title: Fetal response to abbreviated relaxation techniques. A randomized controlled study.
abstract: BACKGROUND
  stress during pregnancy can have adverse effects on the course of pregnancy and on fetal development. There are few studies investigating the outcome of stress reduction interventions on maternal well-being and obstetric outcome.
  
  
  OBJECTIVE
  this study aims (1) to obtain fetal behavioral states (quiet/active sleep, quiet/active wakefulness), (2) to investigate the effects of maternal relaxation on fetal behavior as well as on uterine activity, and (3) to investigate maternal physiological and endocrine parameters as potential underlying mechanisms for maternal-fetal relaxation-transferral.
  
  
  METHODS
  the behavior of 33 fetuses was analyzed during laboratory relaxation/quiet rest (control group, CG) and controlled for baseline fetal behavior. Potential associations between relaxation/quiet rest and fetal behavior (fetal heart rate (FHR), FHR variation, FHR acceleration, and body movements) and uterine activity were studied, using a computerized cardiotocogram (CTG) system. Maternal heart rate, blood pressure, cortisol, and norepinephrine were measured.
  
  
  RESULTS
  intervention (progressive muscle relaxation, PMR, and guided imagery, GI) showed changes in fetal behavior. The intervention groups had higher long-term variation during and after relaxation compared to the CG (p=.039). CG fetuses had more FHR acceleration, especially during and after quiet rest (p=.027). Women in the PMR group had significantly more uterine activity than women in the GI group (p=.011) and than CG women. Maternal heart rate, blood pressure, and stress hormones were not associated with fetal behavior.
  
  
  CONCLUSIONS
  this study indicates that the fetus might participate in maternal relaxation and suggests that GI is superior to PMR. This could especially be true for women who tend to direct their attention to body sensations such as abdominal activity.
authors.affiliation: Department of Developmental Pediatrics, Children's Hospital Boston, Harvard Medical School, Boston, MA 02115, USA. nadine.ﬁnk@childrens.harvard.edu
authors.forename: Nadine S
authors.initials: NS
authors.lastname: Fink
authors.forename: Corinne
authors.initials: C
authors.lastname: Urech
authors.forename: Fornaro
authors.initials: F
authors.lastname: Isabel
authors.forename: Andrea
authors.initials: A
authors.lastname: Meyer
authors.forename: Irène
authors.initials: I
authors.lastname: Hoesli
authors.forename: Johannes
authors.initials: J
authors.lastname: Bitzer
authors.forename: Judith
authors.initials: J
authors.lastname: Alder
mesh_terms: D000328:Adult; D015148:Cardiotocography; D005260:Female; D005323:Fetal Monitoring; D005333:Fetus / Q000502:physiology*; D006340:Heart Rate, Fetal / Q000502:physiology; D006801:Humans; D011247:Pregnancy; D011295:Prenatal Care / Q000379:methods; D012063:Relaxation / Q000502:physiology; D012064:Relaxation Therapy / Q000379:methods*; D012146:Rest / Q000502:physiology; D014590:Uterine Contraction / Q000502:physiology