Bedrest is used prophylactically by 92% of obstetricians to treat 18.2% of the 4 million women who become pregnant each year. It is used in an effort to reduce the incidence of low birth weight. Numerous adverse effects of bedrest have been documented in nonpregnant populations. Physicians, however, have not applied this knowledge to the care of pregnant women. A common attitude is that the physiology of pregnancy is different and thus bedrest is either not harmful to young healthy women or is a small price to pay for a viable infant. Yet, the high costs ($1.03 billion/yr.) and unproven effectiveness for preventing infant complications argue against its widespread use. In addition, we now have evidence that bedrest is prescribed at significant physiologic and psychosocial cost to the mother. Pregnant women on hospital bedrest for as little as 11 days (M=29) suffer from debilitating symptoms of muscular (p< .001) and cardiovascular deconditioning, weight loss (p< .01), and depression (p< .001), some of which may not be reversible. Furthermore, upon discharge, previously bedrested women are expected to immediately remobilize and care for self and infant without rehabilitation, thus placing these vulnerable women at further risk for subsequent illness, injury, and parenting difficulties. However, these data came from a small preliminary study. Additional information is needed to confirm and extend these preliminary findings.
The aims of this study are to identify the physiologic and psychosocial deconditioning effects of pregnancy bedrest, and to determine whether there is a linear relationship between severity of symptoms and length of hospital bedrest in a larger sample of pregnant women on a continuum of length of hospital bedrest. Subjects will be 168 women who are hospitalized with the diagnosis of preterm labor who are free of other medical conditions. Women will be assessed weekly, from the second or third trimester through six weeks postpartum. A noninvasive hemoglobin/myoglobin spectrophotometer will test muscle deoxygenation response to mild plantar flexion exercise. Other measures include body weight, antepartum and postpartum physical and psychologic symptoms, mobility, stressors of hospitalization, mood changes, and resumption of activities of daily living and functional status after childbirth. Knowledge of the effects of antepartum hospital bedrest is needed to reduce the economic, physiologic, and psychosocial costs of treatment, to provide a basis for interventions to prevent and treat adverse effects, to guide postpartum rehabilitation, and to provide a firm scientific base for use of bedrest therapy for high risk pregnant women.

Agency
National Institute of Health (NIH)
Institute
National Institute of Nursing Research (NINR)
Type
Research Project (R01)
Project #
5R01NR003323-02
Application #
2431045
Study Section
Nursing Research Study Section (NURS)
Program Officer
Helmers, Karin F
Project Start
1996-06-01
Project End
2001-02-28
Budget Start
1997-06-01
Budget End
1998-02-28
Support Year
2
Fiscal Year
1997
Total Cost
Indirect Cost
Name
University of Wisconsin Madison
Department
Type
Schools of Nursing
DUNS #
161202122
City
Madison
State
WI
Country
United States
Zip Code
53715
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Maloni, Judith A; Park, Seunghee (2005) Postpartum symptoms after antepartum bed rest. J Obstet Gynecol Neonatal Nurs 34:163-71
Maloni, Judith A; Park, Seunghee; Anthony, Mary K et al. (2005) Measurement of antepartum depressive symptoms during high-risk pregnancy. Res Nurs Health 28:16-26
Maloni, Judith A; Alexander, Greg R; Schluchter, Mark D et al. (2004) Antepartum bed rest: maternal weight change and infant birth weight. Biol Res Nurs 5:177-86
Maloni, Judith A; Schneider, Barbara St Pierre (2002) Inactivity: symptoms associated with gastrocnemius muscle disuse during pregnancy. AACN Clin Issues 13:248-62
Maloni, Judith A; Kane, Janet H; Suen, Lee-Jen et al. (2002) Dysphoria among high-risk pregnant hospitalized women on bed rest: a longitudinal study. Nurs Res 51:92-9