Women's Medicine Collaborative at The Miriam Hospital, Providence, RI, USA; Department of Medicine, Warren Alpert Medical School of Brown University, Providence, RI, USA; Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI, USA.
Women's Medicine Collaborative at The Miriam Hospital, Providence, RI, USA; Department of Medicine, Warren Alpert Medical School of Brown University, Providence, RI, USA; Department of Epidemiology, Warren Alpert Medical School of Brown University, Providence, RI, USA.
J Psychosom Res. 2023 Feb;165:111146. doi: 10.1016/j.jpsychores.2023.111146. Epub 2023 Jan 5.
Hypertensive disorders of pregnancy (HDP) are one of the greatest causes of perinatal morbidity and mortality. Mindfulness training (MT) significantly reduces blood pressure in non-pregnant adults, yet MT has not been tested to reduce blood pressure in the prenatal period.
The objectives of this pilot randomized clinical trial were to test the feasibility, acceptability, and effects of MT on rates of HDP among pregnant participants at risk for HDP. Exploratory analyses examined effects of MT on antenatal blood pressure.
Participants were randomized to an 8-week phone-delivered MT intervention or usual care. Feasibility was defined by MT completion. Acceptability was defined by participants' satisfaction with the intervention. HDP outcomes were collected by medical chart review. Antenatal blood pressure values were extracted from medical records.
Twenty-nine participants were randomized to phone-based MT (N = 15) or usual care (N = 14). 73% participants completed >5 MT sessions, indicating that MT was feasible. One hundred percent of participants indicated they were "satisfied" or "very satisfied" with the intervention, suggesting the intervention was acceptable. Rates of HDP were lower in the MT vs. usual care condition (9% vs. 29%; OR: 0.25, 95% C.I.: 0.02-2.65) although this did not reach statistical significance. Systolic and diastolic blood pressure levels were significantly lower at follow up among those randomized to MT vs. usual care.
Results from this pilot trial suggest that prenatal MT is feasible and acceptable and may be a useful adjunctive preventative treatment for HDP among at-risk pregnant patients.
gov identifier is NCT03679117.
妊娠高血压疾病(HDP)是围产期发病率和死亡率的最大原因之一。正念训练(MT)可显著降低非孕妇的血压,但尚未对其在产前降低血压进行测试。
本试验性随机临床试验的目的是测试正念训练对有 HDP 风险的孕妇 HDP 发生率的可行性、可接受性和效果。探索性分析检查了正念训练对产前血压的影响。
参与者被随机分配到为期 8 周的电话传递 MT 干预或常规护理。可行性定义为 MT 完成情况。可接受性定义为参与者对干预的满意度。HDP 结果通过病历审查收集。产前血压值从病历中提取。
29 名参与者被随机分配到基于电话的 MT(N = 15)或常规护理(N = 14)。73%的参与者完成了 >5 次 MT 课程,表明 MT 是可行的。100%的参与者表示他们对干预“满意”或“非常满意”,这表明干预是可接受的。与常规护理相比,MT 组的 HDP 发生率较低(9% vs. 29%;OR:0.25,95%CI:0.02-2.65),尽管这并未达到统计学意义。与常规护理相比,随机分配到 MT 组的患者在随访时的收缩压和舒张压水平显著降低。
这项试验性研究的结果表明,产前 MT 是可行和可接受的,并且可能是高危孕妇 HDP 的一种有用的辅助预防治疗方法。
gov 标识符为 NCT03679117。