Effect of stretching exercises versus autogenic training on preeclampsia

The Effect of Body Relaxation Techniques on Pre-Eclampsia Syndrome

Background

Hypertension in the second trimester of pregnancy is accompanied by proteinuria that is called Preeclampsia Syndrome (PES). Body relaxation is a technique which makes harmony between mind and body. The aim of this study was to investigate the effect of Body Relaxation Technique (BRT) on some symptoms of Preeclampsia Syndrome (PES).

Materials and Methods

This clinical trial was conducted on 96 high-risk pregnant women who were selected by random sampling method from among women referring to community health centers of Isfahan city. The samples were divided into intervention and control groups by even and odd numbers. The intervention group members received BRT during 16 sessions. Blood pressure and proteinuria were measured and recorded before and after the intervention in both groups at the beginning and in the 36th week of pregnancy. The collected data were analyzed.

Result

According to the Chi-square test, the frequency of PES was 11.10% and 23.50% in the intervention and control groups, respectively (χ2 = 3.95, df = 1, p = 0.046). After the intervention, there was no significant difference between the two groups in terms of the diastolic blood pressure and proteinuria. Systolic blood pressure and stress were also significantly reduced in the intervention group. However, proteinuria was not significantly different between the two groups.

Conclusions

Based on the results, the relaxation technique, as an easy technique, is recommended for pregnant women who are susceptible to pregnancy hypertension and preeclampsia. Moreover, as a clinical complementary method, it can be recommended for preventing the symptoms of PES.

Autogenic Training in Mental Disorders: What Can We Expect?

Autogenic training (AT) is a well-established self-induced relaxation technique based on autosuggestion. From the past two decades, an increasing number of AT studies strongly suggests the practical usefulness of psychophysiological relaxation in the area of medicine. Despite this interest, to date, limited critical clinical reflection on the application and effects of AT in mental disorders exists. The present paper reviews psychophysiological, psychopathological, and clinical aspects of AT in persons with mental disorders with emphasis on implications for future research and practice. Based on a formal literature search, 29 reported studies (7 meta-analyses/systematic reviews) were identified that examined the effects and impact of AT on mental disorders. The main psychophysiological effects of AT include autonomic cardiorespiratory changes paralleled by central nervous system activity modifications and psychological outputs. Studies demonstrate consistent efficacy of AT in reducing anxiety and medium range positive effects for mild-to-moderate depression. The impact on bipolar disorders, psychotic disorders, and acute stress disorder remains unexplored. As an add-on intervention psychotherapy technique with beneficial outcome on psychophysiological functioning, AT represents a promising avenue towards expanding research findings of brain-body links beyond the current limits of the prevention and clinical management of number of mental disorders.

The effectiveness of Jacobson's progressive muscle relaxation technique on maternal, fetal and neonatal outcomes in women with non-severe preeclampsia: a randomized clinical trial

Background

Preeclampsia (PE), as the most common major pregnancy disorder, has serious maternal, fetal and neonatal complications, and outcomes. The present study was designed to determine the effectiveness of Jacobson's progressive muscle relaxation technique on maternal, fetal, and neonatal outcomes in women with non-severe preeclampsia (PE).

Methods

This is a randomized clinical trial conducted from March 21, 2021 to July 22, 2021 in the Kamali referral center in Karaj, Iran. A total of 88 eligible participants were assigned to intervention and control groups (44 in each group) via blocked randomization. The intervention group (6 groups of 6 participants and one group of 8 participants) received Jacobson's progressive muscle relaxation technique in addition to receiving routine care, twice a week for 6 weeks (4 face-to-face sessions and 8 online sessions). The control group only received routine perinatal care. A checklist collected data before and after the intervention. Data were analyzed in SPSS software v.23. To analyze the obtained data, independent t-test, Paired t-test, Mann-Whitney, Chi-square, and Fisher test were used.

Results

The results showed a statistically significant difference between intervention and control groups in terms of Systolic Blood pressure (SBP) (P < 0.001), Diastolic Blood pressure (DBP) (P < 0.001), 24-hour urine protein level (proteinuria) (P < 0.001). and Fasting Blood Sugar (FBS) (P < 0.001), birth Weight (BW) (P = 0.01), baseline Fetal heart rate (BFHR) (P < 0.001) and Number fetal movements based on non-stress test (NFMsN), during 20 min (P < 0.001) after intervention (P < 0.001).

Also In the intervention group, the results showed a statistically significant difference in Amniotic Fluid Index (AFI) (P = 0.01), SBP(P < 0.001), DBP(P < 0.001), proteinuria (P < 0.001), FBS(P < 0.001), BFHR based on non-stress test (NST) (P < 0.001), and NFMsN during 20 min (P < 0.001) in the intervention group before and after the intervention. There was no statistically significant difference in the control group.

Conclusion

This study's results showed the effectiveness of progressive muscle relaxation technique on the improvement of SBP, DBP, proteinuria, FBS, FHR and NFMsN during 20 min based on NST and BW in women with non-severe PE. Therefore, it is recommended to perform this technique in health centers.

Effects of Supervised Exercise on the Development of Hypertensive Disorders of Pregnancy: A Systematic Review and Meta-Analysis

Hypertensive disorders of pregnancy (HDP) are the most common medical complication in pregnancy, affecting approximately 10–15% of pregnancies worldwide. HDP are a major cause of maternal and perinatal morbidity and mortality, and each year, worldwide, around 70,000 mothers and 500,000 babies die because of HDP. Up-to-date high-quality systematic reviews quantifying the role of exercise and the risks of developing HDP are currently lacking. Physical exercise is considered to be safe and beneficial to pregnant women. Supervised exercise has been shown to be safe and to be more beneficial than unsupervised exercise in the general population, as well as during pregnancy in women with obesity and diabetes. Therefore, we undertook a systematic review and meta-analysis to investigate the effects of women performing supervised exercise during pregnancy compared to a control group (standard antenatal care or unsupervised exercise) on the development of HDP. We searched Medline, Embase, CINHAL, and the Cochrane Library, which were searched from inception to December 2021. We included only randomized controlled trials (RCTs) investigating the development of HDP compared to a control group (standard antenatal care or unsupervised exercise) in pregnant women performing supervised exercise. Two independent reviewers selected eligible trials for meta-analysis. Data collection and analyses were performed by two independent reviewers. The PROSPERO registration number is CRD42020176814. Of 6332 articles retrieved, 16 RCTs met the eligibility criteria, comparing a total of 5939 pregnant women (2904 pregnant women in the intervention group and 3035 controls). The risk for pregnant women to develop HDP was significantly reduced in the intervention compared to the control groups, with an estimated pooled cumulative incidence of developing HDP of 3% in the intervention groups (95% CI: 3 to 4) and of 5% in the control groups (95% CI: 5 to 6), and a pooled odds ratio (OR) comparing intervention to control of 0.54 (95% CI:0.40 to 0.72, p < 0.001). A combination of aerobic and anaerobic exercise, or yoga alone, had a greater beneficial effect compared to performing aerobic exercise only (mixed-OR = 0.50, 95% CI:0.33 to 0.75, p = 0.001; yoga-OR = 0.28, 95% CI:0.13 to 0.58, p = 0.001); aerobic exercise only-OR = 0.87, 95% CI:0.55 to 1.37, p = 0.539). Pregnancy is an opportunity for healthcare providers to promote positive health activities, thus optimizing the health of pregnant women with potential short- and long-term benefits for both mother and child. This systematic review and meta-analysis support a beneficial effect of either structured exercise (combination of aerobic, strength, and flexibility workouts) or yoga for preventing the onset of HDP. Yoga, considered a low-impact physical activity, could be more acceptable and safer for women in pregnancy in reducing the risk of developing HDP.

Research on the influence of prenatal exercises on anthropometric and vascular parameters in pregnant women

Introduction/Objective. The frequency of a sedentary lifestyle during pregnancy increases. This contributes to gestational weight gain and has a negative impact on health. This study researched the impact of prenatal exercise on gestational weight gain, blood pressure, and microcirculation in pregnant women who exercised and those who did not exercise. Methods. The study included seventy pregnant women with a normal pregnancy, who attended a psychophysical preparation program for childbirth for eight weeks. The control group (n=35) attended theoretical classes on childbirth, and the experimental group (n=35) attended prenatal exercises as well. Gestational weight gain, blood pressure, and nailfold capillary density were determined and compared between the two groups. Results. Gestational weight gain of 19.94 kg in non-exercising pregnant women was significantly greater than the gestational weight gain of 11.65 kg in pregnant women who exercised. Pregnant women who did not exercise had an increase in systolic (by 15.56 mmHg) and diastolic pressure (by 16.08 mmHg), which is significantly higher compared to pregnant women who exercised. In this group, systolic pressure increased by 2.5 mmHg, while diastolic did not change. A significant difference in the nailfold capillary density at the end of the prenatal program has not been determined. Conclusion. Prenatal exercise of moderate-intensity has a positive effect on gestational weight gain and the level of blood pressure in pregnant women. The nailfold capillary density has not differed significantly after the prenatal program in pregnant women who have exercised and in those who have not.

Differences in epidemiology of patients with preeclampsia between China and the US (Review)

Preeclampsia (PE) is a complex complication that occurs during pregnancy. Studies indicated that morbidity from PE exhibits marked variations among geographical areas. Disparities in the incidence of PE between China and the US may be due to differences in ethnicity and genetic susceptibility, maternal age, sexual culture, body mass index, diet, exercise, multiple pregnancies and educational background. These epidemiological differences may give rise to differences between the two countries in terms of diagnostic and therapeutic criteria for PE. PE may be largely attributed to susceptibility genes and lifestyles, such as diet, body mass index and cultural norms regarding sexual relationships. The epidemiologic differences of patients with PE between the two countries indicated that appropriate prevention plans for PE require to be developed according to local conditions.

Pregnant women's perceptions of physical activity: Adaptation of the pregnancy physical activity questionnaire in Dubai, a multicultural society

Background: There are major health benefits of physical activity (PA) during pregnancy, yet there is scant data about a woman’s knowledge and understanding of these benefits globally.

Design and Methods: We aimed to evaluate the knowledge, attitude, and practice of pregnant women in the United Arab Emirates concerning exercise. We wanted to investigate why some women exercise while others do not exercise during pregnancy. We used a cross-sectional study using a paper-based questionnaire involving pregnant women at antenatal clinics in the Dubai health Authority. The Modified form of Pregnancy Physical Activity Questionnaire (PPAQ) was adapted in both Arabic and English and used in this study.

Results: Women aging 25-35 that had a higher educational level, were employed, having 1 or 2 previous pregnancies, and having better knowledge on the benefits of Physical Activity (PA) during pregnancy had better exercise profiles.

Conclusions: Our results demonstrate that the majority of the women that participated in our study were shown to have low PA during pregnancy. Better education and communication of the benefits of PA during pregnancy are needed to improve exercise among pregnant women in the UAE population. We found that improved education of women specific to PA with involvement of a healthcare provider were associated with an increase in PA during pregnancy.

The Effect of Exercise Training During Pregnancy to Improve Maternal Vascular Health: Focus on Gestational Hypertensive Disorders

Hypertensive disorders of pregnancy, including gestational hypertension and pre-eclampsia, occur in up to 10% of pregnancies and are associated with increased life-long cardiovascular risk. Physical activity improves cardiovascular health in pregnancy and may lower the risk of developing hypertensive disorders of pregnancy. However, a minority of pregnant women comply with the recommended level of physical activity. Adequate knowledge on the physiological effects of exercise in healthy pregnancy could help to overcome potential barriers as pregnancy is a unique window of opportunity to improve health outcomes for both mother and child. In this mini review, we discuss structural and functional vascular adaptations during healthy and hypertensive pregnancies, we elaborate on the effects of exercise on the vasculature and review the safety and existing evidence of exercise training as preventive therapy for gestational hypertensive disorders.

Cerebrospinal beta-amyloid peptides(1-40) and (1-42) in severe preeclampsia and HELLP syndrome - a pilot study

During pregnancy, substantial alterations in cerebral plasticity, vascular remodeling and neuronal growth occur in the maternal brain. We investigated whether concentrations of selected neurodiagnostic biomarkers in the cerebrospinal fluid of women with preeclampsia/HELLP syndrome differ from those in healthy controls using enzyme-linked immunosorbent assay technique. We found that tau protein concentrations (p = 0.016) and phospho-tau/tau ratio (p < 0.001) in cerebrospinal fluid were significantly lower in 39 preeclamptic women compared to 44 healthy controls during third trimester of pregnancy. Beta-amyloid(1-40)/(1-42) ratio was significantly higher in HELLP syndrome than in severe preeclampsia (8.49 + 2.73 vs. 4.71 + 1.65; p = 0.007). We conclude that beta-amyloid(1-40)/(1-42) ratio in cerebrospinal fluid can discriminate severe preeclampsia and HELLP syndrome. High beta-amyloid peptide and low tau protein concentrations are associated with impaired development of the materno-feto-placental unit and correlate with placental dysfunction.