Massage To Improve Uterine Artery Blood Flow
| Status: | Completed |
|---|---|
| Conditions: | Depression, Depression, Women's Studies |
| Therapuetic Areas: | Psychiatry / Psychology, Reproductive |
| Healthy: | No |
| Age Range: | 18 - 40 |
| Updated: | 4/21/2016 |
| Start Date: | February 2012 |
| End Date: | September 2015 |
Massage to Reduce Intrauterine Artery Resistance, Prematurity and Low Birthweight
This project will investigate the effects of massage therapy on depressed pregnant women.
The investigators expect that massage therapy will improve blood flow from the mother to the
fetus and reduce prematurity and depression.
The investigators expect that massage therapy will improve blood flow from the mother to the
fetus and reduce prematurity and depression.
Prenatal depression has been associated with adverse neonatal outcomes including preterm
birth and low birthweight. Potential underlying mechanisms for prenatal depression effects
on prematurity and low birthweight involve the elevated sympathetic nervous system SNS and
Hypothalamic Pituitary Adrenal HPA Axis function noted in depressed pregnant women. These
may lead to increased uterine artery resistance and the resulting limited blood flow, oxygen
and nutrients to the fetus. Moderate pressure massage therapy may reduce this problem in
depressed pregnant women by decreasing SNS and HPA axis function, resulting in decreased
uterine artery resistance, increased oxygen and nutrients to the fetus and lower prematurity
and low birthweight. An alternative model being explored here is that moderate pressure
massage may increase progesterone/estriol ratios, which counteract the negative cortisol
effects on gestational age. Eighty pregnant women with depression symptoms will be recruited
at approximately 20 weeks gestation and randomly assigned to a moderate pressure massage
therapy or to a SHAM light pressure massage touch/attention control group. The women will
receive 20-minute weekly massage therapy sessions from 20 to 30 weeks gestation. At 20 and
30 weeks gestation, depressed symptoms will be assessed using the CES-D, and saliva samples
will be collected to assay alpha amylase as an SNS marker, cortisol as an HPA axis marker
and progesterone and estriol levels. Maternal Doppler ultrasound will be conducted to assess
the uterine artery resistance index as an estimate of uterine artery blood flow. Upon
delivery, the mothers' medical charts will be reviewed to record gestational age and
birthweight. The investigators are hypothesizing that the moderate pressure massage group
will elicit an increase in progesterone/estriol ratios and decreases in alpha amylase and
cortisol levels, which in turn will lead to reduced uterine artery resistance and a lower
incidence of prematurity and low birthweight.
birth and low birthweight. Potential underlying mechanisms for prenatal depression effects
on prematurity and low birthweight involve the elevated sympathetic nervous system SNS and
Hypothalamic Pituitary Adrenal HPA Axis function noted in depressed pregnant women. These
may lead to increased uterine artery resistance and the resulting limited blood flow, oxygen
and nutrients to the fetus. Moderate pressure massage therapy may reduce this problem in
depressed pregnant women by decreasing SNS and HPA axis function, resulting in decreased
uterine artery resistance, increased oxygen and nutrients to the fetus and lower prematurity
and low birthweight. An alternative model being explored here is that moderate pressure
massage may increase progesterone/estriol ratios, which counteract the negative cortisol
effects on gestational age. Eighty pregnant women with depression symptoms will be recruited
at approximately 20 weeks gestation and randomly assigned to a moderate pressure massage
therapy or to a SHAM light pressure massage touch/attention control group. The women will
receive 20-minute weekly massage therapy sessions from 20 to 30 weeks gestation. At 20 and
30 weeks gestation, depressed symptoms will be assessed using the CES-D, and saliva samples
will be collected to assay alpha amylase as an SNS marker, cortisol as an HPA axis marker
and progesterone and estriol levels. Maternal Doppler ultrasound will be conducted to assess
the uterine artery resistance index as an estimate of uterine artery blood flow. Upon
delivery, the mothers' medical charts will be reviewed to record gestational age and
birthweight. The investigators are hypothesizing that the moderate pressure massage group
will elicit an increase in progesterone/estriol ratios and decreases in alpha amylase and
cortisol levels, which in turn will lead to reduced uterine artery resistance and a lower
incidence of prematurity and low birthweight.
Inclusion Criteria:
- Uncomplicated singleton pregnancy
- Depression
- < 20 weeks GA at recruitment
Exclusion Criteria:
- Pregnancy complications
- HIV
- Smoking, drug use
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University of Miami A private research university with more than 15,000 students from around the...
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