Table 6 Lifestyle interventions
Author | Intervention Description | Study Design / Analytical Approach | Intervention Delivery | Intervention Facilitator | Intervention Length | Data Time Points (PN = postnatal, GE = gestational) | Number of Participants (Intervention vs Control) | Retention Rate | Recruitment Sites and Methods | Mental Health Measures | Sleep Measures | Results Summary |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
Chang et al. (2015), Taiwan [42] | Drinking chamomile tea | RCT, between group | Self-delivered after instruction | No personal contact | One cup per day for 2 weeks | • Baseline (6 weeks PN) • Intervention end • 10 weeks PN | 80 enrolled (40 vs 40) 73 completed (35 vs 37) | 91% | Teaching hospital | EPDS-10 | PSQS-F1 PSQS-F2 | • Intervention group better sleep efficiency related to physical-symptoms immediately post intervention but not at 4 weeks (PSQS-F1) • No difference between groups in sleep efficiency related to infant night-care and daytime dysfunction (PSQS-F2) • Intervention group fewer depressive symptoms immediately post intervention and at 4 weeks |
Chen et al. (2015), Taiwan [43] | Drinking lavender tea | RCT, between group | Self-delivered after instruction | No personal contact | One cup per day for 2 weeks | • Baseline (6 weeks PN) • Intervention end • 10 weeks PN | 80 enrolled (40 vs 40) 76 completed (38 vs 38) | 95% | Medical centre clinic | EPDS-10 | PSQS-14 | • No difference between groups for sleep quality • Intervention group fewer depressive symptoms immediately post intervention but not at 4 weeks, (difference also seen at baseline) |
Field et al. (1999), USA [44] | Full body massage therapy with mother in side-lying position | RCT, between and within group | Face-to-face, individual sessions | Trained massage therapists | Ten 20-min massages twice weekly for 5 weeks | • Baseline (14–30 weeks GE) • First day of intervention (before/after treatment) • Last day of intervention (before/after treatment) • Intervention end | 26 enrolled (14 vs 12) 26 completed (14 vs 12) | 100% | Obstetrics and gynecology clinics and community advertisements | STAI-20 POMS-D CES-D-20 PAAS-P PAAS-L PAAS-W PAAS-PO | VSH-D VSH-E VSH-S | • Within group improvements in immediate (beginning to end of massage) depressive (POMS) and anxiety (STAI) symptoms • Intervention (within group) reported less disrupted sleep post intervention (VHS-D) • No difference within group on VHS effectiveness or supplementary sleep subscales • A significant group by days interaction on VHS sleep disturbance with intervention group having less disrupted sleep at intervention end • Intervention group reported less perinatal worries post intervention (PAAS-P) • No difference between groups on other PAAS subscales post intervention • No difference between groups on the CES-D post intervention |
Field et al. (2013), USA [45] | Combined form of tai chi and yoga combining balance and stretching | RCT, between group | Face-to-face, group sessions | Trained yoga instructor | One 20- minute session per week for 12 weeks | • Baseline (13–40 weeks GE) • Intervention end | 92 enrolled (46 vs 46) 75 completed (37 vs 38) | 82% | Prenatal ultrasound clinics affiliated with large university medical centre | CES-D-20 CES-DA CES-DS STAI-40 | VSH-15 | • Greater improvement in depression scores (CES-D total and subscale scores) and anxiety scores (STAI) for intervention group • Decrease in sleep disturbances for intervention group compared to an increase in sleep disturbances for control group |
Lewis et al. (2014), USA [52] | Gradual increase in moderate to vigorous intensity physical activity with and telephone support and education sessions | RCT, between group | Individual telephone sessions | Health counsellor | 11 phone sessions in 6 months (weekly in 1st month, bi-weekly in 2nd & 3rd month, in 4th, 5th & 6th month) | • Baseline (0–8 weeks PN) • Intervention end | 130 enrolled (66 vs 64) 124 completed (61 vs 63) | 95% | Online and traditional media, targeted emails and physician referrals | SCID-I PHQ-9 EPDS | PSQI-19 | • No difference between groups for sleep quality post intervention • Intervention group fewer depressive symptoms on the PHQ-9 and EPDS but no differences by clinical interview (DSM-IV) |
Liu (Y.) et al (2016), Taiwan [53] | Music listening of pre-recorded symphonic or classical, nature sounds, lullabies or Chinese children’s rhymes/songs CD’s | RCT, within and between group | CD, self-delivered after instruction | Not reported | 30 mins listening every bedtime for 2 weeks | • Baseline (18–34 weeks GE) • Intervention end | 128 enrolled (65 vs 63) 121 completed (61 vs 60) | 95% | Medical centre antenatal clinic | STAI-20 | PSQI-19 | • Improvements in sleep quality pre-post for both groups and better sleep quality post for intervention • Improved anxiety symptoms for intervention group pre-post and fewer anxiety symptoms post for intervention |
Liu (Y.) et al. (2021), Taiwan [54] | Exercise intervention, freeform, long-step walking exercise 20–30 min per session and three sessions per week. | Quasi experimental, non-randomised, between group | Home based, self-delivered after instruction | Research assistant | 20–30 min sessions, 3 times per week for 12 weeks | • Baseline (6 weeks PN) • Mid intervention (4 weeks) • Intervention end | 104 enrolled (50 vs 54) 96 completed (1 month) (47 vs 49) 88 completed (3 month) (41 vs 47) | 92% (mid intervention) 85% (intervention end) | Teaching hospital | EPDS-10 | PSQS-F1 PSQS-F2 | • No difference between groups on depressive symptoms • No difference between groups for infant night-care-related daytime dysfunction (PSQS-F1) • Intervention group fewer physical symptoms related to sleep inefficiency (PSQS-F2) mid intervention but not post intervention |
Mindell et al. (2018), USA [56] | Nightly two-step massage-based bedtime routine and quiet activities (e.g., cuddling and singing lullaby), lights out within 30 min after completing the full-body massage | RCT, between group | Self-delivered (after instruction) | Not reported | Nightly for 3 weeks | • Baseline (3–18 months PN) • Intervention end | Enrolled not reported 123 completed (64 vs 59) | Not reported | Independent clinical research organization | EPDS-10 BMIS-16 STAI-40 | PSQI-B PSQI-SOL PSQI-Awak PSQI-DAwak PSQI-TST PSQI-19 PSQI> 5 ESS-8 | • Intervention groups had reduction in number of night wakings, improved sleep quality and a significant reduction in % mothers designated as poor sleepers • No difference between groups for daytime sleepiness (ESS), bedtime, sleep latency, TST and time spent awake • No difference between groups for depressive (EDPS) or anxiety symptoms (STAI) • Intervention group had improved BMIS scores from baseline to week one and two |
Teychenne et al. (2020), Australia [67] | Home-based physical activity including treadmill or stationary bicycle, access to smartphone app, logbook for goal setting and self-monitoring, online forum for social support | RCT, between group | Self-delivered after instruction, with online forum for feedback and support | Research assistant | 12 weeks (regularity not reported) | • Baseline (3–9 months PN) • Mid intervention (4 weeks) • Mid intervention (8 weeks) • Intervention end | 62 enrolled (32 vs 30) 56 completed (31 vs 25) | 90% | Social media and websites and flyers at Maternal Child Health Centres | EPDS GAD-7 | PSQI-3 | • No difference between groups for depressive symptoms (EPDS or GAD) • No difference between groups for sleep quality |
Xue et al. (2020), China [71] | Drinking magnolia tea | RCT, between group | Self-delivered after instruction | No personal contact | One cup per day for 3 weeks | • Baseline (newly delivered) • Intervention end • 6 weeks PN | 112 enrolled (56 vs 56) 101 completed (50 vs 51) | 90% | Not reported | EPDS-10 | PSQS-F1 PSQS-F2 | • Intervention group better physical-symptom-related sleep inefficiency immediately post intervention but not at 6 weeks postnatal • No difference between groups in sleep inefficiency related to infant night-care and daytime dysfunction • Intervention group fewer depressive symptoms immediately post intervention and at 6 weeks postnatal |
Yang et al. (2018), Taiwan [72] | Aerobic gymnastic involving sitting and standing exercises using a DVD in the home | RCT, within and between group | DVD, self-delivered after instruction | No personal contact | 15 min sessions, 3 times per week for 12 weeks | • Baseline (6 weeks PN) • Mid intervention (4 weeks) • Intervention end | 140 enrolled (70 vs 70) 122 completed (60 vs 62) | 87% | Medical centre postnatal clinic | EPDS-10 | PSQS-14 PSQS-F1 PSQS-F2 | • PSQS total score decreased in the intervention compared to control at intervention end but no significant effect of group, time or interaction • PSQS sleep inefficiency score decreased for intervention group mid and post intervention. Control group decreased (significant effect of time but not group or interaction) • Depressive symptoms decreased for the intervention group mid and post intervention. Control group decreased (significant effect of time but not group or interaction) |