The DOI matches its Crossref record; 134 of the 134 references it cites were found in a registry or an index.
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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In the citing paper
“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]
In the citing paper
“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]
In the citing paper
“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]
In the citing paper
“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]
In the citing paper
“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]
In the citing paper
“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]
In the citing paper
“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]
In the citing paper
“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]
In the citing paper
“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]
In the citing paper
“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]
In the citing paper
“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]
In the citing paper
“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]
In the citing paper
“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]
In the citing paper
“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]
In the citing paper
“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]
In the citing paper
“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]
In the citing paper
“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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“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).”
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“Limitations to the study of the side effects of bed rest have been extensively detailed elsewhere [10].”
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“In an attempt to shorten hospital stays, some physicians are discharging patients earlier or placing them on home care (Maloni, 2010).”
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Kent, R. A., Yazbek, M., Heyns, T., & Coetzee, I. (2015) · Midwifery · doi:10.1016/j.midw.2014.08.003 · Cited by 36
“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
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“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…”
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“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).”
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“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.”
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“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].”
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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
Roussot, A., Goueslard, K., Cottenet, J., von Théobald, P., Rozenberg, P., & Quantin, C. (2021) · Clinical Epidemiology · doi:10.2147/clep.s288046 · Cited by 2
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
“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
“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
Zarei, M., Zahedifard, T., & Nori, R. (2018) · Biomedical Research and Therapy · doi:10.15419/bmrat.v5i02.419 · Cited by 2
“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
Ukhawounam, U., Limruangrong, P., Pungbangkadee, R., & Vongsirimas, N. (2023) · International Journal of Women s Health · doi:10.2147/ijwh.s418693 · Cited by 1
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
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
Cardiovascular Disease in Pregnancy
Graves, C. R. (2017) · Cambridge University Press eBooks · doi:10.1017/9781316662571.037 · Cited by 1
Gastrointestinal Disorders in Pregnancy
Patrick, S. K., & Schneider, K. M. (2017) · Cambridge University Press eBooks · doi:10.1017/9781316662571.042 · Cited by 1
Davis, G. H. (2017) · Cambridge University Press eBooks · doi:10.1017/9781316662571.007 · Cited by 1
Davis, G. H. (2017) · Cambridge University Press eBooks · doi:10.1017/9781316662571.054 · Cited by 1
Ferrell, G. (2017) · Cambridge University Press eBooks · doi:10.1017/9781316662571.014 · Cited by 1
Substance Use in Women and Pregnancy
Roche, N., & Oparaji, D. C. (2017) · Cambridge University Press eBooks · doi:10.1017/9781316662571.050 · Cited by 1
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
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
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
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
Metadata
- 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 › Obstetrics and Gynecology › 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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