Resting Heart Rate Variability and the Effects of Biofeedback Intervention in Women with Low-Risk Pregnancy and Prenatal Childbirth Fear
Resting Heart Rate Variability and the Effects of Biofeedback Intervention in Women with Low-Risk Pregnancy and Prenatal Childbirth Fear
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DOI：
10.1007/s10484-018-9389-1
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发表时间：
2018-02
影响因子：
3
通讯作者：
Yoshimi Narita;H. Shinohara;Hideya Kodama
中科院分区：
文献类型：
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作者：
Yoshimi Narita;H. Shinohara;Hideya Kodama
在怀孕结束时，妇女对分娩的焦虑有时会达到临床关注的程度。我们调查了在最后三个月期间患有分娩恐惧的低风险孕妇是否表现出关于静息心率变异性（HRV）的具体发现，并检查了HRV生物反馈是否可以减少这种恐惧并改变静息HRV。我们测量了97名低风险孕妇在妊娠第32 - 34周的分娩恐惧水平（Wijma分娩预期/经验问卷，W-DEQ）和静息HRV指标，并建议W-DEQ评分≥ 66（n = 40）的妇女在家练习HRV生物反馈（StressEraser）。然后，我们在妊娠3-4周后的第36 - 37周重新评估这些措施，无论妇女是否练习该方法。我们发现，当W-DEQ截止值传统上设置为≥ 66时，分娩恐惧对静息HRV指标没有显著影响。然而，W-DEQ评分≥ 90的女性（n = 5）的高频功率显著低于其对应者（p = 0.028）。进行HRV生物反馈的女性W-DEQ评分显著降低（n = 18，p < 0.001），但未进行该方法的女性W-DEQ评分无变化（n = 20）。这些结果表明，W-DEQ评分≥ 90分（而非常规标准（W-DEQ评分≥ 66分）的孕妇，其副交感神经活性较低，HRV生物反馈干预可有效降低这些孕妇的分娩恐惧。
Anxiety about labor in women at the end of pregnancy sometimes reaches levels that are clinically concerning. We investigated whether low-risk pregnant women with childbirth fear during the last trimester demonstrate specific findings with regard to resting heart rate variability (HRV) and examined whether HRV biofeedback can reduce this fear and alter resting HRV. We measured the levels of childbirth fear (Wijma delivery expectancy/experience questionnaire, W-DEQ) and resting HRV indexes in 97 low-risk pregnant women in their 32nd–34th week of gestation and advised women with W-DEQ scores of ≥ 66 (n = 40) to practice HRV biofeedback (StressEraser) at home. We then reassessed these measures 3–4 weeks later in the 36th–37th week of gestation regardless of whether the women practiced the method. We found that childbirth fear had no significant effect on resting HRV indexes when the W-DEQ cutoff was conventionally set at ≥ 66. However, women with W-DEQ scores of ≥ 90 (n = 5) had a significantly lower high-frequency power than their counterparts (p = 0.028). The W-DEQ scores reduced significantly in women who performed HRV biofeedback (n = 18, p < 0.001), but there was no change in those who did not perform the method (n = 20). These findings suggested that very high W-DEQ scores (≥ 90), but not the conventional criteria (W-DEQ score ≥ 66), of the fear of childbirth were associated with low parasympathetic activity among low-risk pregnant women and that HRV biofeedback intervention can effectively decrease the fear of childbirth in these women.