...
Article
Background: Evidence concerning the impact of COVID-19-related stress exposure on prenatal attachment in pregnant women is unknown. In this study we sought to assess the effect of psychological distress and risk perception of COVID-19 on prenatal attachment in a Italian sample of pregnant women. Methods: 1179 pregnant women completed an anonymous online survey and self-report questionnaires measuring socio-demographic and obstetric characteristics, psychological distress (STAI Form Y-1-2 and BDI-II), prenatal attachment (PAI) and risk perception of COVID-19. Data were collected from March 2020 to April 2020 referring to the national lockdown period. Results: After adjusting for the socio-demographic and obstetric factors in the multivariable analysis, we found out the state anxiety was shown to be a significant predictor (p<.0001) of prenatal attachment. Moreover, the COVID-19-risk perception positively moderate the relationship between trait anxiety and prenatal attachment (p=.0008), indicating that when COVID-19-risk perception is high, the effects of trait anxiety on prenatal attachment is attenuated. The synergistic effect between STAI Form Y-1 and COVID-19-risk perception index on PAI is partially mediated by STAI Form Y-2 score. Conclusions: Findings from this study showed that state anxiety related to COVID-19 outbreak in pregnant women may affect the prenatal attachment process of the expectant mother negatively. However, an adequate and functional perception of COVID-19 could enhance prenatal attachment. These results underline the importance of monitoring the prenatal attachment process and the mother's mental health during pandemics, to safeguard maternal and infant mental health
... Indeed, Kehl and colleagues reported a significant reduction in state anxiety levels after only six music therapy sessions, which started after the first week of the infants' life [23]. Interestingly, several studies argue that there may even be a role for music therapy during pregnancy, evidenced by the reduction of maternal anxiety following such interventions [40,41]. This, however, requires further research. ...
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Having an infant in the neonatal intensive care unit (NICU) elicits maternal anxiety, which may hamper parent−child bonding. We performed a prospective cohort study to describe anxiety in mothers of infants born before 30 weeks of gestation during NICU stay in The Netherlands, and investigated the influence of infant stress and gestational age. Second, we performed a randomized-controlled live-performed music therapy trial (LPMT trial) to investigate whether music therapy applied to the infant alleviated maternal anxiety. The relation between infant stress, gestational age, and maternal anxiety was measured in 45 mother−infant dyads, using the Neonatal Infant Stressor Scale and the State-Trait Anxiety Inventory (STAI). The effect of LPMT on anxiety was assessed in 21 mothers whose infants were assigned to either LPMT (n = 12) or waitlist (n = 9). Mothers completed the STAI before and after this period. Maternal anxiety decreased over time in all mothers, and was strongly related with infant stress (r = 0.706, p < 0.001), but not with gestational age. Anxiety scores decreased by 12% after LMPT, and increased by 1% after a waitlist period (p = 0.30). Our results indicate that LPMT in the weeks after birth may accelerate the reduction of maternal anxiety. Further research should focus on the effects on mother−child bonding.
... 6 Listening to music also causes the glucocorticoids such as cortisol, which are strongly related to the state of stress, to have a reduced release, with a consequent benefit regarding fetal development, since they are able to cross the placental barrier and directly interfere in fetal physiology. 7 A form of treatment that aims at the physical, mental and psychological integration of the patient, music therapy is also one of the methods used as a support in pregnancy. Some studies in the literature have shown that musical interventions have an insignificant effect on the reduction in stress during pregnancy 8 and in the decrease in pain during childbirth. ...
Article
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Objective To investigate in the literature the studies on the benefits of music therapy interventions among pregnant women in the prenatal, delivery and postpartum periods. Data Sources The search for articles was carried out in the following electronic databases: VHL, LILACS, SciELO, Portal CAPES, PsycINFO, ERIC, PubMed/Medline, and journals specialized in this field: Revista Brasileira de Musicoterapia ("Brazilian Journal of Music Therapy") and Voices. Study Selection Descriptors in Portuguese (musicoterapia, gravidez, gestantes, revi-são), English (music therapy, pregnancy, pregnant women, review) and Spanish (musico-terapia, embarazo, mujeres embarazadas, revisión) were used. The search was delimited between January 2009 and June 2019. The process of selection and evaluation of the articles was performed through peer review. Data Collection The following data were extracted: article title, year of publication, journal, author(s), database, country and date of collection, purpose of the study, sample size, type of care, intervention, instruments used, results, and conclusion. The data were organized in chronological order based on the year of publication of the study. Summary of the Data In total, 146 articles were identified, and only 23 studies were included in this systematic review. The articles found indicate among their results relaxation, decreased levels of anxiety, psychosocial stress and depression, decreased pain, increase in the maternal bond, improvement in the quality of sleep, control of the fetal heart rate and maternal blood pressure, and decreased intake of drugs in the postoperative period. Conclusion Music therapy during the prenatal, delivery and postpartum periods can provide benefits to pregnant women and newborns, thus justifying its importance in this field.
... And based on the research results, listening to music can increase relaxation is in a minimum duration of 20-40 minutes. It should be consistently applied so that it will produce a far more optimal effect (Gonzalez, 2018). ...
Article
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Anxiety is a psychological factor that contributes to labor pain. The prevalence of mothers who experience anxiety before labor is 10-50%. Intervention to reduce anxiety and increase relaxation by listening to music. The research purpose is to analyze labor anxiety and pain to the group given intervention Langgam, music instrumental of Javanese style, with midwifery care routine. The research method used by Randomized Controlled Trial Experimental is an experimental study using random procedure to allocate various research factors to the research subject, so only the chance factor places the research subject into the intervention or control groups. There are 60 research subjects, the primiparous mothers, in the labor phase in Surakarta Hospital from December 2nd, 2019 - February 27th, 2020, with simple random sampling. Data analysis by Mann Whitney test and independent simple T-test. Result: For anxiety level, there is a significant difference between Javanese style Instrumental music (mean: 33.9) and midwifery care routine (mean: 37.9) with p value = 0.000. For labor pain, there is a significant difference between Javanese style Instrumental music (mean: 64.83) and midwifery care routine (mean: 76.13) with p value = 0.000. Conclusion: Langgam Music Instrumental of Javanese Style can reduce labor anxiety and pain in primiparous mothers in the first phase of active labor.
... Although there is a dearth of interventions designed to address gender-role risk factors among Mexican mothers [10,68], researchers and clinical practitioners can draw on culturally-relevant interventions designed to improve poor maternal mental health outcomes among women of Mexican descent [69][70][71] and other Latina women. Recent studies using complementary and integrative health interventions, such as music therapy [72,73], have yielded encouraging results. The use of complementary and integrative health approaches is particularly important given potential fears of stigma and barriers to traditional psychotherapeutic and pharmacological interventions among Latina women [74]. ...
Article
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Anxiety during pregnancy and after childbirth can have negative consequences for a woman and her baby. Despite growing interest in the perinatal mental health of Mexican women living in the U.S., perinatal anxiety symptom (PAS) rates and risk factors have yet to be established for women in Mexico. We sought to determine PAS rates and identify risk factors, including the traditional female role (TFR) in a sample of Mexican women. This secondary data analysis is based on 234 Mexican women who participated in a longitudinal study on perinatal depression in Mexico. Anxiety symptoms were assessed in pregnancy and at six weeks postpartum. Rates were determined through frequencies, and multiple logistics regressions were conducted to identify risk factors in the sample. The PAS rate was 21% in pregnancy and 18% postpartum. Stressful life events and depressive symptoms were associated with a higher probability of PAS. Adherence to TFR increased the probability of prenatal anxiety; lower educational attainment and low social support during pregnancy increased the probability of postpartum anxiety. The PAS rates were within the range reported in the literature. The TFR was only associated with anxiety in gestation, highlighting the role of this culturally relevant risk factor. Culturally responsive early interventions are therefore required.
... 75 Gebelikte, sakinleştirici enstrümantal müzik terapisinin, 3. trimesterde artan anksiyete düzeylerini azaltabileceği doğrulanmaktadır. 76 Başka bir çalışmada, müzik terapisinin gebelikte yaşanan stresi azalttığı, fakat maternal-fetal bağlanma üzerinde anlamlı bir etki yaratmadığı sonucuna varılmıştır. Ayrıca müziğin, hiçbir yan etkisi olmayan, düşük maliyetli ve gebelikte etkili bir stres azaltma yöntemi olduğu vurgulanmıştır. ...
... Epidemiological studies have shown that the mental health problems of pregnant women are mainly anxiety and depression (3,(14)(15). In addition, the incidence of anxiety during pregnancy was obviously higher than depression, and the occurrence of many postpartum depression is closely related to prenatal anxiety (16,17). Pregnant women are more prone to anxiety with the prevalence of gestational anxiety ranging from 15% to 23%, in comparison with the general population with 3 to 5% of anxiety symptoms (6). ...
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Background: COVID-19 with high infectivity and high concealment has been widely spread around the world. This major public health event has caused anxiety among the public, including pregnant women. The aim of this study was to assess the incidence of anxiety symptoms in pregnant women during the COVID-19 pandemic and its influencing factors. Methods: Using an ongoing prospective pregnancy registry, we performed a single center cross-sectional analysis to investigate the overall prevalence of anxiety symptoms among pregnant women during the COVID-19 pandemic. Online questionnaires were used to collect information including sociodemographic data, physical activity and economic situations. The Zung Self-Rating Anxiety Scale (SAS) was used to assess anxiety symptoms. The univariate regression analysis was performed to detect factors potentially influencing anxiety symptoms among pregnant women. The multivariate regression analysis was also conducted to analyze the association of physical exercise and economic burden with anxiety symptoms by adjusting for other variables. Results: A total of 1,517 pregnant women entered the analysis. The study reported that 31.64% of the respondents had anxiety symptoms. Those with bank loans were at higher odds of suffering from anxiety symptoms compared to those without bank loans [(adjusted odds ratio (aOR) 1.494, 95% confidence interval (CI) 1.181~1.889]. Those who took 2,000~5,000 steps/day (aOR 0.825, 95% CI 0.603~0.875) and >5,000 steps/day (aOR 0.924, 95% CI 0.439~0.945) were at lower odds of suffering from anxiety symptoms compared to those who took <500 steps/day. Similarly, the adjusted odds ratios for anxiety symptoms was 0.750 (95% CI 0.663~0.790) and 0.800 (95% CI 0.226~0.889) lower in participants with exercise frequencies of 4-6, and ≥7 times/week, compared to those with a frequency of <2 times/week. Conclusions: Three in ten pregnant women experienced anxiety symptoms during the COVID-19 pandemic, and anxiety symptoms showed association with bank loans and physical exercise. To prevent anxiety of pregnant women, the promotion of healthy lifestyles, improvement of mental health services, and expansion of social support should be implemented during epidemics. In parallel, the integration of psycho-educational interventions with mental health services among public health centers is required to minimize anxiety symptoms in pregnancy women.
... 75 Gebelikte, sakinleştirici enstrümantal müzik terapisinin, 3. trimesterde artan anksiyete düzeylerini azaltabileceği doğrulanmaktadır. 76 Başka bir çalışmada, müzik terapisinin gebelikte yaşanan stresi azalttığı, fakat maternal-fetal bağlanma üzerinde anlamlı bir etki yaratmadığı sonucuna varılmıştır. Ayrıca müziğin, hiçbir yan etkisi olmayan, düşük maliyetli ve gebelikte etkili bir stres azaltma yöntemi olduğu vurgulanmıştır. ...
Article
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T Gebelik birçok açıdan değişimlerin yaşandığı ve bu değişimlerle baş etmeyi gerektiren önemli bir dönemdir. Bu dönemde kadın, sağlık problemi yaşamasa da yaşam kalitesini olumsuz etkileyebilecek fizyolojik problemler yaşayabilmektedir. Günümüzde yaygın kullanılan tamamlayıcı tıp uygulamaları gebelikte yaşanan fizyolojik problemlerin tedavisinde de kullanılmaktadır. Gebeliğin erken döneminde görülen bulantı kusma için en sık kullanılan yöntemler akupunktur, zencefil, hipnozdur. Bu dönemdeki bir diğer sorun olan üriner sistem enfeksiyonlarında aromaterapi, kızılcık ekstresi, yaban mersini ve probiyotik kullanılmaktadır. Hipnoz, meditasyon, akupunktur, masaj ve gevşeme uygulamaları bu dönemde görülen baş ağrısını azaltmada etkilidir. Gebeliğin geç dönem sorunları arasında yer alan ödem için masaj terapisi ve ayak refleksolojisi kullanılabilmektedir. Aynı dönemde oluşan bel, sırt ve pelvik ağrıyı azaltmak için refleksoloji ve aromaterapiler kullanılmakta, uyku problemini gidermek amacıyla ayurveda tıbbı, papatya çayı, müzik terapisi ve gevşeme egzersizleri kullanılabilmektedir. Oluşan sıcak basmaları ayurveda tıbbıyla giderilebilmektedir. Gebelikte hissedilen yorgunluk yoga, egzersiz ve ginseng ile, stres ve anksiyete ise müzik terapisi ve lavantayla giderilebilmektedir. Sonuç olarak; gebeliğin kadının yaşamında yeri önemlidir. Gebe, fiziksel ve ruhsal olarak sürekli değişim içindedir. Yaşanan değişimler birtakım rahatsızlıklara yol açmaktadır. Bu rahatsızlıkların giderilmesinde çeşitli tamamlayıcı tıp uygulamaları etkilidir. Sağlık profesyonellerinin tamamlayıcı tıp uygulamalarının gebelikte kullanımıyla ilgili bilgilendirilmeleri, gebelere gerektiğinde önerilerde bulunmaları fiziksel ve psikolojik olarak sağlıklı bir gebelik dönemi açısından oldukça önemlidir
... In our pilot study without a comparison group, a significant reduction in the mean state anxiety levels was found after completing the 1-week eMBI (P<.03). Recent studies including other MBIs during pregnancy found similar effects with significantly lower STAI scores (P<.001) after interventions such as yoga, music therapy, or progressive muscle relaxation [50,59]. Compassion-focused therapy represents another promising approach for effectively treating depression and anxiety in perinatal populations [60]. ...
Article
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Background Peripartum depression and anxiety disorders are highly prevalent and are correlated with adverse maternal and neonatal outcomes. Antenatal care in Germany does not yet include structured screening and effective low-threshold treatment options for women facing peripartum depression and anxiety disorders. Mindfulness-based interventions (MBIs) are increasingly becoming a focus of interest for the management of such patients. Studies have shown a decrease in pregnancy-related stress and anxiety in expectant mothers following mindfulness programs. Objective The aim of this study was to explore the clinical effectiveness of a 1-week electronic course of mindfulness on prenatal depression and anxiety in hospitalized, high-risk pregnant women. We hypothesized that participating in a 1-week electronic MBI (eMBI) could alleviate symptoms of depression and anxiety during the hospital stay. Methods A prospective pilot study with an explorative study design was conducted from January to May 2019 in a sample of 68 women hospitalized due to high-risk pregnancies. After enrolling into the study, the participants were given access to an eMBI app on how to deal with stress, anxiety, and symptoms of depression. Psychometric parameters were assessed via electronic questionnaires comprising the Edinburgh Postnatal Depression Scale (EPDS), State-Trait Anxiety Inventory (STAI-S), and abridged version of the Pregnancy-Related Anxiety Questionnaire (PRAQ-R). Results We observed a high prevalence of peripartum depression and anxiety among hospitalized high-risk pregnant women: 39% (26/67) of the study participants in the first assessment and 41% (16/39) of the participants in the second assessment achieved EPDS scores above the cutoff value for minor/major depression. The number of participants with anxiety levels above the cutoff value (66% [45/68] of the participants in the first assessment and 67% [26/39] of the participants in the second assessment) was significantly more than that of the participants with anxiety levels below the cutoff value, as measured with the STAI-S. After completing the 1-week electronic course on mindfulness, the participants showed a significant reduction in the mean state anxiety levels (P<.03). Regarding pregnancy-related anxiety, participants who completed more than 50% of the 1-week course showed lower scores in PRAQ-R in the second assessment (P<.05). No significant changes in the EPDS scores were found after completing the intervention. Conclusions Peripartum anxiety and depression represent a relevant health issue in hospitalized pregnant patients. Short-term eMBIs could have the potential to reduce anxiety levels and pregnancy-related anxiety. However, we observed that compliance to eMBI seems to be related to lower symptoms of pregnancy-related stress among high-risk patients. eMBIs represent accessible mental health resources at reduced costs and can be adapted for hospitalized patients during pregnancy.
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Pendahuluan: Kecemasan yang berlebihan pada sesuatu hal yang tidak realistis dapat menyebabkan gangguan kecemasan. Penduduk dunia sepertiganya dipengaruhi oleh gangguan anxietas selama masa hidupnya menurut survei epidemiologi (Soodan and Arya, 2015). Diperlukan untuk memastikan pengobatan yang sesuai dengan jenis gangguan kecemasan. Untuk mengatasi ansietas dengan pemberian psikotropika, dapat menimbulkan dan memberikan efek samping yang berbahaya (Puspita, 2019). Memberikan informasi mengenai perkembangan pengobatan secara fisioterapi yang digunakan pada penderita gangguan kecemasan berdasarkan tipe gangguannya tujuan dari review artikel ini. Metode: Menggunakan beberapa sumber data untuk dijadikan referensi pada review artikel ini terdiri dari 20 jurnal ilmiah, 5 textbook, dan 2 website resmi yaitu National Institute of Mental Health dan Ministry of Health. Therapy) Pencarian artikel jurnal dilakukan secara elektronik dengan menggunakan beberapa database, yaitu: database Sage, Sience Direct, Proquest, dan Google Scholar dari Januari 2013 sampai Juli 2022. Hasil: Beberapa alternatif fisioterapi mengurangi kecemasan dengan progressive muscle relaxation, terapi music, terapi murotal, terapi berpikiran positif dan CBT (Cognitif Behavior Therapy) Metode. terhadap berbagai penyakit dan masalah fisikologis pada manusia. Kesimpulan: Pengobatan alternatif fisioterapi dapat secara efektif menurunkan kecemasan pada berbagai pasien yang mengalami masalah penyakit tubuh dan jiwa.
Article
Introduction: Anxiety negatively affects pregnant women and their fetuses. It can cause misleading test readings in electronic fetal monitoring, affect the duration of the first stage of labor, and influence certain aspects related to childbirth. This study aimed to evaluate the effects of virtual reality and music therapy on anxiety levels, maternal and fetal physiologic parameters, and labor and birth outcomes. Methods: A total of 343 full-term pregnant women participated in a randomized controlled trial and were divided into 3 parallel groups: music therapy intervention (n = 104), virtual reality intervention (n = 124), and control (n = 115). The interventions were delivered during a nonstress test in the third trimester and during labor. Data were collected from April 2017 to May 2018. Measures included the Spielberger State-Trait Anxiety Inventory, maternal blood pressure, maternal and fetal heart rates, and labor and birth outcomes. The study was registered in the Australian New Zealand Clinical Trial Registry (ACTRN12621001647820). Results: Women in the music therapy and virtual reality groups had lower levels of anxiety after a nonstress test (P < .001), and the women were more likely to have a reactive nonstress test (P < .001) compared with the control group. After the nonstress test and intervention were complete, the music therapy and virtual reality groups had significant decreases in systolic blood pressure (P < .001), diastolic blood pressure (P < .001), and maternal heart rate (P = .003) compared with the control group. Furthermore, fetuses in the control group were more likely to experience nonreassuring fetal heart rate tracings compared with the music therapy and virtual reality groups, respectively (P = .004). Discussion: Our findings support the use of music and virtual reality during nonstress tests and labor as nonpharmacologic interventions to reduce anxiety, improve maternal and fetal physiologic parameters, and improve labor and birth outcomes. This research should be replicated in diverse perinatal settings.
Article
Purpose: The purpose of this research was to investigate the music therapy (MT) effect on blooddonation anxiety and vital signs of participants. Materials and Methods: The study is a simple blind, controlled, randomized clinical trial. Participants were allocated by means of randomized controlled sampling. The study was performed in the blood donation centre of an University Hospital in İzmir, Turkey. The study was carried out in 60 participants, 30 randomized to the experimental group and 30 randomized to the control group .The control group was given routine attention, and the experimental group was given an MT intervention. The anxiety levels were measured by means State Anxiety Inventory (SAI) of pre and post questionnaires by a blinded investigator. Results: Vital signs of donors were measured pre and post intervention. There were statistical differences between the control and experimental group in heart rate, breath rate, systolic and diastolic blood pressures measured pre and post intervention. A significant difference was found before and after the application in the anxiety score after MT (p < .05). Conclusions: The music therapy application was accepted and evaluated positively by the participants for decreasing the anxiety of the donors before donation. Including the music therapy to the nurse care, applied routinely for the donors of the blood donation, is recommended. Keywords: Music therapy, blood donation, donor anxiety __________________________________________________________________________________
Chapter
Pregnancy is a time when many women might be focusing on their health, perhaps to a greater degree than previously. Pregnancy, as every other personal experience, must be viewed holistically. Women and pregnant people often experience increased levels of stress due to fear, partly compounded by medicalized systems of maternity care. These systems can make depersonalize the experience of pregnancy. Wellbeing, although hard to define, incorporates an understanding of the intersections between mind, body and self: mood, emotion, thought and embodied experience are all part of wellbeing and this is particularly relevant during pregnancy. Too often, biomedical approaches to pregnancy care overlook emotional wellbeing and Complementary therapies such as aromatherapy, music and acupuncture offer an adjunct to conventional maternity care and the chance to optimize bio-psycho-social wellbeing throughout pregnancy, and support pregnant people to address the emotional changes and challenges of this period of growth and becoming. This chapter focuses on some ways to use complementary therapies such as aromatherapy, music, and acupuncture to enhance a person’s sense of emotional wellbeing during pregnancy. It touches on some of the psychological, personal, emotional, and physical challenges associated with the pregnancy journey, and considers ways that women and childbearing people can take charge of their own emotional state and enhance their ability to adapt to the changing landscape of body, mind, and personal world during this time of transition.
Chapter
Fertility is a bio-psycho-social issue and one deeply embedded in psychological and emotional processes. The mind and emotions affect the body and vice versa. We live in a society which profoundly regulates and markets the body and its processes, and places high expectations on individuals to “perform” health and wellbeing (in the same way it places high expectations on people to “perform” pregnancy and parenthood). Similarly, mental wellbeing is marketed as something that is the individual’s responsibility and falsely touted as fixable if one simply engages in specific (often cost-associated) acts of self-care. The stress and challenge of family planning, particularly if there are issues with fertility, can greatly add to the mental load which can result in stress and suboptimal emotional wellbeing. The lack of centralized communal belief systems and a secularization of culture and thought in the West may add to this. Fertility in our society is powerfully embedded in social identities and expectations, particularly of women. Those experiencing infertility and fertility treatments will encounter a range of emotional effects. Fertility should be understood from a holistic perspective, with reference to its impact on identity, self, and spirituality. This chapter explores a number of complementary therapies which might provide support and enable self-care for people adjusting to the impact of infertility on their mental and emotional wellbeing, including hypnosis, aromatherapy, music and sound, Ayurveda, and touch/massage therapies.
Article
Background : The heavy care burden, the long-term dependence of the disabled elderly, and the changing social roles can put elderly caregivers at high risk for mental disorders. This study aimed to explore the prevalence and related factors of depression and anxiety among elderly caregivers and examine the role of resilience in depression and anxiety. Methods : A multicentre cross-sectional survey was designed. A total of 953 elderly caregivers in nursing homes were recruited in three provinces in China using convenience sampling. Depression and anxiety were measured by self-rating depression scale (SDS) and self-rating anxiety scale (SAS). Multivariate logistic regression analysis was used to explore the key factors associated with depression and anxiety. Results : The median SDS score was 40 (interquartile interval 34-48), and the median SAS score was 48 (interquartile interval 38-56). In this cohort, 19.4% reported depression and 44.0% anxiety. Working hours, sensitive personality and health status were related factors for depression symptom. In terms of anxiety symptoms, its related factors included working hours, health status and higher monthly income. Furthermore, resilience was associated with depression and anxiety among caregivers. Limitations : A selection bias may be caused by convenience sampling and voluntary participation. Conclusion : Depression and anxiety symptoms were common in the cohort of Chinese elderly caregivers in the nursing home. The factors explored in this study may contribute to the development of individualised interventions for depression and anxiety symptoms.
Article
To assess the effect of music on fetal well-being and anxiety levels and vital signs of pregnant women during the non-stress test. The study was a randomized controlled clinical trial. The sample comprised of 74 (37 music and 37 control group) pregnant women. In the music group, post-procedure pulse values were statistically lower than the pre-procedure values (p < 0.001). There was no difference between the groups in terms of baseline fetal heart rate, variability, fetal movement, presence and number of accelerations-decelerations, non-stress test result parameters. The number of fetal movements was statistically higher in the music group, compared to the control group (p < 0.001). The state anxiety inventory scores lower in the music group after the procedure, compared to the control group (p < 0.001). Researchers determined that music affects vital sign values, fetal movements, reduced the state and trait anxiety levels of pregnant women during the non-stress test procedure.
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Introduction: It is well known that music acts as an analgesic. Facilitates muscle relaxation, reduction of physical pain and mental tension. Purpose of this original investigation: study the effect of music on maternal anxiety during cardiotocography as well as its effect on embryonic cardiac function in relation to mother’s heart rate. Method and materials: The survey, conducted in external midwifery medical services of Alexandra’s Hospital, involved 80 pregnant women who met the criteria for participation. They were divided in two groups. The 40 pregnant women were the Musical Group, and the other 40 were the Control Group. In both groups, the STAI scale was used. The control group underwent cardiotocography examination without listening to music. The Musical Group were selected to hear the music track ‘Kung Fu Piano: Cello Ascends’, a cover of the Piano Guys band. The hearing started 5 minutes before the end of the cardiotocography, with headset playing frequencies that are within the frequency spectrum of the music track and special music player, and 10 minutes before the end of the cardiotocography the pulse oximeter Beurer P080 was placed. In this music track we did music and frequency analysis with the following programs: SPAN of Voxeno and Reaper of Cocos, as well as Theory-Harmony of Music, to see if at the time certain changes in the track occur, there are corresponding changes in the heart rate of the mother and the fetus. Results: In our study we observed that music significantly decreased the level of anxiety of women subjected to non-stress test (NST) (Median anxiety score prior to the conduct of the non-stress test 53.38 (49-57) vs 25.20 (23-28) following the completion of the test. Moreover differences among women that heard music were significant compared to those that did not (25.20 (21-28) vs 56 (48-64)) despite the fact that baseline differences among the two groups were comparable (54.45 (59-67) vs 50.80 (53-58). Finally, following performance of music analysis we observed significant variations in the baseline heartbeat of pregnant women as well as in the cardiotocographic analysis of fetuses (number of accelerations, baseline rhythm); those patterns were directly related to musical characteristics of the track that women listened to. Conclusions: Music has a positive effect on pregnancy. It is a non-invasive way of anxiety relief, as well as a simple, non-time-consuming way of improving cardiotocography among low risk cases; thus, potentially diminishing false-positive results which may result in unnecessary deliveries.
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Background: Although pregnancy and motherhood are enjoyable experiences, they are associated with numerous biopsychological changes requiring adaptation. The present study aimed to assess the effects of relaxing music on life distress and Maternal-Fetal Attachment (MFA) in pregnant women. Methods: This was a quasi-experimental study with a pre-test, post-test and a control group design. The research population included all Iranian pregnant women referring to Laleh Hospital in Tehran City, Iran, in 2020. In total, 30 women were selected using the convenience sampling method and randomly assigned into the intervention and control groups (n=15/group). The required data were collected using the Life Distress Inventory (LDI) and the Maternal-Fetal Attachment Scale (MFAS). The intervention group listened to relaxing music for twelve 45-50-minute sessions in the morning and during routine midwifery visits; however, the controls received no intervention. The collected data were analyzed using Multivariate Analysis of Covariance (MANCOVA) in SPSS V. 22. Results: The obtained results indicated that the intervention group reported a lower level of life distress in the post-test, compared to the controls (P=0.0001, F=15.860). The intervention group also achieved a higher mean score on MFA, than the control group (P=0.0001, F=35.872). Conclusion: According to the present research findings, reproductive health and nursing professionals, and psychologists would recommend music as a complementary therapy to reduce stress and distress experienced by expecting mothers and to improve MFA.
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p> Objetivo: avaliar o efeito da musicoterapia sobre os parâmetros vitais, ansiedade e as sensações vivenciadas no período gestacional. Método: estudo de intervenção mista antes e depois, realizado com 30 gestantes atendidas em clínica-escola e no projeto de extensão universitária. Utilizou-se formulário de caracterização sociodemográfica, escala de ansiedade-estado, parâmetros vitais e roteiro de entrevista semiestruturado. Os dados foram analisados por estatística descritiva, inferencial e análise temática de conteúdo. Resultados: houve melhoria da frequência de pulso (p<0,000), respiração (p=0,002), frequência cardíaca (p<0,000) e saturação de oxigênio (p=0,002) evidenciando a efetividade da música sobre estes sinais vitais. Conclusão: a gestação gera possíveis sensações negativas que podem impactar o estado emocional, e a musicoterapia promoveu impacto positivo, pois favoreceu a redução do grau da ansiedade, repercutiu na mobilidade da criança e possuiu efeito significativo na melhoria da pulsação, respiração, frequência cardíaca e saturação de oxigênio. Descritores: Musicoterapia. Ansiedade. Sinais Vitais. Gestantes. Enfermagem.</p
Chapter
Methods of assessment for identifying gravid women who may be experiencing difficulties in one or more of the seven major psychosocial dimensions are presented. An original self-report questionnaire (the Prenatal Self-Evaluation Questionnaire, PSEQ, 79 items) and a second shorter questionnaire (PSEQ – sf, 53 items) that provide parallel measures of the major dimensions assessed in the clinical interviews are described, as well as the psychometric properties and validation results of their use to date. Suggestions are provided for conducting clinical interviews and for summarizing the information obtained in the form of quantitative ratings. Methods for learning and developing proficiency in assessment skills are also provided. Suggestions are made for clinical interventions and research applications of both interview and questionnaire assessment of maternal psychosocial development and adaptation to pregnancy for high-risk and non-high-risk expectant parents and couples. Preceding chapters describe seven psychosocial dimensions of maternal prenatal development for both primigravid and multigravid women. This chapter discusses methods of assessment for identifying gravid women who may be experiencing difficulties in one or more of the seven major psychosocial dimensions discussed. In the last section of the chapter, we present a brief review of potential therapeutic interventions to reduce anxiety and conflict, and to promote psychosocial adaptation to pregnancy.
Article
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High-risk pregnancy increases the morbidity and mortality of the mother and the fetus. Pregnant women under high risks suffer anxiety and stress related to many reasons such as health problems concerning her and the baby, uncertainty, hospitalization and leaving the family. As the pregnancy will be at risk in a high-risk condition, the mother may be anxious in contacting the fetus and the connection can be effected negatively. In pregnancy, high anxiety and weak prenatal attachment, affects the pregnant and fetus’ health negatively. It has been reported that some practices such as social support, listening or singing music/lullaby, yoga and meditation both reduce anxiety and increase prenatal attachment during pregnancy. In the prenatal period, the nurse has many roles such as educator, role model, consultant and resource person in order to cope with the risky conditions of the pregnant woman, to connect with the fetus in a healthy way and to protect her mental health. Nurses have to determine and follow the anxiety and attachment levels of the pregnant, to benefit from evidence based practices to reduce anxiety and increase prenatal attachment by considering the possible harms of anxiety and insufficient maternal attachment on the pregnant and the fetus.
Article
Purpose Music therapy has been used for relaxation in traditional medicine. This study explored the effect of music therapy on the physical and mental parameters of cancer patients during hematopoietic stem cell transplantation (HSCT). Design and Methods Thirty patients who were hospitalized for bone marrow transplantation were included. Traditional Music Therapy of Islamic Turkish Culture was applied to the patients during the transplantation process. Specific physical and psychological parameters of patients were evaluated before and after music therapy. Findings A positive relationship between anxiety and distress scores was observed. Music therapy had a significant impact on increasing levels of oxygen saturation, and decreasing anxiety and distress levels of the HSCT patients (P < .05). Practice Implications Music therapy may provide positive effects for patients during HSCT.
Article
Purpose: Stress and anxiety are prevalent during pregnancy and postpartum with adverse effects on mothers and newborns, yet women's psychological and emotional needs are often given a lower priority than their physical wellbeing. The purpose of this study was to assess feasibility of implementing a bedside music therapy intervention to alleviate stress and anxiety, provide emotional support, and facilitate mother-baby bonding for women during antepartum and postpartum hospitalization at a large urban medical center. Study design and methods: Over 15 months, women on three units who were hospitalized during antepartum or postpartum were referred for music therapy and received a single bedside session from a credentialed music therapist (MT-BC), including tailored interventions and education in relaxation techniques. A retrospective analysis of postintervention feedback questionnaires and process notes was conducted to assess participant receptivity and satisfaction, and the feasibility of implementing the program on the units. Results: Music therapy was provided to 223 postpartum and 97 antepartum patients. The program was found to be feasible and well received, including high satisfaction, positive effects on participants' relaxation and sense of connection with their baby, and enthusiastic reception from providers and staff. Qualitative feedback revealed salient themes including the effect of the intervention on mothers' mental, emotional and physical states, and the soothing effect of music on their newborns. Clinical implications: Hospitals are in a unique position to provide support services and self-care education for women during their antepartum and postpartum hospitalization. Music therapy can be integrated successfully into inpatient care as a nurturing and patient-centered form of psychosocial support.
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Prenatal sleep disturbance has been associated with undesirable birthing outcomes. To determine the effectiveness in improving sleep quality of listening to music at home, 121 Taiwanese pregnant women with poor sleep quality (Pittsburgh Sleep Quality Index; PSQI score > 5) were systematically assigned, with a random start to music listening (n = 61) or control (n = 60) group. Participants in the music listening group self-regulated listening to music in addition to receiving general prenatal care similar to that in the control group for two weeks. The PSQI, Perceived Stress Scale, and State- Anxiety Inventory were used to assess outcomes. ANCOVA analyses were used with the pretest scores as covariates and showed significant improvement in sleep quality, stress, and anxiety in the Music Listening group compared with control group. The most frequently used music genre by participants in the experimental group was Lullabies, followed by Classical music and Crystal Baby music. This study supported that two-week music listenin interventions may reduce stress, anxiety and yield better sleep quality for sleep-disturbed pregnant women. The analysis of participants' journals also implied that the expectant mothers' choices on musical genres may correlate more with the perceived prenatal benefits or the desire to interact with their unborn child.
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The State Trait Anxiety Inventory (STAI) has been widely used in research with pregnant women. However, few studies have examined its validity for this group. In this paper the content validity of the STAI, the impact of location and consequences for further participation of higher STAI scores are investigated for 215 pregnant women who completed the STAI at hospital or community based clinics. The study participants answered the open ended question, ‘How do you feel about your pregnancy?’ and whether or not they would be willing to take part in further research. Results indicated that STAI state scores reflected the nature of women's spontaneous comments regarding their pregnancy, with lower anxiety related to more ‘positive’ comments. The state scores were also found to be sensitive to the risk level associated with the clinic where the inventory was completed; higher scores related to high‐risk localities. Women with the highest levels of state or trait anxiety were also less likely to wish to take part in further research. The study concludes that the STAI does reflect the anxiety‐related experiences of pregnant women and that its use with pregnant women is appropriate in this respect; however, we recommend that future research notes the issue of potential recruitment biases.
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Aimed to investigate (a) the effect of non-stress test (NST) and music on maternal anxiety (b) the effect of maternal anxiety and music on fetal heart rate (FHR) changes. The two hundred and one pregnant women coming for routine prenatal care were randomized to receive either music (n=96) or no music (n=105) during NST. Before and after the test, these women were asked to complete the Spielberg State-Trait Anxiety Inventory on two interviews; primary outcome was considered as a maternal state anxiety score before and after NST. Secondary outcome was the baseline FHR, the number of fetal movement, large accelerations, dubious NST, variable decelerations, and the minimum procedure time. Before NST, the mean state anxiety score of the music and control groups was found as 38.1 +/- 8.8 and 38.08 +/-8.2, respectively (p>0.05). On the other hand, after NST, the mean state anxiety score of the music and control groups was found as 35.5 +/- 8.2 and 40.2 +/- 9.2, respectively (p<0.001). While in control group, NST brought about a statistically significant increase in a state anxiety score (38.08 +/- 8.2 versus 40.2 +/- 9.2, p<0.001), listening to music during NST resulted in decrease in a state anxiety score of the study group but it was not statistically significant (38.1 +/- 8.8 versus 35.5 +/- 8.2, p>0.05). The baseline FHR of the music group was significantly higher than that of the control group (134.09 +/- 7.2 versus 130.3 +/- 5.7, p<0.001).The number of fetal movement in the music group was significantly higher than that of the control group (8.9 +/- 4.7 versus 5.9 +/- 3.9, p<0.001). The number of large accelerations in music group was significantly higher than that of the control group (5.7 +/- 2.1 versus 4.5 +/- 2.04, p<0.001). The minimum procedure time in music group was significantly lower than that of control group (13.4 +/- 5.2 versus 15.6 +/- 6.1, p<0.05). The number of dubious NST and variable decelerations was found to be similar for both groups (p>0.05). NST has anxiogenic effects on mothers and listening to music during the test has positive impact on both maternal and fetal parameters but it is an open question whether maternal anxiety during pregnancy may affect fetal accelerations to such an extent that it could influence clinical judgments.
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To examine effects of mother's anxiety and depression and associated risk factors during early pregnancy on fetal growth and activity. Repeated measures of mother's anxiety (State-Anxiety Inventory (STAI-S)) and depression (Edinburgh Postnatal Depression Scale (EPDS)) and related socio demographics and substance consumption were obtained at the 1st and 2nd pregnancy trimesters, and fetus' (N = 147) biometric data and behavior was recorded during ultrasound examination at 20-22 weeks of gestation. Higher anxiety symptoms were associated to both lower fetal growth and higher fetal activity. While lower education, primiparity, adolescent motherhood, and tobacco consumption predicted lower fetal growth, coffee intake predicted lower fetal activity. Vulnerability of fetal development to mother's psychological symptoms as well as to other sociodemographic and substance consumption risk factors during early and mid pregnancy is suggested.
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To determine whether the pattern of prenatal stress, as compared to prenatal stress assessed at a single gestational time point, predicts preterm delivery (PTD). Perceived stress and anxiety were assessed in 415 pregnant women at 18-20 and 30-32 weeks' gestation. Gestational length was determined by last menstrual period and confirmed by early pregnancy ultrasound. Births were categorized as preterm (< 37 weeks) or term. At neither assessment did levels of anxiety or perceived stress predict PTD. However, patterns of anxiety and stress were associated with gestational length. Although the majority of women who delivered at term exhibited declines in stress and anxiety, those who delivered preterm exhibited increases. The elevated risk for PTD associated with an increase in stress or anxiety persisted when adjusting statistically for obstetric risk, pregnancy-related anxiety, ethnicity, parity, and prenatal life events. These data suggest that the pattern of prenatal stress is an important predictor of PTD. More generally, the findings support the possibility that a decline in stress responses during pregnancy may help to protect mother and fetus from adverse influences associated with PTD.
Article
Background: Research indicates perinatal loss is associated with anxiety, depression and stress in women and partners during subsequent pregnancies. However, there are no robust estimates of anxiety, depression and stress for this group. We meta-analytically estimated rates of anxiety, depression and stress in pregnant women and their partners during pregnancies after previous perinatal loss METHODS: Databases (Medline, PsychInfo, Embase, Cinahl Plus) and grey literature were searched from 1995 through to May 2016. Search terms included: depression, anxiety, or stress with perinatal loss (miscarry*, perinatal death, spontaneous abortion, fetal death, stillbirth, intrauterine death, TOPFA) and subsequent pregnancy. Case-controlled, English-language studies using validated measures of anxiety, depression or stress in women or partners during pregnancy following perinatal loss were included. Data for effect sizes, study and demographic data were extracted. Results: We identified nineteen studies representing n = 5114 women with previous loss; n = 30,272 controls; n = 106 partners with previous perinatal loss; and n = 91 control men. Random effects modelling demonstrated significant effects of perinatal loss on anxiety (d = 0.69, 95% CI = 0.41-0.97) and depression (d = 0.22, 95% CI = 0.15-0.30) in women; but no effect on stress (d = - 0.002, 95% CI = - 0.0639 to 0.0605). Limitations: This study was limited by the quality of available studies, underpowered moderator analyses and an inability to examine additional covariates. Insufficient data were available to generate reliable effects for psychological distress in partners. Conclusions: Our findings confirm elevated anxiety and depression levels during pregnancies following perinatal loss. Further research on predictors of distress in women and their partners is required.
Article
Background: Music has been used for medicinal purposes throughout history due to its variety of physiological, psychological and social effects. Objective: To identify the effects of prenatal music stimulation on the vital signs of pregnant women at full term, on the modification of fetal cardiac status during a fetal monitoring cardiotocograph, and on anthropometric measurements of newborns taken after birth. Material and method: A randomized controlled trial was implemented. The four hundred and nine pregnant women coming for routine prenatal care were randomized in the third trimester to receive either music (n = 204) or no music (n = 205) during a fetal monitoring cardiotocograph. All of the pregnant women were evaluated by measuring fetal cardiac status (basal fetal heart rate and fetal reactivity), vital signs before and after a fetal monitoring cardiotocograph (maternal heart rate and systolic and diastolic blood pressure), and anthropometric measurements of the newborns were taken after birth (weight, height, head circumference and chest circumference). Results: The strip charts showed a significantly increased basal fetal heart rate and higher fetal reactivity, with accelerations of fetal heart rate in pregnant women with music stimulation. After the fetal monitoring cardiotocograph, a statistically significant decrease in systolic blood pressure, diastolic blood pressure and heart rate in women receiving music stimulation was observed. Conclusion: Music can be used as a tool which improves the vital signs of pregnant women during the third trimester, and can influence the fetus by increasing fetal heart rate and fetal reactivity.
Article
Background. Many researchers have pointed out the strong relationship between maternal psychological well-being and fetal welfare during pregnancy. The impact of music interventions during pregnancy should be examined in depth, as they could have an impact on stress reduction, not only during pregnancy but also during the course of delivery, and furthermore induce fetal awareness. Objective. This study aimed to investigate the effect of music on maternal anxiety, before and after a non-stress test (NST), and the effect of music on the birthing process. Material and method. The four hundred and nine pregnant women coming for routine prenatal care were randomized in the third trimester to receive either music (n = 204) or no music (n = 205) stimulation during an NST. The primary outcome was considered as the maternal state anxiety score before and after the NST, and the secondary outcome was the birthing process Results. Before their NST, full-term pregnant women who had received music intervention were found to have a similar state-trait anxiety score to those from the control group, with 38.10 ± 8.8 and 38.08 ± 8.2 respectively (p < 0.97). After the NST, the mean state-trait anxiety score of each group was recorded, with results of 30.58 ± 13.2 for those with music intervention, and 43.11 ± 15.0 for those without music intervention (p < 0.001). In the control group, the NST was followed by a statistically significant increase in the state-trait anxiety score (38.08 ± 8.2 versus 43.11 ± 15.0, p < 0.001). However, listening to music during the NST resulted in a statistically significant decrease in the state-trait anxiety score of the study group (38.10 ± 8.8 versus 30.58 ± 13.2, OR = 0.87, p < 0.001). Furthermore, the first stage of labor was shorter in women who received music stimulation (OR= 0.92, p < 0.004). They also presented a more natural delivery beginning (spontaneous) and less medication (stimulated and induced) than those who were not stimulated musically, with statistically significant differences (p < 0.01). Conclusion. Prenatal music intervention could be a useful and effective tool to reduce anxiety in full-term pregnant women during an NST and improve the delivery process by reducing the first stage of labor in nulliparous women.
Article
While music listening has been studied as an intervention to help reduce anxiety in pregnant women, few studies have explored the effect of music listening on pregnancy-specific stress relief. This study examines the effects of music listening on psychosocial stress and maternal-fetal attachment during pregnancy. A randomized controlled trial was implemented. A valid sample of 296 pregnant women in their second or third trimester was randomly distributed into an experimental group (n=145) and a control group (n=151). The experimental group received routine prenatal care and music listening. The control group received routine prenatal care only. Data were collected using a demographic form, Pregnancy Stress Rating Scale (PSRS), Perceived Stress Scale (PSS), and Maternal-Fetal Attachment Scale (MFAS). The post-test results identified a significantly lower level of psychosocial stress in the experimental group than in the control group, particularly in terms of the stresses related to baby care and changing family relationships and to maternal role identification. However, no statistically significant differences in terms of perceived stress and maternal-fetal attachment were found between the post-test results of the two groups. This study provides evidence in support of using of music in interventions designed to relieve psychosocial stress in prenatal women. IRB approval number: ER98223. Copyright © 2015 Elsevier Ltd. All rights reserved.
Article
This prospective study tracked hassles, pregnancy-specific stress, and state anxiety during pregnancy. A second objective was to identify predictors of each stress dimension. Pregnant women n=161 completed the Hassles Scale, the Pregnancy-Specific Stress Questionnaire (PEQ), and the state-anxiety scale (STAI-state) monthly, beginning in the third month of pregnancy. Hassles were found to be stable throughout the pregnancy. Women reported significantly higher pregnancy-specific stress in the first and third trimester of pregnancy, whereas state anxiety increased in the third trimester compared with the first and second trimesters. Poorer marital adjustment predicted higher Hassles during pregnancy and higher PEQ and STAI-state in the third trimester. Women who reported that the pregnancy would have a negative impact on their career scored higher on Hassles during pregnancy and higher on the PEQ in the third trimester. The occurrence of a gestational complication during pregnancy was related to higher pregnancy-specific stress in the third trimester. Younger women also reported higher PEQ results in the third trimester. The data provide support for a multidimensional conceptualization of stress during pregnancy.
Article
Mental health problems during pregnancy can influence fetal growth. However, studies examining the influence of maternal mental health across the normal range of birth outcomes are uncommon. This study examined the associations between symptoms of maternal depression and anxiety during pregnancy on birth size among term Asian infants. One thousand forty-eight Asian pregnant women from a cohort Growing Up in Singapore Towards Healthy Outcomes were recruited between 2009 to 2010 at two Singaporean maternity hospitals. At 26 weeks gestation, depressive symptoms were measured with the Edinburgh Postnatal Depression Scale (EPDS) and the Beck Depression Inventory II (BDI-II), and anxiety was measured with the Spielberger State-Trait Anxiety Inventory (STAI). Health personnel recorded birthweight, birthlength, gestational age, and head circumference at birth. Nine hundred forty-six women who delivered term infants had complete data. For this sample, the mean birthweight was 3146.6 g [standard deviation (SD) 399.0], the mean birthlength was 48.9 cm (SD 2.0). After controlling for several potential confounders, there was a significant negative association between STAI and birthlength [β = -0.248, confidence interval (CI) [-0.382, -0.115], P < 0.001] and a small negative association between EPDS and birthlength (β = -0.169, CI [-0.305, -0.033], P = 0.02). No associations were found between scores on the EPDS, BDI-II, and STAI with birthweight or head circumference. Our preliminary data suggest that among term infants, anxiety and depressive symptoms are not associated with birthweight, while anxiety and depressive symptoms are associated with a shorter birthlength.
Article
An inductive qualitative approach was employed to explore women’s experiences of their body and mood during pregnancy and the postpartum. In‐depth interviews were conducted with 20 perinatal women (n at late pregnancy=10; n in the early postpartum period=10). While most of the sample reported adapting positively to body changes experienced during pregnancy, the postpartum period was often associated with body dissatisfaction. Women reported several events unique to pregnancy which helped them cope positively with bodily changes (e.g. increased perceived body functionality, new sense of meaning in life thus placing well‐being of developing foetus above body aesthetics, perceptual experiences such as feeling baby kick, increased sense of social connectedness due to pregnancy body shape, and positive social commentary); however, these events no longer protected against body dissatisfaction post‐birth. While women reported mood lability throughout the perinatal period, the postpartum was also a time of increased positive affect for most women, and overall most women did not associate body changes with their mood. Clinical implications of these findings included the need for education about normal postpartum body changes and their timing, and the development of more accurate measures of perinatal body image.
Article
Suicide is the leading cause of maternal death in the UK. Recognizing risk factors for major postnatal mental illness, and the distinction between normal emotional changes and psychiatric disorder during pregnancy, is critical in routine antenatal care. Recent developments in screening and prevention, and recommendations arising from the Confidential Enquiries into Maternal Deaths will help achieve best practice in caring for mentally ill women during pregnancy and in the early postnatal period. There is a need for such issues to be routinely included in the professional training of obstetric, midwifery, primary care and psychiatric staff.
Article
Examined the effects of a music assisted relaxation (MAR) program on the physiological and emotional status of 10 pediatric burn patients (aged 8–20 yrs) undergoing a surgical procedure. During the preoperative period, they received MAR interventions that included music listening, deep diaphragmatic breathing, progressive muscle relaxation, and imagery. 10 control Ss received standard preoperative interventions only. Results indicated a significant decrease in scores on the State-Trait Anxiety Inventory for Children for Ss in the experimental group. Physiological measures including heart rate, respiration rate, blood pressure, and temperature showed no significant change from the pre- to postintervention period in either group. All Ss responded positively to the MAR intervention on a postoperative questionnaire, and staff members supported the interventions. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
Summary Anxiety in pregnancy has been studied in 249 primiparous Caucasian women, using the State-Trait Anxiety Inventory. The level of anxiety was assessed on three occasions during pregnancy. The tendency to anxiety (trait) decreased from 16 to 28 weeks of pregnancy. In addition, anxiety in response to the situation (state) decreased significantly in the second trimester but increased again in the third trimester of pregnancy. Higher levels of anxiety were found during pregnancy in those women who were subsequently given oxytocin augmentation in spontaneous labour than in those who were not. In addition, high levels of anxiety were found in those who subsequently had epidural analgesia.
Article
OBJECTIVE: We review intervention trials that have used the State-Trait Anxiety inventory (STAI) as a measure of maternal anxiety in pregnancy in order to provide ranges in scores before and after participation in complementary therapy-based interventions to highlight the expected ranges of scores in pregnancy and determine whether anxiety in pregnancy is amenable to change when measured by the STAI. METHODS: Combinations of the key words "STAI", "state anxiety", "pregnancy", "anxiety", "maternal", "stress", "outcome" and "intervention" were used to search publications between January 1970 and January 2011. Studies eligible for inclusion recruited low risk, adult women to a non-pharmacological intervention or a comparator group, and measured anxiety at baseline and post-intervention. RESULTS: Ten studies were eligible. Scores were routinely high compared to expected ranges in non-pregnant populations. Studies examining the immediate effects of an intervention consistently reported significantly lowered STAI scores after a single session. Likewise, studies examining the effect of interventions consisting of multiple sessions over the course of pregnancy found that those in the intervention group were more likely to show an improvement in STAI scores. LIMITATIONS: Heterogeneity in type and duration of intervention prevent drawing conclusions on which were most effective in reducing anxiety. CONCLUSION: Scores on the STAI appear amenable to change during pregnancy, both after a single session and multiple sessions of interventions designed to reduce maternal anxiety. This review offers a guideline for the expected range of scores for future studies examining the efficacy of interventions in pregnancy when using the STAI.
Article
We review a significant body of evidence from independent prospective studies that if a mother is stressed while pregnant, her child is substantially more likely to have emotional or cognitive problems, including an increased risk of attentional deficit/hyperactivity, anxiety, and language delay. These findings are independent of effects due to maternal postnatal depression and anxiety. We still do not know what forms of anxiety or stress are most detrimental, but research suggests that the relationship with the partner can be important in this respect. The magnitude of these effects is clinically significant, as the attributable load of emotional/behavioral problems due to antenatal stress and/or anxiety is approximately 15%. Animal models suggest that activity of the stress-responsive hypothalamic-pituitary-adrenal (HPA) axis and its hormonal end-product cortisol are involved in these effects in both mother and offspring. The fetal environment can be altered if stress in the mother changes her hormonal profile, and in humans, there is a strong correlation between maternal and fetal cortisol levels. However, many problems remain in understanding the mechanisms involved in this interaction. For example, maternal cortisol responses to stress decline over the course of pregnancy, and earlier in pregnancy, the link between maternal and fetal cortisol is less robust. It is possible that the effects of maternal anxiety and stress on the developing fetus and child are moderated by other factors such as a maternal diet (e.g., protein load). It is suggested that extra vigilance or anxiety, readily distracted attention, or a hyper-responsive HPA axis may have been adaptive in a stressful environment during evolution, but exists today at the cost of vulnerability to neurodevelopmental disorders.
Article
OBJECTIVE: Our purpose was to determine whether various measures of poor psychosocial status in pregnancy are associated with spontaneous preterm birth, fetal growth restriction, or low birth weight. STUDY DESIGN: Anxiety, stress, self-esteem, mastery, and depression were assessed at 25 to 29 weeks in 2593 gravid women by use of a 28-item Likert scale. Scores for each psychosocial subscale were determined, and an overall psychosocial score was calculated. Scores were divided into quartiles, and the lowest quartile scores were used to define poor psychosocial status. The percent spontaneous preterm birth, low birth weight, and fetal growth restriction in women with low and high psychosocial scores were compared. Logistic regression analyses provided the odds ratios and 95% confidence intervals. RESULTS: Analyses revealed that stress was significantly associated with spontaneous preterm birth and with low birth weight with odds ratios of 1.16, p = 0.003, and 1.08, p = 0.02, respectively, for each point on the scale. A low score on the combined scale or on any subscale other than stress did not predict spontaneous preterm birth, fetal growth restriction, or low birth weight. After multivariate adjustment was performed for psychosocial status, substance use, and demographic traits, black race was the only variable significantly associated with spontaneous preterm birth, fetal growth restriction, and low birth weight; stress and low education were associated with spontaneous preterm birth and low birth weight. CONCLUSION: Stress was associated with spontaneous preterm birth and low birth weight even after adjustment for maternal demographic and behavioral characteristics. Black race continues to be a significant predictor of spontaneous preterm birth, fetal growth restriction, and low birth weight even after adjustment for stress, substance use, and other demographic factors. (Am J Obstet Gynecol 1996;175:1286-92.)
Article
This study examined the effect of an acute maternal stress response and anxiety on fetal heart rate. Seventeen healthy, 3rd-trimester pregnant women (mean age = 26 +/- 6 years) were instrumented for continuous electrocardiography, blood pressure (BP), respiration, and fetal heart rate (HR). Subjects completed the state anxiety subscale of the State Trait Personality Inventory (STPI), then rested quietly in a semirecumbent position for a 5-min baseline period, followed by either a 5-min arithmetic or Stroop color-word task. Over the entire 5-min stress period and when averaged across all subjects, the stressors led to significant increases in maternal systolic BP and respiratory rate but changes in maternal HR, diastolic BP, and fetal HR were not significant. However, when subjects were dichotomized into groups that had above or below average anxiety scores [ANX(+) and ANX(-)], both groups had similar respiration rate increases to the stressors, but the BP and fetal heart rate (FHR) responses were significantly different. Women in the ANX(-) group had significantly greater BP responses compared to women in the ANX(+) group whereas the fetuses of ANX(+) women showed significant HR increases and the fetuses of ANX(-) women exhibited nonsignificant decreases. These findings suggest that women's acute emotional reactivity during pregnancy can influence fetal HR patterns and that a stress-induced increase in maternal BP is not the primary signal by which a women's stress response is transduced to her fetus. The results are consistent with the hypothesis that maternal psychological variables may shape the neurobehavioral development of the fetus.
Article
Previous research has implicated high levels of antenatal anxiety as a predictor of postnatal depression, but there is a paucity of evidence on the relationship between the various forms of anxiety and postnatal depression. A longitudinal study of 246 mothers (56 with antenatal generalised anxiety disorder (GAD), 68 with antenatal generalised social phobia, 28 with both disorders in the antenatal period, and 94 with no antenatal GAD or social phobia) allowed us to explore whether antenatal social phobia and GAD predict high Edinburgh Postnatal Depression Scale (EPDS) scores (probable depression >12) at 10-14 days, 10-12 weeks, 10 months, 14 months, and 24 months postnatally. We found that, after accounting for the presence of other antenatal anxiety disorders, antenatal depression, maternal age at child's birth, socio-economic status and ethnicity in the models, antenatal GAD independently predicted depression at all time points after delivery. A less robust relationship was found for antenatal social phobia, which predicted postnatal depression at only 10 months after birth. One possibility consistent with our findings is that there may be differences in the timing of postnatal depression with different forms of antenatal anxiety disorders.
Article
Prenatal maternal stress is associated with adverse birth outcomes and may be reduced by relaxation exercises. The aim of the present study was to compare the immediate effects of two active and one passive 10-min relaxation technique on perceived and physiological indicators of relaxation. 39 healthy pregnant women recruited at the outpatient department of the University Women's Hospital Basel participated in a randomized controlled trial with an experimental repeated measure design. Participants were assigned to one of two active relaxation techniques, progressive muscle relaxation (PMR) or guided imagery (GI), or a passive relaxation control condition. Self-reported relaxation on a visual analogue scale (VAS) and state anxiety (STAI-S), endocrine parameters indicating hypothalamic-pituitary-adrenal (HPA) axis (cortisol and ACTH) and sympathetic-adrenal-medullary (SAM) system activity (norepinephrine and epinephrine), as well as cardiovascular responses (heart rate, systolic and diastolic blood pressure) were measured at four time points before and after the relaxation exercise. Between group differences showed, that compared to the PMR and control conditions, GI was significantly more effective in enhancing levels of relaxation and together with PMR, GI was associated with a significant decrease in heart rate. Within the groups, passive as well as active relaxation procedures were associated with a decline in endocrine measures except epinephrine. Taken together, these data indicate that different types of relaxation had differential effects on various psychological and biological stress systems. GI was especially effective in inducing self-reported relaxation in pregnant women while at the same time reducing cardiovascular activity.
Article
High-anxiety and depression rates have been reported in women during pregnancy; however men and parity effects have not been studied as extensively. The purpose of this study was to analyze anxiety and depression in women and their partners during pregnancy, namely differences between the 1st, 2nd and 3rd pregnancy trimesters, between women and men, and between primiparous and multiparous. A sample of 300 women and their partners (n=560) were recruited during the 1st pregnancy trimester and have completed the STAI-S (State Anxiety Inventory) and the EPDS (Edinburgh Postnatal Depression Scale) in the 1st, 2nd and 3rd pregnancy trimesters. Anxiety symptoms follow a U pattern in pregnancy, while depression symptoms decrease throughout pregnancy. Women show higher anxiety and depression values than men, although patterns of time variation are similar. Primiparous women and men display higher anxiety levels in the 1st than in the 3rd trimester, while multiparous register higher values in the 3rd than in the 1st pregnancy trimester. Different time variation in pregnancy was found for anxiety and depression symptoms; however anxiety and depression symptoms are particularly high during the 1st trimester. Intervention needs will be analyzed according to the results.
Article
The purpose of this study was to determine if there is a relationship between fetal behavior and maternal anxiety during pregnancy. The study population consisted of 18 uncomplicated human pregnancies at 38 to 40 weeks gestation. Maternal anxiety was assessed one time using Spielberger's State-Trait Anxiety Inventory. After an overnight fast, each mother was given a standard meal on arrival to the fetal testing unit. Each fetus was examined for 4 hours using heart rate monitoring and real-time sonography. Fetal behavioral states were assigned based on heart rate pattern and the presence or absence of eye and gross body movements. We found that, compared with fetuses of mothers with low trait anxiety scores, fetuses of mothers with relatively high trait anxiety scores spent significantly more time in quiet sleep and exhibited less gross body movement when in active sleep. The results of this pilot study raise the possibility that maternal anxiety during pregnancy may have a significant effect on fetal behavior.
Article
Nulliparous women with singleton gestation were assessed prospectively for anxiety levels with the State-Trait Anxiety Inventory, which measured state (situational and transitional) and trait (dispositional and stable) anxiety, with high scores indicating high anxiety. Bivariate and multivariate methods were used for data analysis. Anxiety assessments (n = 239) were obtained in 88 women at different stages of gestation. Mean anxiety scores were lowest at 22 to 26 weeks. A woman's successive scores were highly correlated. The trait anxiety (A-T) scores were higher for married women. A positive correlation was present between anxiety scores and gestational age at delivery. Low A-T scores correlated with low birthweight, preterm delivery, and chorioamnionitis. High state anxiety (A-S) levels correlated with the presence of meconium in the amniotic fluid and neonatal congenital abnormalities. Postdate delivery also was associated with higher although statistically insignificant anxiety scores. Women who presented to the labor and delivery room for various complaints had higher A-S and A-T levels. Maternal anxiety level was associated with adverse perinatal outcome; specifically, prematurity and low birthweight correlated with low A-T levels.
Article
Our purpose was to determine (1) whether a fetal acoustic stimulation test results in more palpable fetal movement compared with a mock test (control) and (2) whether palpated fetal movements after a fetal acoustic stimulation test are accompanied by a reactive nonstress test. In a randomized controlled trial we studied women seen in the labor and delivery suite for various indications. Women were excluded for multiple gestation, < 31 weeks' gestational age, treatment with magnesium sulfate or narcotics, or ruptured membranes. Informed consent was obtained from eligible women, who were then randomized to a test or control group. We placed an acoustic stimulator on the abdomen of each woman, but only the test group was stimulated. We assessed fetal movement by a grading system: 0 = no fetal movement felt by patient or tester, 1 = fetal movement felt by patient only, 2 = fetal movement felt by tester, 3 = visual movement seen by tester. A positive fetal acoustic stimulation test result was defined as one with any fetal movement felt or seen by the tester (grades 2 or 3). We then performed a nonstress test. We compared rates of a positive fetal acoustic stimulation test in the test and control groups with the chi 2 test. A p value < 0.05 was considered significant. We randomized 297 women to the test group and 280 women to the control (mock test) group. Of women tested with the fetal acoustic stimulation test. 81% had fetal movement by palpation or visualization (grades 2 or 3) compared with 19% of the control group (p < 0.0001, odds ratio 19.29, 95% confidence interval 12.42 to 30.07). Of the test group, 283 (95%) had a reactive nonstress test and 14 (5%) had nonreactive tests; the control group had 267 (95%) reactive and 13 (5%) nonreactive nonstress tests. Of 242 patients in the test group with a positive fetal acoustic stimulation test, 236 (98%) had a reactive nonstress test. Of those in the test group with fewer than three contractions per 10 minutes. 164 (89%) had a positive fetal acoustic stimulation test. Of these, 162 (99%) had a reactive nonstress test. The fetal acoustic stimulation test evokes significantly more palpated or visualized fetal movement than in controls. Palpated or visualized fetal movement after acoustic stimulation was almost always accompanied by a reactive nonstress test.
Article
The aim of this study was to investigate if fetal circulation is affected by maternal anxiety. 37 nulliparous women were studied prospectively in the third trimester of pregnancy, with self-rate tests of anxiety (STAI). Doppler ultrasound examination of the umbilical artery and fetal middle cerebral artery was performed at 37-40 gestational weeks. The pulsatility index (PI) was calculated and corrected for heart rate. The women were divided into groups of increasing levels of anxiety. The fetuses of women with high trait anxiety scores had significantly higher PI values in the umbilical artery (p = 0.0056), significantly lower PI values in the fetal middle cerebral artery (p = 0.0029) and significantly lower cerebro-umbilical PI ratios (p = 0.0002), suggesting a change in blood distribution in favor of brain circulation in the fetuses. Maternal weight, weight-increase, height, age, marital status, smoking habits, drinking habits and socio-economic factors known to affect fetal well-being did not interfere with these findings. No significant differences in birth-weight, length and head circumference were found between infants born to mothers with higher trait anxiety levels compared to mothers with lower trait anxiety levels. Our results suggest that maternal stress, in terms of trait anxiety, influences fetal cerebral circulation.
Article
This study tested the hypothesis that maternal stress is associated with elevated maternal levels of corticotropin releasing hormone and activation of the placental-adrenal axis before preterm birth. In a behavior in pregnancy study, 524 ethnically and socioeconomically diverse women were followed up prospectively and evaluated at 3 gestational ages: 18 to 20 weeks, 28 to 30 weeks, and 35 to 36 weeks. Maternal variables included demographic data, medical conditions, perceived stress level, and state anxiety. Maternal plasma samples were collected at each gestational age. Eighteen case patients with spontaneous onset of preterm labor were matched against 18 control subjects who were delivered at term, and their samples were assayed for corticotropin-releasing hormone, adrenocorticotropic hormone, and cortisol by means of radioimmunoassay. Statistical tests were used to examine mean differences in these hormones. In addition, the relationship between stress level and each hormone was tested with a Pearson correlation coefficient and hierarchic multiple regressions in each group. Patients who had preterm delivery had significantly higher plasma corticotropin-releasing hormone levels than did control subjects at all 3 gestational ages (P <.0001). Analyses did not find any differences in reported levels of stress between 18 to 20 weeks' gestation and 28 to 30 weeks' gestation. A hierarchic multiple regression indicated that maternal stress level at 18 to 20 weeks' gestation and maternal age accounted for a significant amount of variance in corticotropin-releasing hormone at 28 to 30 weeks' gestation, after controlling for corticotropin-releasing hormone at 18 to 20 weeks' gestation (P <. 001). In addition, patients who were delivered preterm had significantly elevated plasma levels of adrenocorticotropic hormone at all 3 gestational ages (P <.001) and significantly elevated cortisol levels at 18 to 20 weeks' gestation and 28 to 30 weeks' gestation (P <.001). Maternal plasma levels of corticotropin-releasing hormone are significantly elevated at as early as 18 to 20 weeks' gestation in women who are subsequently delivered preterm. Changes in corticotropin-releasing hormone between 18 to 20 weeks' gestation and 28 to 30 weeks' gestation are associated with maternal age and stress level at 18 to 20 weeks' gestation. Maternal stress and corticotropin-releasing hormone levels may be potential markers for the patient at risk for preterm birth. Activation of the placental maternal pituitary-adrenal axis is consistent with the classic endocrine response to stress.
Article
This prospective study tracked hassles, pregnancy-specific stress, and state anxiety during pregnancy. A second objective was to identify predictors of each stress dimension. Pregnant women (n=161) completed the Hassles Scale, the Pregnancy-Specific Stress Questionnaire (PEQ), and the state-anxiety scale (STAI-state) monthly, beginning in the third month of pregnancy. Hassles were found to be stable throughout the pregnancy. Women reported significantly higher pregnancy-specific stress in the first and third trimester of pregnancy, whereas state anxiety increased in the third trimester compared with the first and second trimesters. Poorer marital adjustment predicted higher Hassles during pregnancy and higher PEQ and STAI-state in the third trimester. Women who reported that the pregnancy would have a negative impact on their career scored higher on Hassles during pregnancy and higher on the PEQ in the third trimester. The occurrence of a gestational complication during pregnancy was related to higher pregnancy-specific stress in the third trimester. Younger women also reported higher PEQ results in the third trimester. The data provide support for a multidimensional conceptualization of stress during pregnancy.
Article
To determine whether maternal state and trait anxiety levels affect fetal movements or fetal heart rate (FHR) in the third trimester. Forty-one healthy pregnant nulliparous women not on medication and with a singleton pregnancy. Maternal anxiety was assessed using the Spielberger State- Trait Anxiety Inventory (Form Y) at 36 gestational weeks. The fetuses of the women were examined at 37-40 gestational weeks with ultrasound observation of fetal movements and cardiotocography (CTG). The results of the fetal examinations were compared between women with low and high anxiety scores (low scores being defined as scores below the median and high scores as scores equal to or above the median of the study population), and correlation analyses between anxiety scores and the outcome variables were performed. The presence and duration (expressed as a percentage of the total examination time) of FHR patterns A, B, C, and D, the percentage duration of fetal movements in each FHR pattern, baseline FHR and FHR variability in each FHR pattern. The presence of FHR patterns A, B, C, and D, the duration of FHR patterns A, B, and C, FHR variability in FHR patterns A, B, and C, baseline FHR and the percentage duration of fetal movements in each FHR pattern did not differ between women with low and high state and trait anxiety scores. In fetuses with FHR pattern D, the duration of FHR pattern D increased with increasing maternal trait anxiety scores, (rho=0.88; p=0.008), and FHR variability in FHR pattern D increased with maternal state and trait anxiety scores (r=0.86, p=0.01; r=0.96, p=0.001). Maternal anxiety does not seem to affect fetal movements or baseline FHR in late pregnancy, but there is a possible association between maternal anxiety and the duration of FHR pattern D and FHR variability in FHR pattern D.
Article
To examine the hypothesis that the effects of postnatal depression on children's behavioral/emotional problems are explained by antenatal maternal mood. The current study investigated this hypothesis in the Avon Longitudinal Study of Parents and Children, a prospective, community-based study that has followed a cohort of women since pregnancy (n = 7,144) who delivered their baby between April 1, 1991, and December 31, 1992. Self-report measures of maternal anxiety and depression were assessed at repeated intervals in pregnancy and the postnatal period. Children's behavioral/emotional problems were assessed by parent report at age 4 years. After controlling for smoking, alcohol use, birth weight for gestational age, maternal age, child sex, and socioeconomic status, postnatal depression at 8 weeks (OR = 2.27 [1.55-3.31]) and 8 months (OR = 1.68 [1.12-2.54]) was associated with children's behavioral/emotional problems. Subsequent analyses that included antenatal maternal mood indicated that antenatal anxiety in late pregnancy and not antenatal depression was also independently associated with behavioral/emotional problems at age 4 (OR = 1.72 [1.14-2.59]); 8 week postnatal depression remained a significant predictor after antenatal maternal mood was statistically controlled for (OR = 1.56 [1.04-2.32]). Antenatal anxiety and postnatal depression represent separate risks for behavioral/emotional problems in children and act in an additive manner.
Article
One hundred sixty-six women were classified as experiencing high or low anxiety during the second trimester of pregnancy. The high anxiety women also had high scores on depression and anger scales. In a follow-up across pregnancy, the fetuses of the high anxiety women were noted to be more active and to experience growth delays. The high anxiety mothers' high prenatal norepinephrine and low dopamine levels were followed by their neonates having low dopamine and serotonin levels. The high anxiety mothers' newborns also had greater relative right frontal EEG activation and lower vagal tone. Finally, the newborns of high anxiety mothers spent more time in deep sleep and less time in quiet and active alert states and showed more state changes and less optimal performance on the Brazelton Neonatal Behavior Assessment Scale (motor maturity, autonomic stability and withdrawal). These data highlight the need for prenatal intervention for elevated anxiety symptoms during pregnancy.
Article
Associations between antenatal maternal anxiety, measured with the State Trait Anxiety Inventory, and disorders in 8- and 9-year-olds were studied prospectively in 71 normal mothers and their 72 firstborns. Clinical scales were completed by the mother, the child, the teacher, and an external observer. Hierarchical multiple regression analyses showed that maternal state anxiety during pregnancy explained 22%, 15%, and 9% of the variance in cross-situational attention deficit hyperactivity disorder symptoms, externalizing problems, and self-report anxiety, respectively, even after controlling for child's gender, parents' educational level, smoking during pregnancy, birth weight, and postnatal maternal anxiety. Anxiety at 12 to 22 weeks postmenstrual age turned out to be a significant independent predictor whereas anxiety at 32 to 40 weeks was not. Results are consistent with a fetal programming hypothesis.
Article
To assess whether links exist between maternal trait anxiety (STAI), perceived life event (LE) stress and depression (Edinburgh scale) and infant temperament. Women in the third trimester of pregnancy returned psychological self-report questionnaires; infant temperament was evaluated at 4 and 6 months by maternal and paternal report, while depression (concurrent Edinburgh scale) was also assessed at four and six months. As data were returned inconsistently at 4 and 6 months, we combined these two time points for simplicity of reporting and optimisation of numbers. Univariate logistic regressions on 970 subjects indicated that the pregnancy STAI (>40) scores were associated with 2.56- and 1.57-fold increases (maternal and paternal, respectively), in the odds of "difficult" infant temperament at 4 or 6 months. Concurrent Edinburgh scores (OR of 3.06 and 2.64 for maternal reports, respectively) were also predictive of infant temperament. Age, education, income, marital status, obstetric complications, infant gender and prematurity were not predictive of infant temperament. In stepwise multiple logistic regression analyses, the antenatal trait STAI (odds ratio 1.96) significantly predicted maternal reports of "difficult" temperament at 4 or 6 months independent of both antenatal and postnatal depression scores. There were similar trends for paternal reports of "difficult" temperament but these were not significant. Antenatal depression and perceived LE stress were not predictive of temperament. Finally, women (N=14) reporting domestic violence (DV) in pregnancy had highly significant increased Edinburgh and STAI scores. Maternal trait anxiety was predictive of "difficult" infant temperament, independent of "concurrent" depression and key sociodemographic and obstetric risk factors. These findings, while needing replication using objective measures of infant temperament, suggest that antenatal psychological interventions aimed at minimising anxiety may optimize infant temperament outcomes. There may be some benefit in shaping specific interventions to women reporting specific risk factors such as DV or past abuse.
Article
Antenatal anxiety has received increased attention with regards to both its impact on infant outcomes and as a risk factor for postnatal depression. The measurement of anxiety in the perinatal setting, however, has proven to be challenging. The aims of the present study are to: determine whether antenatal anxiety as measured by the Brief Measure of Worry Severity (BMWS) is a significant predictor of postnatal depression (PND); examine the psychometric properties of a new measure of anxiety - the BMWS - in an antenatal sample; and examine the comparative capacity of the BMWS to the Speilberger State Trait Anxiety Inventory (STAI) in predicting PND. A sample of 748 women completed the BMWS and STAI during the third trimester of pregnancy and returned the Edinburgh Postnatal Depression Scale (EPDS) at 8 weeks postpartum. Women with high antenatal anxiety on the BMWS were 2.6 times more likely to have probable PND than those with low scores, even after controlling for confounding factors, including level of antenatal depression on the EPDS. In contrast, the STAI was no longer a significant predictor of PND after controlling for these variables. The BMWS has good construct validity, with scores on this scale correlating strongly with scores on other measures of anxiety, depression and perinatal risk. When compared to those who participated in the follow-up at 8 weeks postnatally, those who did not participate appeared to be at greater risk of developing PND, raising the possibility of attrition bias within this sample. The findings from this study suggest that the BMWS has utility in measuring antenatal anxiety in both clinical and research settings and that antenatal anxiety is an important precursor of PND.
Article
The purpose of this study was to identify correlates of anxiety symptoms during pregnancy and determine the strength of the relationship between anxiety symptoms and adverse perinatal outcomes. A meta-analytic review was conducted of studies that evaluated the relationship between self-reported anxiety symptoms during pregnancy and potential correlates or perinatal outcomes. Fifty studies of 48 samples of women met inclusion criteria. Anxiety symptoms during pregnancy were associated with a number of psychosocial variables including depressive symptoms (r = 0.66), stress (r = 0.40), and self-esteem/self-worth (r = -0.47). There were no significant associations of anxiety symptoms with perinatal outcomes (all rs < 0.19). Anxiety symptoms during pregnancy appear to be associated with similar psychosocial variables as anxiety at other times. There is no evidence of an association of anxiety symptoms with adverse perinatal outcomes among those studied thus far. However, significant gaps still exist in the literature in this area.