Antepartum Bed Rest for Pregnancy Complications: Efficacy and Safety for Preventing Preterm Birth
Abstract
Preterm birth is the major maternal-child health issue across developed nations and the leading cause of perinatal mortality and morbidity. Of all deaths of infants <1 year of age in the United States in 2005, 68.6% occurred in infants born prior to term. Although the preterm birth rate in European countries is 5-7%, the U.S. preterm birth rate is 12.7%, representing an increase of 9% since 2000. Antepartum bed rest/activity restriction (ABR/AR) has been a mainstay of treatment to prevent preterm birth for the past 30 years prescribed for nearly 1 million women in the United States annually, despite a lack of evidence for its effectiveness. In fact, there is increasing evidence that ABR causes several adverse physiologic and psychological side effects among women and their infants. Unfortunately, these findings have had little impact on clinical practice. This integrative review of literature provides a comprehensive analysis of the evidence for the practice of prescribing ABR and its physiologic, behavioral, and experiential side effects. It also presents a model to guide continuing research about the effects of maternal bed rest as well as evidence supporting the use of home care with bed rest, a different, safe, and feasible model of prenatal care for treating women with pregnancy complications used particularly in other countries. Finally, suggestions to improve the health of high-risk pregnant and postpartum women and their infants are provided.
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There is no evidence to support the use of activity restriction during pregnancy at home or in hospital.
“There is no evidence to support the use of activity restriction during pregnancy at home or in hospital, and practitioners should not assume efficacy for bed-rest treatment until evidence is produced [9,10,18,19].”
From Lack of evidence for prescription of antepartum bed rest (2011) · cites this paper as [10]
The assumption that antepartum bed-rest treatment is safe for mothers and their fetuses/infants has no data providing evidence to support it.
“The second assumption behind antepartum bed-rest treatment, that it is safe for mothers and their fetuses/infants, has no data providing evidence to support it [10].”
From Lack of evidence for prescription of antepartum bed rest (2011) · cites this paper as [10]
Studies of women treated with pregnancy bed-rest identify psychosocial problems as a side effect.
“Studies of women treated with pregnancy bed-rest identify numerous side effects, including muscle atrophy, bone loss, weight loss, decreased infant birthweight in singleton gestations and gestational age at birth, and psychosocial problems.”
From Lack of evidence for prescription of antepartum bed rest (2011) · cites this paper as [10]
Studies of women treated with pregnancy bed-rest identify weight loss as a side effect.
“Studies of women treated with pregnancy bed-rest identify numerous side effects, including muscle atrophy, bone loss, weight loss, decreased infant birthweight in singleton gestations and gestational age at birth, and psychosocial problems.”
From Lack of evidence for prescription of antepartum bed rest (2011) · cites this paper as [10]
Studies of women treated with pregnancy bed-rest identify bone loss as a side effect.
“Studies of women treated with pregnancy bed-rest identify numerous side effects, including muscle atrophy, bone loss, weight loss, decreased infant birthweight in singleton gestations and gestational age at birth, and psychosocial problems.”
From Lack of evidence for prescription of antepartum bed rest (2011) · cites this paper as [10]
Studies of women treated with pregnancy bed-rest identify decreased infant birthweight in singleton gestations as a side effect.
“Studies of women treated with pregnancy bed-rest identify numerous side effects, including muscle atrophy, bone loss, weight loss, decreased infant birthweight in singleton gestations and gestational age at birth, and psychosocial problems.”
From Lack of evidence for prescription of antepartum bed rest (2011) · cites this paper as [10]
Studies of women treated with pregnancy bed-rest identify decreased gestational age at birth as a side effect.
“Studies of women treated with pregnancy bed-rest identify numerous side effects, including muscle atrophy, bone loss, weight loss, decreased infant birthweight in singleton gestations and gestational age at birth, and psychosocial problems.”
From Lack of evidence for prescription of antepartum bed rest (2011) · cites this paper as [10]
Studies of women treated with pregnancy bed-rest identify muscle atrophy as a side effect.
“Studies of women treated with pregnancy bed-rest identify numerous side effects, including muscle atrophy, bone loss, weight loss, decreased infant birthweight in singleton gestations and gestational age at birth, and psychosocial problems.”
From Lack of evidence for prescription of antepartum bed rest (2011) · cites this paper as [10]
The variables of bed-rest treatment and high-risk pregnancy are confounded.
“Thus, the variables of bed-rest treatment and high-risk pregnancy are confounded [10].”
From Lack of evidence for prescription of antepartum bed rest (2011) · cites this paper as [10]
Some practitioners believe that bed rest is of little benefit but report continued use.
“Still, other practitioners believe that bed rest is of little benefit but report continued use [1,4,10].”
From Lack of evidence for prescription of antepartum bed rest (2011) · cites this paper as [10]
Most obstetric healthcare providers are unaware of the adverse effects of bed rest or they believe that effects are of minor consequence.
“Research documents that most obstetric healthcare providers are unaware of the adverse effects of bed rest or they believe that effects are of minor consequence [1,3,4,10,18].”
From Lack of evidence for prescription of antepartum bed rest (2011) · cites this paper as [10]
Prescription of bed rest may continue because fellow colleagues also prescribe it.
“Prescription of bed rest may continue because fellow colleagues also prescribe it [4,10].”
From Lack of evidence for prescription of antepartum bed rest (2011) · cites this paper as [10]
Others state that they use bed rest because there are limited effective interventions to prevent preterm birth, and that abstaining from using interventions in high-risk pregnancy is difficult since neonatal outcomes are often serious.
“Others state that they use bed rest because there are limited effective interventions to prevent preterm birth, and that abstaining from using interventions in high-risk pregnancy is difficult since neonatal outcomes are often serious [4,10].”
From Lack of evidence for prescription of antepartum bed rest (2011) · cites this paper as [10]
Continued use of bed rest appears to be due to a lack of knowledge or attention to research regarding effectiveness and the adverse side effects, or a discounting of the evidence.
“Therefore, continued use appears to be due to a lack of knowledge or attention to research regarding effectiveness and the adverse side effects, or a discounting of the evidence [4,10].”
From Lack of evidence for prescription of antepartum bed rest (2011) · cites this paper as [10]
Prescription of bed rest appears to be based upon the belief that rest does little harm and that maternal activity is related to physical forces that stimulate uterine contractions, cervical effacement and dilation.
“Prescription of bed rest appears to be based upon the belief that rest does little harm and that maternal activity is related to physical forces that stimulate uterine contractions, cervical effacement and dilation [1,4,10].”
From Lack of evidence for prescription of antepartum bed rest (2011) · cites this paper as [10]
Prescription of bed rest in the USA, Canada and other countries continues.
“Despite these new data, prescription of bed rest in the USA, Canada and other countries continues [1–4,10].”
From Lack of evidence for prescription of antepartum bed rest (2011) · cites this paper as [10]
Health concerns, loss of control, uncertainty, isolation, separation from home, bed rest, physical discomfort, and invasive obstetric treatments are important stressors for hospitalized pregnant women.
“Health concerns, loss of control, uncertainty, isolation, separation from home, bed rest, physical discomfort, and obstetric treatments that are often physically and psychologically invasive constitute important stressors (11, 12).”
From Acceptance, experiences, and needs of hospitalized pregnant women toward an electronic mindfulness-based intervention: A pilot mixed-methods study (2022) · cites this paper as [12]
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BackgroundResultInfluentialSelf-citationPlacenta previa: Antepartum conservative management, inpatient versus outpatient
Mouer, J. R. (1994) · American Journal of Obstetrics and Gynecology · doi:10.1016/s0002-9378(94)70341-8 · Cited by 53 · see citing works
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Inactivity: Symptoms Associated With Gastrocnemius Muscle Disuse During Pregnancy
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Self-citationThe Evolution of Bed Rest as a Clinical Intervention
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Energy absorption, lean body mass, and total body fat changes during 5 weeks of continuous bed rest.
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Effect of bed rest during pregnancy on bone turnover markers in pregnant and postpartum women
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Prescription of Activity Restriction to Treat High-Risk Pregnancies
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Self-citationAntepartum Bed Rest: Maternal Weight Change and Infant Birth Weight
Maloni, J. A., Alexander, G. R., Schluchter, M. D., Shah, D. M., & Park, S. (2004) · Biological Research For Nursing · doi:10.1177/1099800403260307 · Cited by 39 · see citing works
Self-citationImpact of Maternal Activity Restriction for Preterm Labour on the Expectant Father
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IMPACT OF PRESCRIBED ACTIVITY RESTRICTION DURING PREGNANCY ON WOMEN AND FAMILIES
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Multiple Gestation: Side Effects of Antepartum Bed Rest
Maloni, J. A., Margevicius, S. P., & Damato, E. G. (2006) · Biological Research For Nursing · doi:10.1177/1099800406291455 · Cited by 36 · see citing works
Self-citationBed Rest and Sensory Disturbances
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Community-based home-care program for the management of pre-eclampsia: an alternative.
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Physical and Psychosocial Effects of Anteparturn Hospital Bedrest: A Review of the Literature
Maloni, J. A., & Kasper, C. E. (1991) · Image: the Journal of Nursing Scholarship · doi:10.1111/j.1547-5069.1991.tb00667.x · Cited by 33 · see citing works
Self-citationBlood pressure values in children with intrauterine growth retardation.
Fattal‐Valevski, A., Bernheim, J., Leitner, Y., Redianu, B., Bassan, H., & Harel, S. (2001) · PubMed · Cited by 31 · see citing works
In-home nursing care for women with high-risk pregnancies: outcomes and cost
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Fathers' Experience of Their Partners' Antepartum Bed Rest
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Self-citationReducing the Preterm Birth Rate: A Population Health Strategy
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Changes in serum markers of bone turnover during normal pregnancy
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Hospitalization for Women With Arrested Preterm Labor
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Decisional conflict in general practice: Strategies of patient management
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“Waiting” as Experienced by Women Hospitalized During the Antepartum Period
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State of Nursing Science: On the Edge
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High risk pregnancy monitored antenatally at home
Monincx, W. M., Zondervan, H. A., Birnie, E., Ris, M., & Bossuyt, P. M. (1997) · European Journal of Obstetrics & Gynecology and Reproductive Biology · doi:10.1016/s0301-2115(97)00122-x · Cited by 21 · see citing works
Bed rest and high-risk pregnancy. Differentiating the effects of diagnosis, setting, and treatment.
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BED REST AND HIGH-RISK PREGNANCY
Maloni, J. A. (1996) · Nursing Clinics of North America · doi:10.1016/s0029-6465(22)00142-6 · Cited by 20 · see citing works
Self-citationPlacenta previa: Antepartum conservative management, inpatient versus outpatient
Mouer, J. R. (1994) · American Journal of Obstetrics and Gynecology · doi:10.1016/s0002-9378(12)91835-9 · Cited by 17 · see citing works
Monincx, W. M., Birnie, E., Zondervan, H. A., Bleker, O. P., & Bonsel, G. J. (2001) · European Journal of Obstetrics & Gynecology and Reproductive Biology · doi:10.1016/s0301-2115(00)00351-1 · Cited by 16 · see citing works
Women's responses to two models of antepartum high-risk care: Day stay and hospital stay
Stainton, M. C., Lohan, M., Fethney, J., Woodhart, L., & Islam, S. (2006) · Women and Birth · doi:10.1016/j.wombi.2006.08.001 · Cited by 15 · see citing works
Where and to What Extent is Prevention of Low Birth Weight Possible?
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Psychological Effects of Long-Duration Space Missions and Stress Amelioration Techniques
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COMMITTEE ON CREATING A VISION FOR SPACE MEDICINE DURING TRAVEL BEYOND EARTH ORBIT
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Clinical and Economic Outcomes of Preterm Labor Management: Inpatient vs Outpatient
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Long-Term Effects of Antepartum Bed Rest on Offspring
Bellieni, C. V., Bagnoli, F., Perrone, S., Caparelli, N., Cordelli, D. M., Melissa, B., & Buonocore, G. (2003) · Neonatology · doi:10.1159/000071949 · Cited by 8 · see citing works
Women's experiences of being in high-risk antenatal care day stay and hospital admission
Stainton, M. C., Lohan, M., & Woodhart, L. (2005) · Australian Midwifery · doi:10.1016/s1448-8272(05)80014-8 · Cited by 8 · see citing works
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The Psychological Aspects of Immobilization
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Program Evaluation of Hospital-Based Antenatal Home Care for High-Risk Women
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Dietary Studies in the Joint US-Russian Space Program
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Descriptive Epidemiology and Trends
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Helewa, M. E., Heaman, M. I., & Dewar, L. D. (2000) · Journal SOGC · doi:10.1016/s0849-5831(16)30417-7 · Cited by 2 · see citing works
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Practice Bulletin No. 171: Management of Preterm Labor
(2016) · Obstetrics and Gynecology · doi:10.1097/aog.0000000000001711 · Cited by 538 · see citing works
Bed rest in singleton pregnancies for preventing preterm birth
Sosa, C. G., Althabe, F., Belizán, J. M., & Bergel, E. (2015) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd003581.pub3 · Cited by 172 · see citing works
“Doing the month”: P ostpartum practices in C hinese women
Liu, Y. Q., Petrini, M. A., & Maloni, J. A. (2014) · Nursing and Health Sciences · doi:10.1111/nhs.12146 · Cited by 105 · see citing works
Self-citationMaloni, J. A., Przeworski, A., & Damato, E. G. (2013) · Archives of Psychiatric Nursing · doi:10.1016/j.apnu.2012.12.001 · Cited by 80 · see citing works
Self-citationVoltolini, C., Torricelli, M., Conti, N., Vellucci, F. L., Severi, F. M., & Petraglia, F. (2013) · Reproductive Sciences · doi:10.1177/1933719113477496 · Cited by 63 · see citing works
“Furthermore, the potential harm, including venous thromboembolism, bone demineralization, and deconditioning, and the negative effects, such as loss of employment, should not be underestimated.(173,174)”
BackgroundBed rest with and without hospitalisation in multiple pregnancy for improving perinatal outcomes
da Silva Lopes, K., Takemoto, Y., Ota, E., Tanigaki, S., & Mori, R. (2017) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd012031.pub2 · Cited by 59 · see citing works
“Women who are recommended to partially rest are not restricted in physical activity, but encouraged to stay in bed for a few hours during the day (Maloni 2010; Sciscione 2010).”
BackgroundLiu, Y. Q., Maloni, J. A., & Petrini, M. A. (2012) · Biological Research For Nursing · doi:10.1177/1099800412465107 · Cited by 55 · see citing works
“These results are not surprising given that activity restriction commonly causes cardiovascular and musculoskeletal deconditioning from which individuals do not quickly recover despite 2 weeks of mobilization (Maloni, 2010; Maloni & Schneider, 2002).”
BackgroundResultInfluentialSelf-citationLack of evidence for prescription of antepartum bed rest
Maloni, J. A. (2011) · Expert Review of Obstetrics & Gynecology · doi:10.1586/eog.11.28 · Cited by 53 · see citing works
“Limitations to the study of the side effects of bed rest have been extensively detailed elsewhere [10].”
BackgroundResultInfluentialSelf-citation(2015) · Obstetrics and Gynecology · doi:10.1097/aog.0000000000001265 · Cited by 46 · see citing works
Eleje, G. U., Eke, A. C., Ikechebelu, J. I., Ezebialu, I. U., Okam, P. C., & Ilika, C. P. (2020) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd012871.pub2 · Cited by 44 · see citing works
“[PMID: 22579125] Maloni 2010 Maloni JA.”
BackgroundInfluentialWomen's Experience of Hospitalized Bed Rest During High‐Risk Pregnancy
Rubarth, L. B., Schoening, A. M., Cosimano, A., & Sandhurst, H. (2012) · Journal of Obstetric, Gynecologic & Neonatal Nursing · doi:10.1111/j.1552-6909.2012.01349.x · Cited by 43 · see citing works
“In an attempt to shorten hospital stays, some physicians are discharging patients earlier or placing them on home care (Maloni, 2010).”
BackgroundInfluentialThe support needs of high-risk antenatal patients in prolonged hospitalisation
Kent, R. A., Yazbek, M., Heyns, T., & Coetzee, I. (2015) · Midwifery · doi:10.1016/j.midw.2014.08.003 · Cited by 36 · see citing works
“Bed rest is a very common obstetrical management to restrict maternal activity even though there is minimal evidence that it decreases the risk of preterm delivery (Maloni, 2010).”
BackgroundBigelow, C. A., & Stone, J. L. (2011) · Mount Sinai Journal of Medicine A Journal of Translational and Personalized Medicine · doi:10.1002/msj.20243 · Cited by 39 · see citing works
Vasapollo, B., Presti, D. L., Gagliardi, G., Farsetti, D., Tiralongo, G. M., Pisani, I., Novelli, G. P., & Valensise, H. C. C. (2017) · Ultrasound in Obstetrics and Gynecology · doi:10.1002/uog.17489 · Cited by 34 · see citing works
Tocolysis: A Review of the Literature
Hanley, M., Sayres, L. C., Reiff, E. S., Wood, A. M., Grotegut, C. A., & Kuller, J. A. (2019) · Obstetrical & Gynecological Survey · doi:10.1097/ogx.0000000000000635 · Cited by 33 · see citing works
Adjunctive Therapies to Cerclage for the Prevention of Preterm Birth: A Systematic Review
DeFranco, E., Valent, A. M., Newman, T., Regan, J. K., Smith, J. C., & Muglia, L. J. (2013) · Obstetrics and Gynecology International · doi:10.1155/2013/528158 · Cited by 32 · see citing works
“The American College of Obstetricians and Gynecologists stated in the recent practice bulletin on the management of preterm labor (2012) that antibiotics should not be used to prolong gestation in women with preterm labor and intact membranes, and bedrest for the prevention of preterm birth should…”
BackgroundCoyne, L., & Stockdale, C. K. (2017) · Cambridge University Press eBooks · doi:10.1017/9781316662571.036 · Cited by 29 · see citing works
Development of a Tool to Assess Risk for Falls in Women in Hospital Obstetric Units
Heafner, L., Suda, D., Casalenuovo, N. M., Leach, L. S., Erickson, V., & Gawlinski, A. (2013) · Nursing for Women s Health · doi:10.1111/1751-486x.12018 · Cited by 28 · see citing works
Biggio, J. (2013) · Obstetrics and Gynecology · doi:10.1097/aog.0b013e318294480d · Cited by 28 · see citing works
Smorti, M., Ginobbi, F., Simoncini, T., Pancetti, F., Carducci, A., Mauri, G., & Gemignani, A. (2021) · Current Psychology · doi:10.1007/s12144-021-01902-5 · Cited by 27 · see citing works
“The most common treatment for prevention of preterm birth in the United States is antepartum bed rest and, in some cases, hospitalized bed rest (Maloni, 2010).”
BackgroundCampbell, F., Salam, S. S., Sutton, A., Jayasooriya, S., Mitchell, C. A., Amabebe, E., Balen, J., Gillespie, B., Parris, K. M., Soma‐Pillay, P., et al. (2022) · BMJ Open · doi:10.1136/bmjopen-2021-052576 · Cited by 24 · see citing works
Bendix, J. M., Hegaard, H. K., Langhoff‐Roos, J., & Bergholt, T. (2016) · Clinical Epidemiology · doi:10.2147/clep.s102029 · Cited by 23 · see citing works
“56) Partner status Cohabitant with partner 39,750 (7) 494,242 (93) 1 1 Single status 8,239 (11) 69,329 (89) 1.”
Zemet, R., Schiff, E., Manovitch, Z., Cahan, T., Yoeli-Ullman, R., Brandt, B., Hendler, I., Dorfman-Margolis, L., Yinon, Y., Sivan, E., et al. (2018) · PLoS ONE · doi:10.1371/journal.pone.0198949 · Cited by 23 · see citing works
Integrative Therapies for Women with a High Risk Pregnancy During Antepartum Hospitalization
Schlegel, M. L., Whalen, J. L., & Williamsen, P. M. (2016) · MCN The American Journal of Maternal/Child Nursing · doi:10.1097/nmc.0000000000000279 · Cited by 22 · see citing works
“Being hospitalized during pregnancy is known to exacerbate some of these symptoms (Maloni, 2010).”
BackgroundInfluentialThe Effect of Maternal Postpartum Practices on Infant Gut Microbiota: A Chinese Cohort Study
Wang, Y., Liu, Y., Bai, J., & Chen, X. (2019) · Microorganisms · doi:10.3390/microorganisms7110511 · Cited by 20 · see citing works
“The restriction of physical activity is known to cause musculoskeletal and cardiovascular deconditioning [32,41].”
BackgroundVettore, M. V., Dias, M. A. B., Vettore, M. V., & Leal, M. D. C. (2013) · Revista Brasileira de Saúde Materno Infantil · doi:10.1590/s1519-38292013000200002 · Cited by 21 · see citing works
Nakamura, Y., Takeishi, Y., Atogami, F., & Yoshizawa, T. (2012) · Nursing and Health Sciences · doi:10.1111/j.1442-2018.2011.00676.x · Cited by 20 · see citing works
“High-risk pregnant women are often hospitalized during their pregnancy and treated with bed rest or activity restriction, and 24 h continuous intravenous treatment with ritodrine hydrochloride (Maloni, 2010).”
BackgroundMaternal development experiences of women hospitalized to prevent preterm birth
Lederman, R. P., Boyd, E., Pitts, K., Roberts-Gray, C. R., Hutchinson, M. S., & Blackwell, S. C. (2013) · Sexual & Reproductive Healthcare · doi:10.1016/j.srhc.2013.10.004 · Cited by 20 · see citing works
“Among the ways hospitalization with ABR was indicated to have had a positive influence upon maternal development were: heightened identification with motherhood protector role; intensification of renewal or deepening of the pregnant woman’s relationship with her own mother or a mother substitute; and enhanced couple s…”
BackgroundResultInfluentialPhysiological Effects of Aquatic Exercise in Pregnant Women on Bed Rest
Sechrist, D. M., Tiongco, C. G., Whisner, S. M., & Geddie, M. D. (2015) · Occupational Therapy In Health Care · doi:10.3109/07380577.2014.982314 · Cited by 19 · see citing works
Effects of support interventions in women hospitalized with preterm labor
Kao, M.-H., Hsu, P.-F., Tien, S.-F., & Chen, C.-P. (2019) · Clinical Nursing Research · doi:10.1177/1054773817744323 · Cited by 17 · see citing works
“Previous reports have revealed the relationship between PTL and anxiety and depression (Heaman & Gupton, 1998; Maloni, 2010).”
MacGibbon, K. (2020) · Journal of Infusion Nursing · doi:10.1097/nan.0000000000000363 · Cited by 18 · see citing works
Bed-rest exercise, activity restriction, and high-risk pregnancies: A feasibility study
Brun, C. R., Shoemaker, J. K., Bocking, A., Hammond, J.-A., Poole, M., & Mottola, M. F. (2011) · Applied Physiology Nutrition and Metabolism · doi:10.1139/h11-036 · Cited by 16 · see citing works
Kim, Y. J., & Park, Y.-J. (2018) · Asian Nursing Research · doi:10.1016/j.anr.2017.12.003 · Cited by 16 · see citing works
Schiele, C., Goetz, M., Hassdenteufel, K., Müller, M., Graf, J., Zipfel, S., & Wallwiener, S. (2022) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2022.939577 · Cited by 12 · see citing works
“Health concerns, loss of control, uncertainty, isolation, separation from home, bed rest, physical discomfort, and obstetric treatments that are often physically and psychologically invasive constitute important stressors (11, 12).”
BackgroundBone Status in Activity-Restricted Pregnant Women Assessed Using Calcaneal Quantitative Ultrasound
Brandao, K. L., Mottola, M. F., Gratton, R., & Maloni, J. (2013) · Biological Research For Nursing · doi:10.1177/1099800411423807 · Cited by 12 · see citing works
“Antenatal activity restriction (AR), employed as the main treatment modality for high-risk obstetric conditions (Maloni, 2010; Sciscione, 2010), may exacerbate pregnancy-induced bone resorption and compromise maternal bone status.”
BackgroundSelf-citationEleje, G. U., Ikechebelu, J. I., Eke, A. C., Okam, P. C., Ezebialu, I. U., & Ilika, C. P. (2017) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd012871 · Cited by 12 · see citing works
Assessments of maternal psychosocial adaptation for pre-labor hospitalized pregnant women in Japan
Nakamura, Y., Yoshizawa, T., & Atogami, F. (2011) · Nursing Reports · doi:10.4081/nursrep.2011.e9 · Cited by 11 · see citing works
Liu, Y., Hu, J., Chen, X., Yu, Y., & Bai, J. (2020) · Midwifery · doi:10.1016/j.midw.2020.102796 · Cited by 10 · see citing works
Recommendations of activity restriction in high-risk pregnancy scenarios: a Danish national survey
Bendix, J., Hegaard, H. K., Bergholt, T., & Langhoff-Roos, J. (2015) · Journal of Perinatal Medicine · doi:10.1515/jpm-2013-0347 · Cited by 9 · see citing works
“However, AR has not been proven to have any preventive effect [2, 6, 7, 26, 29] , but it is associated with several adverse effects [11, 12, 25] such as venous thromboembolism [10] ; depression, mental stress, and psychosocial effects [13 – 15, 34] ; and a decrease in bone mineral density [21] and muscle mass [16] .”
BackgroundSilva-José, C., Mottola, M. F., Palacio, M., Sánchez‐Polán, M., Zhang, D., Refoyo, I., & Barakat, R. (2023) · Journal of Personalized Medicine · doi:10.3390/jpm14010014 · Cited by 9 · see citing works
“Moreover, a significant drawback of bed rest lies in its restriction of various stimuli, including kinesthetic, tactile, auditory, visual, environmental, intellectual, emotional, and social interactions, which can have adverse consequences [15].”
BackgroundON BEING MOTHER AND PATIENT: DIALECTICAL STRUGGLES DURING MEDICALLY HIGH‐RISK PREGNANCY
McCoyd, J. L. M., Munch, S., & Curran, L. (2018) · Infant Mental Health Journal · doi:10.1002/imhj.21744 · Cited by 9 · see citing works
Depressive symptoms during pregnancy: Exploring the role of sitting
Watts, J. N., Miller, Y. D., & Marshall, A. L. (2012) · Mental health and physical activity · doi:10.1016/j.mhpa.2012.08.001 · Cited by 9 · see citing works
Effects of Relaxation-Focused Nursing Care in Women in Preterm Labor
Özberk, H., Mete, S., & Bektaş, M. (2020) · Biological Research For Nursing · doi:10.1177/1099800420941253 · Cited by 9 · see citing works
“During this period, women may develop physical problems such as a decrease in muscle functions, edema, and pain (Maloni, 2010), and psychological problems such as stress, fear, and anxiety (Oliveira & Mandu, 2015; Rodrigues et al., 2016).”
BackgroundMaternal Bed Rest and Infant Health
Durrance, C. P., & Guldi, M. (2015) · American Journal of Health Economics · doi:10.1162/ajhe_a_00021 · Cited by 8 · see citing works
“…the fetus results in a situation where two providers, faced with the same patient, would make different bed rest recommendations, which is also what Maloni et al. (1998) found in their survey.10 The mixed findings in the medical literature, which fuels the uncertainty regarding the effectiveness…”
BackgroundDecesare, J. Z. (2017) · Cambridge University Press eBooks · doi:10.1017/9781316662571.029 · Cited by 8 · see citing works
Zemet, R., Orvieto, R., Watad, H., Barzilay, E., Zilberberg, E., Lebovitz, O., Mazaki‐Tovi, S., & Haas, J. (2021) · Reproductive BioMedicine Online · doi:10.1016/j.rbmo.2021.01.013 · Cited by 7 · see citing works
Parto prematuro: abordagens presentes na produção científica nacional e internacional
Pohlmann, F. C., Kerber, N. P. D. C., Viana, J. D. S., de Carvalho, V. F., Vallejos, C. C. C., & de Souza, C. S. (2016) · Enfermería Global · doi:10.6018/eglobal.15.1.231881 · Cited by 6 · see citing works
Bendix, J. M., Kjærgaard, H. W., & Zoffmann, V. (2013) · Journal of Neonatal Nursing · doi:10.1016/j.jnn.2013.04.011 · Cited by 7 · see citing works
“From clinical experience it is known that some pregnant women handle this type of treatment well, whereas others become distressed with mood alterations and cognitive changes (Barlow et al., 2008; Maloni, 2010).”
Kılıç, M., & Erci, B. (2016) · Turkiye Klinikleri Journal of Nursing Sciences · doi:10.5336/nurses.2015-49259 · Cited by 5 · see citing works
Cross‐Barnet, C., Courtot, B., Benatar, S., Hill, I. T., Johnston, E. M., & Cheeks, M. L. (2018) · Maternal and Child Health Journal · doi:10.1007/s10995-018-2556-4 · Cited by 5 · see citing works
“Besides 17P, interventions to prevent recurrent preterm birth either have no known effectiveness (e.g. bed rest/activity restriction) (Maloni 2010; SMFM 2014), limited effectiveness (e.g. tocolytics) (Haas et al.”
BackgroundActivity Restriction Increases Deoxypyridinoline Excretion in Hospitalized High-Risk Pregnant Women
Vanderspank, D., Bernier, S. M., Sopper, M. M., Watson, P., & Mottola, M. F. (2014) · Biological Research For Nursing · doi:10.1177/1099800412463120 · Cited by 4 · see citing works
“Despite the negative side effects of AR, women are prescribed some form of bed rest in 20% of all pregnancies each year (Maloni, 2010).”
BackgroundMethodBendix, J. M., Backhausen, M. G., Hegaard, H. K., Rom, A. L., Mølsted, S., & Løkkegaard, E. (2023) · BMC Pregnancy and Childbirth · doi:10.1186/s12884-023-05371-5 · Cited by 4 · see citing works
Alcalde, M. C. (2013) · NWSA Journal · doi:10.1353/ff.2013.0045 · Cited by 4 · see citing works
Shaffer, S. K., & Stockdale, C. K. (2017) · Cambridge University Press eBooks · doi:10.1017/9781316662571.033 · Cited by 4 · see citing works
Feasibility of incorporating a bed-rest exercise program during a twin pregnancy: Case reports
Brun, C. R., Hammond, J.-A., & Mottola, M. F. (2012) · Open Journal of Obstetrics and Gynecology · doi:10.4236/ojog.2012.23052 · Cited by 4 · see citing works
“Important antepartum side effects range from loss of muscle strength and muscle atrophy, weight loss, dizziness, headaches and indigestion to possible lifethreatening thromboembolic events [10-15].”
BackgroundSecond Trimester Pregnancy Loss
Casey, F. E. (2017) · Cambridge University Press eBooks · doi:10.1017/9781316662571.026 · Cited by 4 · see citing works
Riskli Gebelerin Algıladığı Stres ve Eş Desteği Arasındaki İlişkinin İncelenmesi
BALTACI, N., & Metin, A. (2024) · Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi · doi:10.37989/gumussagbil.1320098 · Cited by 3 · see citing works
Induction and Augmentation of Labor
Goldberg, A. (2017) · Cambridge University Press eBooks · doi:10.1017/9781316662571.004 · Cited by 3 · see citing works
Prevention of periviable birth: Bed rest, tocolysis, progesterone, and cerclage
Chien, E. K. (2013) · Seminars in Perinatology · doi:10.1053/j.semperi.2013.06.023 · Cited by 3 · see citing works
Factors influencing Stress in Spouses of Hospitalized Women Diagnosed with Preterm Labor
Lee, J. I., & Hong, S. (2019) · Korean journal of women health nursing/Yeoseong geon'gang ganho hag'hoeji/Yeoseong geon-gang ganho hakoeji · doi:10.4069/kjwhn.2019.25.4.459 · Cited by 2 · see citing works
Women's Pregnancy Experiences With a Transvaginal Cervical Cerclage: A Qualitative Study
Lou, S., Jensen, L. G., Hansen, L. K., Uldbjerg, N., Jensen, P. T., Stenstrup, I. R., Sandager, P., Helmig, R. B., & Glavind, J. (2025) · BJOG An International Journal of Obstetrics & Gynaecology · doi:10.1111/1471-0528.18218 · Cited by 3 · see citing works
Roussot, A., Goueslard, K., Cottenet, J., von Théobald, P., Rozenberg, P., & Quantin, C. (2021) · Clinical Epidemiology · doi:10.2147/clep.s288046 · Cited by 2 · see citing works
Yeşilyurt, S. Y., Birinci, T., Taş, S. A., Tosun, G., Özer, M., & Özengın, N. (2024) · International Journal of Gynecology & Obstetrics · doi:10.1002/ijgo.15799 · Cited by 2 · see citing works
“4 Moreover, in pregnant women on bed rest, muscle mass decreases and protein breakdown increases between the third and seventh days, along with an extended period required for muscle reoxygenation after exercise.”
Moshfeghi, M. (2022) · Journal of Obstetrics Gynecology and Cancer Research · doi:10.30699/jogcr.7.5.382 · Cited by 2 · see citing works
“Some methods, such as bed rest and long-term antibiotics, may be harmful when used as adjunctive therapy after cerclage (16-18).”
MethodMano, H., Inokuchi, H., Shoda, N., Nakahara, Y., Ogata, N., & Haga, N. (2014) · リハビリテーション医学 : 日本リハビリテーション医学会誌 · doi:10.2490/jjrmc.51.445 · Cited by 2 · see citing works
Zarei, M., Zahedifard, T., & Nori, R. (2018) · Biomedical Research and Therapy · doi:10.15419/bmrat.v5i02.419 · Cited by 2 · see citing works
“2047 complications of bed rest, such as thromboembolism, fatigue and muscular atrophy, should be reduced (Maloni, 2010).”
BackgroundDie Frühgeburt: Prädiktion, Prävention und Management
Berger, R. E., Helmer, H., Schneider, H., & Surbek, D. (2022) · Springer Reference Medizin · doi:10.1007/978-3-662-44369-9_15-2 · Cited by 1 · see citing works
Ukhawounam, U., Limruangrong, P., Pungbangkadee, R., & Vongsirimas, N. (2023) · International Journal of Women s Health · doi:10.2147/ijwh.s418693 · Cited by 1 · see citing works
The Health Care Dimension: Delivering Care for High-Risk Pregnant Women and Preterm Infants
BRONSTEIN, J. M. (2016) · Springer eBooks · doi:10.1007/978-3-319-32715-0_5 · Cited by 1 · see citing works
The Clinical Dimension: Causes, Treatments, and Outcomes of Preterm Birth
BRONSTEIN, J. M. (2016) · Springer eBooks · doi:10.1007/978-3-319-32715-0_1 · Cited by 1 · see citing works
Cardiovascular Disease in Pregnancy
Graves, C. R. (2017) · Cambridge University Press eBooks · doi:10.1017/9781316662571.037 · Cited by 1 · see citing works
Gastrointestinal Disorders in Pregnancy
Patrick, S. K., & Schneider, K. M. (2017) · Cambridge University Press eBooks · doi:10.1017/9781316662571.042 · Cited by 1 · see citing works
Davis, G. H. (2017) · Cambridge University Press eBooks · doi:10.1017/9781316662571.007 · Cited by 1 · see citing works
Davis, G. H. (2017) · Cambridge University Press eBooks · doi:10.1017/9781316662571.054 · Cited by 1 · see citing works
Ferrell, G. (2017) · Cambridge University Press eBooks · doi:10.1017/9781316662571.014 · Cited by 1 · see citing works
Substance Use in Women and Pregnancy
Roche, N., & Oparaji, D. C. (2017) · Cambridge University Press eBooks · doi:10.1017/9781316662571.050 · Cited by 1 · see citing works
Nausea and Vomiting of Pregnancy and Hyperemesis Gravidarum
Akinlaja, O. A., & Gist, W. (2017) · Cambridge University Press eBooks · doi:10.1017/9781316662571.035 · Cited by 1 · see citing works
Bed rest with and without hospitalisation in multiple pregnancy for improving outcomes
Lopes, K. D. S., Ota, E., Tanigaki, S., & Mori, R. (2016) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd012031 · Cited by 1 · see citing works
Preterm Labor: Understanding of the Mechanism Involved to Improve Prediction and Prevention
Illanes, S. E., Nien, J. K., & Rice, G. E. (2013) · Obstetrics and Gynecology International · doi:10.1155/2013/858506
“[40] C.”
BackgroundGood Research, Good Evidence, and Good Nursing Practice
Leão, E. R. (2014) · Biological Research For Nursing · doi:10.1177/1099800413518423
“In fact, data from a Cochrane review (Crowther & Han, 2010), which Maloni (2010) cited in a review article published in Biological Research for Nursing, demonstrated that, based on the increasing evidence that antepartum bed rest causes several adverse physiologic and psychological side effects…”
BackgroundMiomas submucosos: gran desafío para el ginecólogo
Mea, M. A. D. M., Ventimilla, J. C. B., Martínez, A. M. A., Agudelo, R. E. S., Castañeda, J. D., Posada, J. F. D. L. R., Payares, L. A. A., & Vásquez, R. A. (2013) · Revista de Obstetricia y Ginecología de Venezuela
Bed Rest and Its Continued Use in Women with High-Risk Pregnancy
Reyes, I. D. L. (2015) · doi:10.33015/dominican.edu/2015.nurs.st.02
“…preterm birth Literature Introduction In the United States, antepartum bed rest (ABR) is prescribed by 90% of obstetricians to approximately 1 million out of the 4 million pregnant women labeled high risk each year (Irion, Irion, Lewis & Giglio, 2012; Maloni, 2010; Maloni, 1996).”
BackgroundInfluential20 Aan de zwangerschap gebonden afwijkingen
Heineman, M. J., Evers, J. L. H., Massuger, L. F. A. G., & Steegers, E. A. P. (2016) · Bohn Stafleu van Loghum eBooks · doi:10.1007/978-90-368-1191-0_20
NEEDS DURING BED REST IN HIGH RISK PREGNANCY: A NARRATIVE REVIEW.
Mishra, P., Agasthiya, A., Nageshwar, V., & Muninarayanappa, N. (2017) · International Journal of Advanced Research · doi:10.21474/ijar01/4100
“The types of complications that make a pregnancy high risk include: premature rupture of membranes, preterm labor, placenta previa, diabetes, multiple gestation, hypertension, suspected fetal growth retardation& vaginal bleeding (Maloni, 2010).”
BackgroundRaughley, M. J., & LaMonica, G. E. (2017) · Cambridge University Press eBooks · doi:10.1017/9781316662571.040
Cesarean Delivery Complications and Cesarean Hysterectomy
Altizer, M. D. (2017) · Cambridge University Press eBooks · doi:10.1017/9781316662571.009
Dermatologic Disorders and Pregnancy
Stockdale, C. K., & Martini, S. (2017) · Cambridge University Press eBooks · doi:10.1017/9781316662571.046
Akinlaja, O. A., & Gist, W. (2017) · Cambridge University Press eBooks · doi:10.1017/9781316662571.032
Management of Obstetric Umbilical Cord Complications
Bressman, P. L. (2017) · Cambridge University Press eBooks · doi:10.1017/9781316662571.006
Elson, M. (2017) · Cambridge University Press eBooks · doi:10.1017/9781316662571.047
The Obstetric Patient with Trauma
Plaat, F., & Cox, C. W. F. M. (2017) · Cambridge University Press eBooks · doi:10.1017/9781316662571.031
Petruska, S. (2017) · Cambridge University Press eBooks · doi:10.1017/9781316662571.010
Diabetes Mellitus in Pregnancy
Hamdi, M. (2017) · Cambridge University Press eBooks · doi:10.1017/9781316662571.044
Hematologic Diseases Complicating Pregnancy
Bowersox, N. (2017) · Cambridge University Press eBooks · doi:10.1017/9781316662571.041
Neurological Disease Complicating Pregnancy
Antoniewicz, L. W., & Schneider, K. M. (2017) · Cambridge University Press eBooks · doi:10.1017/9781316662571.039
Selected Endocrine Disorders in Pregnancy
Chen, K. K. (2017) · Cambridge University Press eBooks · doi:10.1017/9781316662571.043 · Cited by 1 · see citing works
Richard, S. D., & Veselis, C. A. (2017) · Cambridge University Press eBooks · doi:10.1017/9781316662571.051
Thromboembolic Complications of Pregnancy
Kuhlmann, Z. C. (2017) · Cambridge University Press eBooks · doi:10.1017/9781316662571.052
Pulmonary Disease in Pregnancy
Shumway, J. B., & Babarinsa, I. (2017) · Cambridge University Press eBooks · doi:10.1017/9781316662571.038
- Authors
- Maloni, J. A.
- Affiliations
- Case Western Reserve University (US)
- Corresponding author
- Maloni, Judith A.
- Venue
- Biological Research For Nursing
- Publisher
- SAGE Publications
- Published
- 2010-08-26
- Volume
- 12
- Issue
- 2
- Pages
- 106-124
- ISSN
- 1099-8004 (ISSN-L)
- 1552-4175
- OpenAlex
- W2032618589
- Cited by
- 135
- References
- 133
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 3 · 2023: 3 · 2022: 4 · 2021: 3 · 2020: 4 · 2019: 5 · 2018: 5 · 2017: 60 · 2016: 9 · 2015: 6 · 2014: 5 · 2013: 13 · 2012: 6
- FWCI
- 0.87
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Biological Research For Nursing (publishedVersion)
- PubMed (publishedVersion)
- Funders
- U.S. Public Health Service (R01 NRO3323)
- Topics
- Health Sciences › Medicine › Epidemiology › Preterm Birth and Chorioamnionitis
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Infant Development and Preterm Care
- Health Sciences › Medicine › Obstetrics and Gynecology › Maternal and Perinatal Health Interventions
- Keywords
- activity limitation, preterm birth prevention, pregnancy complications, psychological impact, home care, high-risk pregnancy, postpartum women, perinatal mortality
- MeSH terms
- Bed Rest, Female, Humans, Obstetric Labor, Premature, Pregnancy, Pregnancy Complications
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