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自主神经功能和炎症在孕妇中参与一项随机对照研究的正念分娩和育儿。

Autonomic function and inflammation in pregnant women participating in a randomized controlled study of Mindfulness Based Childbirth and Parenting.

机构信息

Department of Clinical Neuroscience, Karolinska Institutet, Tomtebodavägen 18A, 171 77, Stockholm, Sweden.

Center for Social Sustainability, Department of Neurobiology, Care Sciences and Society, CSS, Center for Social Sustainability, Karolinska Institutet, Alfred Nobels allé 23, 141 83, Huddinge, Sweden.

出版信息

BMC Pregnancy Childbirth. 2023 Apr 10;23(1):237. doi: 10.1186/s12884-023-05528-2.

Abstract

BACKGROUND

Pregnancy and childbirth are significant events in many women's lives, and the prevalence of depressive symptoms increases during this vulnerable period. Apart from well documented cognitive, affective, and somatic symptoms, stress and depression are associated with physiological changes, such as reduced heart-rate variability (HRV) and activation of the inflammatory response system. Mindfulness Based Interventions may potentially have an effect on both HRV, inflammatory biomarkers, and self-assessed mental health. Therefore, the aim of this study was to assess the effects of a Mindfulness Childbirth and Parenting (MBCP) intervention on HRV, serum inflammatory marker levels, through an RCT study design with an active control group.

METHODS

This study is a sub-study of a larger RCT, where significant intervention effects were found on perinatal depression (PND) and perceived stress. Participants were recruited through eight maternity health clinics in Stockholm, Sweden. In this sub-study, we included altogether 80 women with increased risk for PND, and blood samples and HRV measures were available from 60 of the participants (26 in the intervention and 34 in the control group).

RESULTS

Participants who received MBCP reported a significantly larger reduction in perceived stress and a significantly larger increase in mindfulness, compared to participants who received the active control treatment. However, in this sub-study, the intervention had no significant effect on PND, inflammatory serum markers or measures of HRV.

CONCLUSIONS

No significant differences were found regarding changes in HRV measures and biomarkers of inflammation, larger studies may be needed in the future.

TRIAL REGISTRATION

ClinicalTrials.gov ID:  NCT02441595 . Registered 12 May 2015 - Retrospectively registered.

摘要

背景

妊娠和分娩是许多女性生活中的重要事件,在此期间,抑郁症状的患病率会增加。除了有充分记录的认知、情感和躯体症状外,压力和抑郁还与生理变化有关,如心率变异性(HRV)降低和炎症反应系统激活。基于正念的干预措施可能会对 HRV、炎症生物标志物和自我评估的心理健康产生影响。因此,本研究的目的是通过一项有活性对照组的 RCT 研究设计,评估正念分娩和育儿(MBCP)干预对 HRV、血清炎症标志物水平的影响。

方法

本研究是一项更大 RCT 的子研究,该 RCT 研究中发现干预对围产期抑郁(PND)和感知压力有显著影响。参与者通过瑞典斯德哥尔摩的八家妇产健康诊所招募。在这个子研究中,我们共纳入了 80 名患有 PND 风险增加的女性,其中 60 名参与者(干预组 26 名,对照组 34 名)提供了血液样本和 HRV 测量结果。

结果

与接受活性对照组治疗的参与者相比,接受 MBCP 治疗的参与者报告的感知压力显著降低,正念水平显著提高。然而,在这个子研究中,干预对 PND、炎症血清标志物或 HRV 测量均无显著影响。

结论

在 HRV 测量和炎症生物标志物方面没有发现显著差异,未来可能需要更大规模的研究。

试验注册

ClinicalTrials.gov ID:NCT02441595。注册日期:2015 年 5 月 12 日-回顾性注册。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c5b6/10084615/cf5e61023bde/12884_2023_5528_Fig1_HTML.jpg

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