Teixeira J, Martin D, Prendiville O, Glover V
Department of Paediatrics, Obstetrics and Gynaecology, Chelsea and Westminster Hospital, Imperial College School of Medicine, London, UK.
J Psychosom Obstet Gynaecol. 2005 Dec;26(4):271-6. doi: 10.1080/01674820500139922.
Antenatal maternal anxiety has adverse effects on the fetus and the child. In this study we determined whether a short period of directed or of passive relaxation reduced maternal self-rated anxiety, heart rate, plasma catecholamines, cortisol and uterine artery resistance index, in pregnant women.
Fifty-eight women (28-32 wks gestation) were assigned randomly to a session of directed active or passive (sitting quietly) relaxation. Spielberger self-rating anxiety questionnaires were completed, and a venous blood sample taken, before and after a Doppler scan.
Both active and passive relaxation significantly reduced State Anxiety and maternal heart rate, but the effect was significantly greater with the active relaxation. In contrast, the passive relaxation significantly reduced noradrenaline levels whereas active did not. Adrenaline levels were not changed significantly with either type of relaxation. Both methods significantly reduced cortisol, with a trend for the passive to have a greater effect. The active relaxation had no effect on uterine artery blood flow, whereas there was a statistically significant, but clinically negligible, increase in mean resistance index after passive relaxation.
Both methods reduced maternal State Anxiety and heart rate, the active method more so. However there was a striking lack of correlation with the other biological indices studied. In order to reduce specific biological effects of anxiety during pregnancy, different methods may be needed from those which are most effective at reducing subjective anxiety.
产前母亲焦虑对胎儿和儿童有不良影响。在本研究中,我们确定了短时间的指导性放松或被动放松是否能降低孕妇的自我评定焦虑、心率、血浆儿茶酚胺、皮质醇和子宫动脉阻力指数。
58名妊娠28 - 32周的妇女被随机分配到指导性主动放松或被动(安静坐着)放松环节。在进行多普勒扫描前后,完成斯皮尔伯格自我评定焦虑问卷,并采集静脉血样。
主动放松和被动放松均显著降低了状态焦虑和母亲心率,但主动放松的效果更显著。相比之下,被动放松显著降低了去甲肾上腺素水平,而主动放松则没有。两种放松方式对肾上腺素水平均无显著影响。两种方法均显著降低了皮质醇水平,且被动放松有产生更大影响的趋势。主动放松对子宫动脉血流无影响,而被动放松后平均阻力指数有统计学上显著但临床上可忽略不计的增加。
两种方法均降低了母亲的状态焦虑和心率,主动方法效果更明显。然而,与所研究的其他生物学指标明显缺乏相关性。为了降低孕期焦虑的特定生物学影响,可能需要不同于最有效降低主观焦虑的方法。