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01-12-2014 | Case Report

Internet-based stress management for women with preterm labour—a case-based experience report

Authors: Sandra Scherer, Corinne Urech, Irene Hösli, Sibil Tschudin, Jens Gaab, Thomas Berger, Judith Alder

Published in: Archives of Women's Mental Health | Issue 6/2014

Abstract

Pregnant women with preterm labour (PTL) in pregnancy often experience increased distress and anxieties regarding both the pregnancy and the child’s health. The pathogenesis of PTL is, among other causes, related to the stress-associated activation of the maternal–foetal stress system. In spite of these psychobiological associations, only a few research studies have investigated the potential of psychological stress-reducing interventions. The following paper will present an online anxiety and stress management self-help program for pregnant women with PTL. Structure and content of the program will be illustrated by a case-based experience report. L.B., 32 years (G3, P1), was recruited at gestational week 27 while hospitalized for PTL for 3 weeks. She worked independently through the program for 6 weeks and had regular written contact with a therapist. Processing the program had a positive impact on L.B.’s anxiety and stress levels, as well as on her experienced depressive symptoms and bonding to the foetus. As PTL and the risk of PTB are associated with distress, psychological stress-reducing interventions might be beneficial. This study examines the applicability of an online intervention for pregnant women with PTL. The case report illustrates how adequate low-threshold psychological support could be provided to these women.

Alder J, Fink N, Bitzer J, Hösli I, Holzgreve W (2007) Depression and anxiety during pregnancy: a risk factor for obstetric, fetal and neonatal outcome? A critical review of the literature. J Matern Fetal Neonatal Med 20(3):189–209. doi:10.1080/14767050701209560 PubMedCrossRef

Andersson G, Cuijpers P (2009) Internet-based and other computerized psychological treatments for adult depression: a meta-analysis. Cogn Behav Ther 38(4):196–205. doi:10.1080/16506070903318960 PubMedCrossRef

Andersson G, Ljotsson B, Weise C (2011) Internet-delivered treatment to promote health. Curr opin in psychiatry 24(2):168–172. doi:10.1097/YCO.0b013e3283438028

Barak A, Hen L, Boniel-Nissim M, Shapira N (2008) A comprehensive review and a meta-analysis of the effectiveness of Internet-based psychotherapeutic interventions. J Technol Hum Serv 26:109–160CrossRef

Behrman RE, Butler AS (2007) Consequences of preterm birth In: Behrman RE, Butler AS (eds) Preterm birth: causes, consequences, and prevention. 2010/07/30 edn. National Academies Press (US), Washington (DC). doi: NBK11362 [bookaccession]

Bergant AM, Nguyen T, Heim K, Ulmer H, Dapunt O (1998) German language version and validation of the Edinburgh postnatal depression scale. Dtsch Med Wochenschr 123(3):35–40. doi:10.1055/s-2007-1023895 PubMedCrossRef

Berger T, Andersson G (2009) Internetbasierte psychotherapien: besonderheiten und empirische evidenz [Internet-based psychotherapies: characteristics and empirical evidence]. Psychother, Psychosom und med Psychol 59:159–170CrossRef

BfS (2012) Fortpflanzung, Gesundheit der Neugeborenen [Reproduction, neonatal health]. Neuchâtel, Bundesamt für Statistik. http://www.bfs.admin.ch. Accessed 20 January 2014

Brandon AR, Trivedi MH, Hynan LS, Miltenberger PD, Labat DB, Rifkin JB, Stringer CA (2008) Prenatal depression in women hospitalized for obstetric risk. J Clin Psychiatry 69(4):635–643PubMedCentralPubMedCrossRef

Cohen S, Kamarck T, Mermelstein R (1983) A global measure of perceived stress. J Health Soc Behav 24(4):385–396PubMedCrossRef

Cox JL, Holden JM, Sagovsky R (1987) Detection of postnatal depression. Development of the 10-item Edinburgh postnatal depression scale. Br J Psychiatry 150:782–786PubMedCrossRef

Cuijpers P, van Straten A, Andersson G (2008) Internet-administered cognitive behavior therapy for health problems: a systematic review. J Behav Med 31(2):169–177. doi:10.1007/s10865-007-9144-1 PubMedCentralPubMedCrossRef

de Weerth C, Buitelaar JK (2005) Physiological stress reactivity in human pregnancy—a review. Neurosci Biobehav Rev 29(2):295–312. doi:10.1016/j.neubiorev.2004.10.005 PubMedCrossRef

Dole N, Savitz DA, Hertz-Picciotto I, Siega-Riz AM, McMahon MJ, Buekens P (2003) Maternal stress and preterm birth. Am J Epidemiol 157(1):14–24PubMedCrossRef

Fink NS, Urech C, Cavelti M, Alder J (2012) Relaxation during pregnancy: what are the benefits for mother, fetus, and the newborn? A systematic review of the literature. J Perinat Neonatal Nurs 26(4):296–306. doi:10.1097/JPN.0b013e31823f565b PubMedCrossRef

Giurgescu C (2009) Are maternal cortisol levels related to preterm birth? J Obstet Gynecol Neonatal Nurs 38(4):377–390. doi:10.1111/j.1552-6909.2009.01034.x PubMedCrossRef

Gräfe K, Zipfel S, Herzog W, Löwe B (2004) Screening psychischer störungen mit dem “gesundheitsfragebogen für patienten (PHQ-D)” [screening for psychiatric disorders with the patient health questionnaire (PHQ)]. Diagnostica 50(4):171–181CrossRef

Grote NK, Bridge JA, Gavin AR, Melville JL, Iyengar S, Katon WJ (2010) A meta-analysis of depression during pregnancy and the risk of preterm birth, low birth weight, and intrauterine growth restriction. Arch Gen Psychiatry 67(10):1012–1024. doi:10.1001/archgenpsychiatry.2010.111 PubMedCentralPubMedCrossRef

Hobel CJ, Ross MG, Bemis RL, Bragonier JR, Nessim S, Sandhu M, Bear MB, Mori B (1994) The West Los Angeles Preterm Birth Prevention Project. I. Program impact on high-risk women. Am J Obstet Gynecol 170 (1 Pt 1):54–62. doi:S0002937894004199

Janke J (1999) The effect of relaxation therapy on preterm labor outcomes. J Obstet Gynecol Neonatal Nurs 28(3):255–263PubMedCrossRef

Kaluza G (2004) Stressbewältigung [stress management]. Springer, Berlin, Heidelberg

Khianman B, Pattanittum P, Thinkhamrop J, Lumbiganon P (2012) Relaxation therapy for preventing and treating preterm labour. Cochrane Database Syst Rev 8, CD007426. doi:10.1002/14651858.CD007426.pub2 PubMed

Laux L, Glanzmann P, Schaffner P, Spielberger C (1981) Das state-trait-angstinventar [the state-trait anxiety inventory]. Beltz, Weinheim

Mamelle N (2001) Psychological prevention of early pre-term birth: a reliable benefit. Biol Neonate 79(3–4):268–273PubMed

Mamelle N, Segueilla M, Munoz F, Berland M (1997) Prevention of preterm birth in patients with symptoms of preterm labor—the benefits of psychologic support. Am J Obstet Gynecol 177(4):947–952PubMedCrossRef

Mancuso RA, Schetter CD, Rini CM, Roesch SC, Hobel CJ (2004) Maternal prenatal anxiety and corticotropin-releasing hormone associated with timing of delivery. Psychosom Med 66(5):762–769. doi:10.1097/01.psy.0000138284.70670.d5 PubMedCrossRef

McGrath S, McLean M, Smith D, Bisits A, Giles W, Smith R (2002) Maternal plasma corticotropin-releasing hormone trajectories vary depending on the cause of preterm delivery. Am J Obstet Gynecol 186(2):257–260PubMedCrossRef

Moutquin J-M (2003) Classification and heterogeneity of preterm birth. BJOG 110:30–33PubMedCrossRef

Murray D, Cox JL (1990) Screening for depression during pregnancy with the edinburgh depression scale (EPDS). Journal of Reprod and Infant Psychol 8(2):99–107CrossRef

Orr ST, Reiter JP, Blazer DG, James SA (2007) Maternal prenatal pregnancy-related anxiety and spontaneous preterm birth in Baltimore, Maryland. Psychosom Med 69(6):566–570. doi:10.1097/PSY.0b013e3180cac25d PubMedCrossRef

Reading AE, Cox DN, Sledmere CM, Campbell S (1984) Psychological changes over the course of pregnancy: a study of attitudes toward the fetus/neonate. Health Psychol 3(3):211–221PubMedCrossRef

Rini CK, Dunkel-Schetter C, Wadhwa PD, Sandman CA (1999) Psychological adaptation and birth outcomes: the role of personal resources, stress, and sociocultural context in pregnancy. Health Psychol 18(4):333–345PubMedCrossRef

Ruiz RJ, Fullerton J, Dudley DJ (2003) The interrelationship of maternal stress, endocrine factors and inflammation on gestational length. Obstet Gynecol Surv 58(6):415–428. doi:10.1097/01.OGX.0000071160.26072.DE PubMed

Schneider H, Spätling L (2006) Frühgeburt: pränatale und intrapartale Aspekte [Preterm birth: prenatal and intrapartal aspects]. In: Schneider H, Husslein P, Schneider KTL (eds) Die Geburtshilfe. Springer, Berlin Heidelberg, pp 463–488CrossRef

Spek V, Cuijpers P, Nyklicek I, Riper H, Keyzer J, Pop V (2007) Internet-based cognitive behaviour therapy for symptoms of depression and anxiety: a meta-analysis. Psychol Med 37(3):319–328. doi:10.1017/s0033291706008944 PubMedCrossRef

Spielberger CD, Gorsuch RL, Lushene R, Vagg PR, Jacobs GA (1983) Manual for the state-trait anxiety inventory. Consulting Psychologists Press, Palo Alto

Stamatelou F, Deligeoroglou E, Farmakides G, Creatsas G (2009) Abnormal progesterone and corticotropin releasing hormone levels are associated with preterm labour. Ann Acad Med Singap 38(11):1011–1016PubMed

Urech C, Fink NS, Hösli I, Wilhelm FH, Bitzer J, Alder J (2010) Effects of relaxation on psychobiological wellbeing during pregnancy: a randomized controlled trial. Psychoneuroendocrinology 35(9):1348–1355PubMedCrossRef

Wagner B, Horn AB, Maercker A (2014) Internet-based versus face-to-face cognitive-behavioral intervention for depression: a randomized controlled non-inferiority trial. J Affect Disord 152–154:113–121. doi:10.1016/j.jad.2013.06.032 PubMedCrossRef

Weidner K, Bittner A, Junge-Hoffmeister J, Zimmermann K, Siedentopf F, Richter J, Joraschky P, Gatzweiler A, Stobel-Richter Y (2010) A psychosomatic intervention in pregnant in-patient women with prenatal somatic risks. J Psychosom Obstet Gynaecol 31(3):188–198. doi:10.3109/0167482X.2010.497233 PubMedCrossRef

Title: Internet-based stress management for women with preterm labour—a case-based experience report
Authors: Sandra Scherer
Corinne Urech
Irene Hösli
Sibil Tschudin
Jens Gaab
Thomas Berger
Judith Alder
Publication date: 01-12-2014
Publisher: Springer Vienna
Published in: Archives of Women's Mental Health / Issue 6/2014
Print ISSN: 1434-1816
Electronic ISSN: 1435-1102
DOI: https://doi.org/10.1007/s00737-014-0454-3

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Internet-based stress management for women with preterm labour—a case-based experience report

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