Effects of listening to music on postpartum stress and anxiety levels

Art-based interventions for women's mental health in pregnancy and postpartum: A meta-analysis of randomised controlled trials

OBJECTIVE

Pregnant and postpartum women are vulnerable to psychological problems with a high estimated prevalence. To date, there is no meta-analysis that specifically assesses the effectiveness of art-based interventions to improve mental health in pregnant and postpartum women. The objective of this meta-analysis was to assess the efficacy of art-based interventions when delivered to pregnant and postpartum women.

METHODS

Systematic literature searches were conducted from the inception to 6 March 2022 in seven English databases, including PubMed, Embase, Cochrane Central Register, CINAHL, ProQuest, Scopus, and Web of Science. Randomised controlled trials (RCTs) reporting art-based interventions targeting the improvement of women's mental health in pregnancy and postpartum were included. Cochrane risk of bias tool was applied to assess evidence quality.

RESULTS

Twenty-one randomised controlled trials (RCTs) involving 2,815 participants were eligible for data analysis. A pooled analysis demonstrated that art-based interventions significantly reduced anxiety (SMD = -0.75, 95% CI = -1.10 to -0.40) and depression symptoms (MD = -0.79, 95% CI = -1.30 to -0.28). However, art-based interventions did not alleviate stress symptoms as expected in our findings. Subgroup analysis demonstrated that intervention implementation time, intervention duration and music selected by the participants vs. not could have influence on the efficacy of art-based intervention for anxiety.

CONCLUSION

In perinatal mental health, art-based interventions may be effective in alleviating anxiety and depression. In the future, we still need to conduct high-quality RCTs to validate our findings and enrich clinical application of art-based interventions.

A Systematic Review and Meta-analysis of the Effects of Music Therapy on Postpartum Anxiety and Pain Levels

Introduction: Postpartum anxiety may be associated with depression, postpartum blues, and maternal mood disorders. This systematic review investigated the effects of music therapy on postpartum anxiety and pain levels.

Methods: English databases including Cochrane, Medline, Embase, Web of Science, Scopus, and PubMed and Persian databases including Scientific Information Database (SID) and the Iranian Registry of Clinical Trials (IRCT) were searched. The data were analyzed in RevMan 5.3 and reported as forest plots. The present study was conducted on postpartum women (i.e., the participants). All randomized controlled trials comparing the effects of music (i.e., the intervention) and placebo or routine care (i.e., the control) on postpartum anxiety and pain (i.e., the outcome) were included in the study.

Results: Out of a total of 60 retrieved articles, four eligible articles were selected and entered the meta-analysis process. According to the results, anxiety (MD=-0.68, 95% CI=-1.90 to -0.54, P < 0.001) and pain (MD=-1.85, 95% CI=-3.96 to 0.26, P < 0.001) levels of patients in the music therapy group were reduced more significantly than those in the control group.

Conclusion: The results showed that music therapy can significantly reduce both postpartum anxiety and pain scores. However, due to the high heterogeneity of the studies, more randomized trials using a standard tool such as the Consolidated Standards of Reporting Trials (CONSORT) statement are needed.

Stress, anxiety and depression perceived by couples with recurrent miscarriage

AIM

Recurrent miscarriage is considered a major life event. The main purposes of this study were to compare the differences in stress, anxiety, social support, sleep quality and depressive symptoms in couples experiencing recurrent miscarriage compared to peers who experience full-term normal childbirth in southern Taiwan.

METHODS

Convenience sampling and snowball sampling were used respectively to recruit 78 couples with and 80 couples without recurrent miscarriage from October 2014 to July 2015. Five structured questionnaires including Perceived Stress Scale, State- Anxiety Inventory, Interpersonal Support Evaluation List, Pittsburgh Sleep Quality Index and Edinburgh Depression Scale were administered.

RESULTS

Women who experienced recurrent miscarriage perceived significantly higher levels of stress, anxiety and depressive symptoms than their husbands. Women in the recurrent miscarriage group reported significantly greater depressive symptoms than women of the other group. A stepwise multiple regression analysis indicated key predictors of depressive symptoms among women of childbearing age, accounting for 62.9% of the variance, were anxiety, stress, social support and history of recurrent miscarriage.

CONCLUSION

Women with recurrent miscarriage suffer mild to moderate depressive symptoms and a greater incidence of depression than their peers who experienced normal childbirth. Health professionals can use the knowledge gained from these findings to evaluate women with recurrent miscarriage for stress, anxiety and depressive symptoms and develop supportive interventions.

Tecnologias educativas para promoção do (auto) cuidado de mulheres no pós-parto

RESUMO Objetivo: avaliar a literatura nacional e internacional sobre o uso de tecnologias educativas para promoção do autocuidado de mulheres no pós-parto. Método: trata-se de uma revisão integrativa da literatura. As produções foram coletadas nas bases CINAHL, SCOPUS, PubMed, SciELO, LILACS e Cochrane, utilizando como recorte temporal o período de janeiro/2004 a julho/2014, nos idiomas português, inglês, espanhol e francês, selecionadas a partir dos descritores: postpartum period, educational technology, nursing e self care. Ao final, procedeu-se à análise de 27 artigos. Resultados: dentre as informações, observou-se que as escalas, o aconselhamento e a visita domiciliar foram as tecnologias educativas mais recomendadas. Conclusão: as tecnologias favorecem a comunicação, mas por vezes são dependentes de computador e internet, dificultando o acesso para mulheres de baixa renda.

The effects of music listening on psychosocial stress and maternal-fetal attachment during pregnancy

OBJECTIVE

While music listening has been studied as an intervention to help reduce anxiety in pregnant women, few studies have explored the effect of music listening on pregnancy-specific stress relief. This study examines the effects of music listening on psychosocial stress and maternal-fetal attachment during pregnancy.

DESIGN

A randomized controlled trial was implemented. A valid sample of 296 pregnant women in their second or third trimester was randomly distributed into an experimental group (n=145) and a control group (n=151).

INTERVENTIONS

The experimental group received routine prenatal care and music listening. The control group received routine prenatal care only.

MAIN OUTCOME MEASURES

Data were collected using a demographic form, Pregnancy Stress Rating Scale (PSRS), Perceived Stress Scale (PSS), and Maternal-Fetal Attachment Scale (MFAS).

RESULTS

The post-test results identified a significantly lower level of psychosocial stress in the experimental group than in the control group, particularly in terms of the stresses related to baby care and changing family relationships and to maternal role identification. However, no statistically significant differences in terms of perceived stress and maternal-fetal attachment were found between the post-test results of the two groups.

CONCLUSION

This study provides evidence in support of using of music in interventions designed to relieve psychosocial stress in prenatal women. IRB approval number: ER98223.

Interventions to reduce postpartum stress in first-time mothers: a randomized-controlled trial

BACKGROUND

The postpartum period can be a challenging time particularly for first-time mothers. This study aimed to assess two different interventions designed to reduce stress in the postpartum among first-time mothers.

METHODS

Healthy first-time mothers with healthy newborns were recruited from hospitals in Beirut, Lebanon after delivery. The two interventions were a 20-minute film addressing common stressors in the postpartum period and a 24-hour telephone support hotline. Participants were randomized to one of four study arms to receive either the postpartum support film, the hotline service, both interventions, or a music CD (control). Participants were interviewed at eight to twelve weeks postpartum for assessment of levels of stress as measured by the Cohen Perceived Stress Scale (PSS-10).

RESULTS

Of the 632 eligible women, 552 (88%) agreed to participate in the study. Of those, 452 (82%) completed the study. Mean PSS-10 scores of mothers who received the film alone (15.76) or the film with the hotline service (15.86) were significantly lower than that of the control group (18.93) (p-value <0.01). Among mothers who received the hotline service alone mean PSS-10 score (16.98) was also significantly lower than that of the control group (p-value <0.05).

CONCLUSIONS

Both our postpartum support film and the 24-hour telephone hotline service reduced stress in the postpartum period in first-time mothers. These simple interventions can be easily implemented and could have an important impact on the mental wellbeing of new mothers.

TRIAL REGISTRATION

The trial was registered with clinicaltrials.gov (identifier # NCT00857051) on March 5, 2009.

Effort-reward imbalance at work and pre-clinical biological indices of ill-health: the case for salivary immunoglobulin A

Physiological indices of stress and ill-health (cortisol and salivary immunoglobulin A) were assessed to determine if they were predicted by Siegrist's effort-reward imbalance model (ERI) with an aim of identifying employees at risk of illness. Male Australian dairy farmers (N=66) completed the Perceived Stress Scale, Work related Questions II & III, Eysenck Personality Questionnaire Revised--Short and demographic questions and provided morning saliva samples (at awakening and 30 min post awakening) on a working day, which were subsequently analysed for cortisol and salivary immunoglobulin A (sIgA) concentration levels. A high percentage (45.5%) of the sample reported an imbalance between efforts and rewards in the workplace that may place them 'at risk' for ill-health. After controlling for disposition, sIgA scores were more successfully predicted by the ERI than the cortisol assessments. Although both efforts and rewards were significantly associated with sIgA, efforts were most strongly associated. The dispositional trait overcommitment, did not moderate the experience of stress on the physiologic indices. The current investigation supports the continued use of sIgA in studies that use biomarkers to assess occupational stress. ERI ratio scores >1 aligned with previous findings that suggest elevated risk of illness for these employees.

Psychosocial and psychological interventions for preventing postpartum depression

BACKGROUND

Epidemiological studies and meta-analyses of predictive studies have consistently demonstrated the importance of psychosocial and psychological variables as postpartum depression risk factors. While interventions based on these variables may be effective treatment strategies, theoretically they may also be used in pregnancy and the early postpartum period to prevent postpartum depression.

OBJECTIVES

Primary: to assess the effect of diverse psychosocial and psychological interventions compared with usual antepartum, intrapartum, or postpartum care to reduce the risk of developing postpartum depression. Secondary: to examine (1) the effectiveness of specific types of psychosocial and psychological interventions, (2) the effectiveness of professionally-based versus lay-based interventions, (3) the effectiveness of individually-based versus group-based interventions, (4) the effects of intervention onset and duration, and (5) whether interventions are more effective in women selected with specific risk factors.

SEARCH METHODS

We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (30 November 2011), scanned secondary references and contacted experts in the field. We updated the search on 31 December 2012 and added the results to the awaiting classification section of the review for assessment at the next update.

SELECTION CRITERIA

All published and unpublished randomised controlled trials of acceptable quality comparing a psychosocial or psychological intervention with usual antenatal, intrapartum, or postpartum care.

DATA COLLECTION AND ANALYSIS

Review authors and a research co-ordinator with Cochrane review experience participated in the evaluation of methodological quality and data extraction. Additional information was sought from several trial researchers. Results are presented using risk ratio (RR) for categorical data and mean difference (MD) for continuous data.

MAIN RESULTS

Twenty-eight trials, involving almost 17,000 women, contributed data to the review. Overall, women who received a psychosocial or psychological intervention were significantly less likely to develop postpartum depression compared with those receiving standard care (average RR 0.78, 95% confidence interval (CI) 0.66 to 0.93; 20 trials, 14,727 women). Several promising interventions include: (1) the provision of intensive, individualised postpartum home visits provided by public health nurses or midwives (RR 0.56, 95% CI 0.43 to 0.73; two trials, 1262 women); (2) lay (peer)-based telephone support (RR 0.54, 95% CI 0.38 to 0.77; one trial, 612 women); and (3) interpersonal psychotherapy (standardised mean difference -0.27, 95% CI -0.52 to -0.01; five trials, 366 women). Professional- and lay-based interventions were both effective in reducing the risk to develop depressive symptomatology. Individually-based interventions reduced depressive symptomatology at final assessment (RR 0.75, 95% CI 0.61 to 0.92; 14 trials, 12,914 women) as did multiple-contact interventions (RR 0.78, 95% CI 0.66 to 0.93; 16 trials, 11,850 women). Interventions that were initiated in the postpartum period also significantly reduced the risk to develop depressive symptomatology (RR 0.73, 95% CI 0.59 to 0.90; 12 trials, 12,786 women). Identifying mothers 'at-risk' assisted the prevention of postpartum depression (RR 0.66, 95% CI 0.50 to 0.88; eight trials, 1853 women).

AUTHORS' CONCLUSIONS

Overall, psychosocial and psychological interventions significantly reduce the number of women who develop postpartum depression. Promising interventions include the provision of intensive, professionally-based postpartum home visits, telephone-based peer support, and interpersonal psychotherapy.