Yoga in the NICU for Parents Study

NCT ID: NCT05322161

Last Updated: 2024-05-17

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

51 participants

Study Classification

INTERVENTIONAL

Study Start Date

2021-09-29

Study Completion Date

2024-01-31

Brief Summary

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The purpose of this proposal is to test the efficacy of yoga as a mind and body intervention to decrease stress, anxiety, and depression in parents of critically ill neonates hospitalized in the Seattle Children's and University of Washington neonatal intensive care units (NICUs).

Detailed Description

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Preterm infants are often critically ill and require prolonged hospitalization in neonatal intensive care units (NICUs). The care of these infants is often regionalized so that specialized treatment can be performed in centers with specific expertise. An unintended consequence of regionalization of care is the physical and emotional isolation parents experience when a child is hospitalized far from family, friends, and work. As a result of these stressors, loss of parental control, autonomy, and concern for a child's wellbeing, nearly half of NICU mothers develop anxiety, depression, or posttraumatic stress disorder, and this may persist for years.

Helping parents cope with the birth and hospitalization of a preterm infant is critical for the parents' health and wellbeing, as well as for the optimal development of the child, as parental anxiety and depression may affect parent-child bonding and result in altered child development. The practice of yoga, which encompasses physical postures (asana), but also includes breathing techniques (pranayama), and meditation (dhyana), has proven benefits in many areas of medicine and wellness including stress management, mental and emotional health and promoting sleep. Given the positive effects on both physical and emotional health, these mind and body techniques are promising as a therapeutic modality by which parental stress, anxiety and depression could be reduced.

This study is unique in that previous studies of yoga have not occurred in hospital settings and have not included subjects in an acute state of distress such as parents of critically ill hospitalized neonates. Furthermore, in the current COVID-19 environment it is important to explore ways to make yoga interventions available to families by remote access, and to test whether this approach is successful.

This will be a randomized controlled pilot study to elucidate the optimal research strategy with which to implement mind and body interventions for parents of NICU patients, at two sites (University of Washington NICU and Seattle Children's Hospital NICU). We aim to enroll 40 NICU mothers and any of their interested partners in the study. We will approach parents after day 10 of infant admission to NICU and begin participation by day 14 of NICU admission.

The investigators hypothesize that a combined program of breath work, physical practice and meditation will decrease parental stress, anxiety, and depression in the NICU.

Conditions

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Postpartum Depression Anxiety Depression Stress Disorder Prematurity

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Control group receives standard of care for parent support. Interventional group receives virtual yoga classes in addition to standard of care for parent support.
Primary Study Purpose

OTHER

Blinding Strategy

SINGLE

Investigators
Investigator is blinded to study allocation (yoga or control group) prior to enrollment. Once participant is randomized the investigator will know which group the participant is in.

Study Groups

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Control

Parents will experience usual care including all available parental support as practiced in the specific site NICU.

Group Type NO_INTERVENTION

No interventions assigned to this group

Yoga Group

In addition to usual care, the parents randomized to the intervention group will be provided a yoga mat and participate in 30-min online led yoga sessions done at least twice weekly at the parent's pace using a secure, virtual platform (website).

Group Type EXPERIMENTAL

yoga classes

Intervention Type BEHAVIORAL

There will be 6 total yoga classes (one introduced per week for a 6 week period). Each yoga session will be divided into three components, which will vary in duration based on a curriculum designed specifically with the post-partum state of mothers in mind:

1. Yoga postures (Asana) = low impact gentle postures meant to be done individually
2. Breathing techniques (Pranayama) = deliberate modifications of breath such as rapid diaphragmatic breathing, slow/deep breathing, alternate nostril breathing, breath holding
3. Meditation (Dhyana) = guided meditation

Interventions

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yoga classes

There will be 6 total yoga classes (one introduced per week for a 6 week period). Each yoga session will be divided into three components, which will vary in duration based on a curriculum designed specifically with the post-partum state of mothers in mind:

1. Yoga postures (Asana) = low impact gentle postures meant to be done individually
2. Breathing techniques (Pranayama) = deliberate modifications of breath such as rapid diaphragmatic breathing, slow/deep breathing, alternate nostril breathing, breath holding
3. Meditation (Dhyana) = guided meditation

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* NICU inpatients born \<32 weeks gestation at birth and/or \<1500g, OR estimated length of stay ≥6 weeks
* Parents of current NICU inpatients born \<32 weeks gestation at birth and/or \<1500g OR estimated length of stay ≥6 weeks
* Parents with any level of experience with yoga (none to regular practitioner)
* Child has been admitted to the NICU for at least 10 days
* Parent age ≥18 years
* Parent speaks and reads in either English or Spanish

Exclusion Criteria

* Expected length of stay of NICU inpatient \<6 weeks
* Parent does not speak or read in English only speaks or reads in a language other than English or Spanish
* Parent plans to relinquish child
* Child or parents are too unstable as assessed by the Attending Physician
Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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University of Washington

OTHER

Sponsor Role collaborator

Seattle Children's Hospital

OTHER

Sponsor Role lead

Responsible Party

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Sara Neches

Principal Investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Sara Neches, MD

Role: PRINCIPAL_INVESTIGATOR

Seattle Children's Hospital

Locations

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Seattle Children's Hospital

Seattle, Washington, United States

Site Status

University of Washington

Seattle, Washington, United States

Site Status

Countries

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United States

References

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Treyvaud K, Spittle A, Anderson PJ, O'Brien K. A multilayered approach is needed in the NICU to support parents after the preterm birth of their infant. Early Hum Dev. 2019 Dec;139:104838. doi: 10.1016/j.earlhumdev.2019.104838. Epub 2019 Aug 27.

Reference Type BACKGROUND
PMID: 31471000 (View on PubMed)

Yaari M, Treyvaud K, Lee KJ, Doyle LW, Anderson PJ. Preterm Birth and Maternal Mental Health: Longitudinal Trajectories and Predictors. J Pediatr Psychol. 2019 Jul 1;44(6):736-747. doi: 10.1093/jpepsy/jsz019.

Reference Type BACKGROUND
PMID: 30977828 (View on PubMed)

Pace CC, Spittle AJ, Molesworth CM, Lee KJ, Northam EA, Cheong JL, Davis PG, Doyle LW, Treyvaud K, Anderson PJ. Evolution of Depression and Anxiety Symptoms in Parents of Very Preterm Infants During the Newborn Period. JAMA Pediatr. 2016 Sep 1;170(9):863-70. doi: 10.1001/jamapediatrics.2016.0810.

Reference Type BACKGROUND
PMID: 27428766 (View on PubMed)

Winter L, Colditz PB, Sanders MR, Boyd RN, Pritchard M, Gray PH, Whittingham K, Forrest K, Leeks R, Webb L, Marquart L, Taylor K, Macey J. Depression, posttraumatic stress and relationship distress in parents of very preterm infants. Arch Womens Ment Health. 2018 Aug;21(4):445-451. doi: 10.1007/s00737-018-0821-6. Epub 2018 Mar 3.

Reference Type BACKGROUND
PMID: 29502280 (View on PubMed)

Moehler E, Brunner R, Wiebel A, Reck C, Resch F. Maternal depressive symptoms in the postnatal period are associated with long-term impairment of mother-child bonding. Arch Womens Ment Health. 2006 Sep;9(5):273-8. doi: 10.1007/s00737-006-0149-5. Epub 2006 Sep 8.

Reference Type BACKGROUND
PMID: 16937313 (View on PubMed)

Treyvaud K, Anderson VA, Lee KJ, Woodward LJ, Newnham C, Inder TE, Doyle LW, Anderson PJ. Parental mental health and early social-emotional development of children born very preterm. J Pediatr Psychol. 2010 Aug;35(7):768-77. doi: 10.1093/jpepsy/jsp109. Epub 2009 Dec 2.

Reference Type BACKGROUND
PMID: 19955253 (View on PubMed)

Treyvaud K, Anderson VA, Howard K, Bear M, Hunt RW, Doyle LW, Inder TE, Woodward L, Anderson PJ. Parenting behavior is associated with the early neurobehavioral development of very preterm children. Pediatrics. 2009 Feb;123(2):555-61. doi: 10.1542/peds.2008-0477.

Reference Type BACKGROUND
PMID: 19171622 (View on PubMed)

Kerstis B, Aarts C, Tillman C, Persson H, Engstrom G, Edlund B, Ohrvik J, Sylven S, Skalkidou A. Association between parental depressive symptoms and impaired bonding with the infant. Arch Womens Ment Health. 2016 Feb;19(1):87-94. doi: 10.1007/s00737-015-0522-3. Epub 2015 Apr 10.

Reference Type BACKGROUND
PMID: 25854998 (View on PubMed)

de Cock ESA, Henrichs J, Klimstra TA, Janneke B M Maas A, Vreeswijk CMJM, Meeus WHJ, van Bakel HJA. Longitudinal Associations Between Parental Bonding, Parenting Stress, and Executive Functioning in Toddlerhood. J Child Fam Stud. 2017;26(6):1723-1733. doi: 10.1007/s10826-017-0679-7. Epub 2017 Feb 27.

Reference Type BACKGROUND
PMID: 28572718 (View on PubMed)

Trkulja V, Baric H. Current Research on Complementary and Alternative Medicine (CAM) in the Treatment of Anxiety Disorders: An Evidence-Based Review. Adv Exp Med Biol. 2020;1191:415-449. doi: 10.1007/978-981-32-9705-0_22.

Reference Type BACKGROUND
PMID: 32002940 (View on PubMed)

Cramer H, Lauche R, Anheyer D, Pilkington K, de Manincor M, Dobos G, Ward L. Yoga for anxiety: A systematic review and meta-analysis of randomized controlled trials. Depress Anxiety. 2018 Sep;35(9):830-843. doi: 10.1002/da.22762. Epub 2018 Apr 26.

Reference Type BACKGROUND
PMID: 29697885 (View on PubMed)

Cramer H, Anheyer D, Saha FJ, Dobos G. Yoga for posttraumatic stress disorder - a systematic review and meta-analysis. BMC Psychiatry. 2018 Mar 22;18(1):72. doi: 10.1186/s12888-018-1650-x.

Reference Type BACKGROUND
PMID: 29566652 (View on PubMed)

Cramer H, Anheyer D, Lauche R, Dobos G. A systematic review of yoga for major depressive disorder. J Affect Disord. 2017 Apr 15;213:70-77. doi: 10.1016/j.jad.2017.02.006. Epub 2017 Feb 7.

Reference Type BACKGROUND
PMID: 28192737 (View on PubMed)

Brockington IF, Fraser C, Wilson D. The Postpartum Bonding Questionnaire: a validation. Arch Womens Ment Health. 2006 Sep;9(5):233-42. doi: 10.1007/s00737-006-0132-1. Epub 2006 May 4.

Reference Type BACKGROUND
PMID: 16673041 (View on PubMed)

Matthey S, Barnett B, Kavanagh DJ, Howie P. Validation of the Edinburgh Postnatal Depression Scale for men, and comparison of item endorsement with their partners. J Affect Disord. 2001 May;64(2-3):175-84. doi: 10.1016/s0165-0327(00)00236-6.

Reference Type BACKGROUND
PMID: 11313084 (View on PubMed)

Provided Documents

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Document Type: Study Protocol

View Document

Other Identifiers

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SITE00001252

Identifier Type: OTHER

Identifier Source: secondary_id

STUDY00003325

Identifier Type: -

Identifier Source: org_study_id

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