title: Mind-body interventions during pregnancy for preventing or treating women's anxiety.
abstract: BACKGROUND
  Anxiety during pregnancy is a common problem. Anxiety and stress could have consequences on the course of the pregnancy and the later development of the child. Anxiety responds well to treatments such as cognitive behavioral therapy and/or medication. Non-pharmacological interventions such as mind-body interventions, known to decrease anxiety in several clinical situations, might be offered for treating and preventing anxiety during pregnancy.
  
  
  OBJECTIVE
  To assess the benefits of mind-body interventions during pregnancy in preventing or treating women's anxiety and in influencing perinatal outcomes.
  
  
  METHODS
  We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (30 November 2010), MEDLINE (1950 to 30 November 2010), EMBASE (1974 to 30 November 2010), the National Center for Complementary and Alternative Medicine (NCCAM) (1 December 2010), ClinicalTrials.gov (December 2010) and Current Controlled Trials (1 December 2010), searched the reference lists of selected studies and contacted professionals and authors in the field.
  
  
  METHODS
  Randomized controlled trials, involving pregnant women of any age at any time from conception to one month after birth, comparing mind-body interventions with a control group. Mind-body interventions include: autogenic training, biofeedback, hypnotherapy, imagery, meditation, prayer, auto-suggestion, tai-chi and yoga. Control group includes: standard care, other pharmacological or non-pharmacological interventions, other types of mind-body interventions or no treatment at all.
  
  
  METHODS
  Three review authors independently assessed trials for inclusion all assessed risk of bias for each included study. We extracted data independently using an agreed form and checked it for accuracy.
  
  
  RESULTS
  We included eight trials (556 participants), evaluating hypnotherapy (one trial), imagery (five trials), autogenic training (one trial) and yoga (one trial). Due to the small number of studies per intervention and to the diversity of outcome measurements, we performed no meta-analysis, and have reported results individually for each study. Compared with usual care, in one study (133 women), imagery may have a positive effect on anxiety during labor decreasing anxiety at the early and middle stages of labor (MD -1.46; 95% CI -2.43 to -0.49; one study, 133 women) and (MD -1.24; 95% CI -2.18 to -0.30). Another study showed that imagery had a positive effect on anxiety and depression in the immediate postpartum period. Autogenic training might be effective for decreasing women's anxiety before delivering.
  
  
  CONCLUSIONS
  Mind-body interventions might benefit women's anxiety during pregnancy. Based on individual studies, there is some but no strong evidence for the effectiveness of mind-body interventions for the management of anxiety during pregnancy. The main limitations of the studies were the lack of blinding and insufficient details on the methods used for randomization.
authors: Département de pédiatrie, Université Laval, Centre Hospitalier Universitaire de Québec, 2705 boulevard Laurier, Québec, Québec, Canada, G1V 4G2.
authors: Isabelle
authors: I
authors: Marc
authors: Narimane
authors: N
authors: Toureche
authors: Edzard
authors: E
authors: Ernst
authors: Ellen D
authors: ED
authors: Hodnett
authors: Claudine
authors: C
authors: Blanchet
authors: Sylvie
authors: S
authors: Dodin
authors: Merlin M
authors: MM
authors: Njoya
mesh_terms: D001007:Anxiety / Q000517:prevention & control*; D001326:Autogenic Training; D005260:Female; D006801:Humans; D006990:Hypnosis / Q000379:methods; D019018:Imagery, Psychotherapy / Q000379:methods; D026441:Mind-Body Therapies / Q000379:methods*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000517:prevention & control / Q000523:psychology / Q000628:therapy*; D016032:Randomized Controlled Trials as Topic; D015013:Yoga