Researchers from Université Laval in Quebec, Canada, assessed the benefits of mind-body interventions during pregnancy in preventing or treating women's anxiety and in influencing perinatal outcomes.

They 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), (December 2010) and Current Controlled Trials (1 December 2010), as well as searching the reference lists of selected studies and contacting professionals and authors in the field.

Inclusion criteria were that the studies had to be 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 included: autogenic training, biofeedback, hypnotherapy, imagery, meditation, prayer, auto-suggestion, tai-chi and yoga.  Control groups included: standard care, other pharmacological or non-pharmacological interventions, other types of mind-body interventions or no treatment at all.

Ultimately, this yielded 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, the investigators performed no meta-analysis, and instead were limited to reporting 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.

The researchers concluded that, based on individual studies, there is some evidence for the effectiveness of imagery for the management of anxiety during pregnancy. The main limitations of the studies were the paucity of studies, the lack of blinding and the insufficient details on the methods used for randomization.

Citation: Marc I, Toureche N, Ernst E, Hodnett ED, Blanchet C, Dodin S, Njoya MM. Mind-body interventions during pregnancy for preventing or treating women's anxiety. Cochrane Database Systematic Review. 2011 Jul 6; (7): CD007559.