An Exploratory Analysis of the Utility of Adding Cardiorespiratory Biofeedback in the Standard Care of Pregnancy-Induced Hypertension

Abstract

This study examined the efficacy of a cardiorespiratory biofeedback intervention compared to bed rest in the treatment of 47 women diagnosed with pregnancy-induced hypertension (PIH). The investigation consisted of a historical control group with 31 PIH subjects receiving treatment as usual (TAU), bed rest and antihypertensive medications, and an experimental group with 16 PIH subjects receiving TAU and instruction on using a portable respiratory sinus arrhythmia (RSA) biofeedback device once daily until delivery. Results indicated that systolic and diastolic blood pressure levels were unchanged for either group. Failing to find the intended main effects, a series of exploratory analyses were performed. Findings of associated hypotheses revealed that the RSA BF group had a 35 % higher birth weight than the TAU group. The gestational age at delivery was 10 % greater in the RSA BF group than in the TAU group. A significant relationship was found between the StressEraser Total and the 1-min Apgar score. Eighty-one percent of the subjects stated that the device was relaxing. Fifty percent of the subjects believed that the device helped them fall asleep. Overall, these results suggest that portable RSA biofeedback may be effective in reducing stress during pregnancy and improving perinatal outcomes.

The Effect of Heart Rate Variability Biofeedback Training on Mental Health of Pregnant and Non-Pregnant Women: A Randomized Controlled Trial

“…This study also provides additional support for use of HRV-biofeedback as an anxiety-reducing technique during pregnancy, as in our study HRV-biofeedback resulted in a reduction of anxiety, while the pregnant women in the control group reported an increase of anxiety, which is commonly found during pregnancy [51,52,53]. Additionally, we found that the technique can be mastered in a relatively short time, also by pregnant women, which was demonstrated by Cullins et al [27] as well.…”

“…In a systematic review, Fontein-Kuipers et al [26] demonstrated a small but significant reduction in anxiety and depressive symptoms when pooling three trials using different stress-reducing techniques (i.e., a self-help support book, mindfulness training or acupuncture). HRV-biofeedback has also been tested in two studies for its effect on prenatal stress and birth outcomes [27,28], with positive results. Cullins et al [27] compared a group of women with pregnancy-induced hypertension receiving HRV-biofeedback with a similar historical treatment-as-usual control group and found that gestational age was longer and birth weight at delivery was higher in the HRV-biofeedback group than in the control group.…”

“…HRV-biofeedback has also been tested in two studies for its effect on prenatal stress and birth outcomes [27,28], with positive results. Cullins et al [27] compared a group of women with pregnancy-induced hypertension receiving HRV-biofeedback with a similar historical treatment-as-usual control group and found that gestational age was longer and birth weight at delivery was higher in the HRV-biofeedback group than in the control group. Siepmann et al [28] did not find a statistically significant difference in preterm birth between a HRV-biofeedback condition and a control condition in women with preterm labor.…”

Rumination and Cognitive Distraction in Major Depressive Disorder: an Examination of Respiratory Sinus Arrhythmia

“…RSA data collection is also far less invasive than other methods for collecting biological data. In fact, with the development of technology to collect ambulatory RSA, it is increasingly feasible to measure RSA data in applied research and clinical settings with minimal or no disruption to the individual (Cullins et al, 2013; Goedhart, de Vries, Kreft, Bakker, & de Geus, 2008; Grossman, Wilhelm, & Spoerle, 2004). …”

A Practical Guide to Resonance Frequency Assessment for Heart Rate Variability Biofeedback

“…While all HRV biofeedback training protocols are designed to stimulate the baroreflex, resonance frequency and 6-bpm slow paced breathing approaches may target different frequencies when adults are taller. Although several researchers train individuals to breathe at their resonance frequency (Lehrer et al, 2004;Lin et al, 2012;Steffen et al, 2017), others simply instruct them to breathe at slower-than-normal rates (Zautra et al, 2010;Cullins et al, 2013). There is compelling evidence that breathing near an individual's resonance frequency -but not at the exact rate -increases RSA amplitude and baroreflex gain compared with other frequencies (Vaschillo et al, 2002(Vaschillo et al, , 2004Lehrer et al, 2020a).…”