***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: In a study of the effectiveness of systematic relaxation training alone or combined with biofeedback in the treatment of  hypertension in pregnancy , 60 women were seen weekly for 6 weeks . 18 were given relaxation therapy alone ( group A ) , 18 relaxation plus biofeedback ( group B ) , and there were 24 controls . Whereas two-thirds of the control group had to be admitted to hospital during their pregnancies , less than a third of each experimental group had to be admitted . The experimental groups also had significantly lower systolic and diastolic blood pressure than the control group . There were no significant differences between groups A and B in hospital admission rates or blood-pressure measurements This study examined the effects of a yoga program during pregnancy , on  maternal comfort , labor pain , and birth outcomes .  A r and omized trial was conducted using 74-primigravid Thai women who were equally divided into two groups ( experimental and control ) . The yoga program involved six , 1-h sessions at prescribed weeks of gestation . A variety of instruments were used to assess maternal comfort , labor pain and birth outcomes . The experimental group was found to have higher levels of maternal comfort during labor and 2h post-labor , and experienced less subject evaluated labor pain than the control group . In each group , pain increased and maternal comfort decreased as labor progressed . No differences were found , between the groups , regarding pethidine usage , labor augmentation or newborn Apgar scores at 1 and 5 min . The experimental group was found to have a shorter duration of the first stage of labor , as well as the total time of labor Summary Stress and negative mood during pregnancy increase risk for poor childbirth outcomes and postnatal mood problems and may interfere with mother – infant attachment and child development . However , relatively little research has focused on the efficacy of psychosocial interventions to reduce stress and negative mood during pregnancy . In this study , we developed and pilot tested an eight-week mindfulness-based intervention directed toward reducing stress and improving mood in pregnancy and early postpartum . We then conducted a small r and omized trial ( n = 31 ) comparing women who received the intervention during the last half of their pregnancy to a wait-list control group .  Measures of perceived stress , positive and negative affect , depressed and anxious mood , and affect regulation were collected prior to , immediately following , and three months after the intervention ( postpartum ) . Mothers who received the intervention showed significantly reduced anxiety ( effect size , 0.89 ; p < 0.05 ) and negative affect ( effect size , 0.83 ; p < 0.05 ) during the third trimester in comparison to those who did not receive the intervention . The brief and nonpharmaceutical nature of this intervention makes it a promising c and i date for use during pregnancy Eighty-four depressed pregnant women were recruited during the second trimester of pregnancy and r and omly assigned to a massage therapy group , a progressive muscle relaxation group or a control group that received st and ard prenatal care alone . These groups were compared to each other and to a non-depressed group at the end of pregnancy . The massage therapy group participants received two 20 min therapy sessions by their significant others each week for 16 weeks of pregnancy , starting during the second trimester . The relaxation group provided themselves with progressive muscle relaxation sessions on the same time schedule . Immediately after the massage therapy sessions on the first and last days of the 16-week period the women reported lower levels of anxiety and depressed mood and less leg and back pain . By the end of the study the massage group had higher dopamine and serotonin levels and lower levels of cortisol and norepinephrine . These changes may have contributed to the reduced fetal activity and the better neonatal outcome for the massage group ( i.e. lesser incidence of prematurity and low birthweight ) , as well as their better performance on the Brazelton Neonatal Behavior Assessment . The data suggest that depressed pregnant women and their offspring can benefit from massage therapy Background : Asthma is a serious medical problem in pregnancy and is often associated with stress , anger and poor quality of life . The aim of this study was to determine the efficacy of progressive muscle relaxation ( PMR ) on change in blood pressure , lung parameters , heart rate , anger and health-related quality of life in pregnant women with bronchial asthma . Methods : We treated a sample of 64 pregnant women with bronchial asthma from the local population in an 8-week r and omized , prospect i ve , controlled trial . Thirty-two were selected for PMR , and 32 received a placebo intervention . The systolic blood pressure , forced expiratory volume in the first second , peak expiratory flow and heart rate were tested , and the State-Trait Anger Expression Inventory and  Health Survey ( SF-36 ) were employed . Results : According to the intend-to-treat principle , a significant reduction in systolic blood pressure and a significant increase in both forced expiratory volume in the first second and peak expiratory flow were observed after PMR . The heart rate showed a significant increase in the coefficient of variation , root mean square of successive differences and high frequency ranges , in addition to a significant reduction in low and middle frequency ranges . A significant reduction on three of five State-Trait Anger Expression Inventory scales , and a significant increase on seven of eight SF-36 scales were observed . Conclusions : PMR appears to be an effective method to improve blood pressure , lung parameters and heart rate , and to decrease anger levels , thus enhancing health-related quality of life in pregnant women with bronchial asthma OBJECTIVE To study the effect of integrated yoga practice and guided yogic relaxation on both perceived stress and measured autonomic response in healthy pregnant women . METHOD The 122 healthy women recruited between the 18th and 20th week of pregnancy at prenatal clinics in Bangalore , India , were r and omized to  practicing yoga and deep relaxation or st and ard prenatal exercises 1-hour daily . The results for the 45 participants per group who completed the study were evaluated by repeated measures analysis of variance . RESULTS Perceived stress decreased by 31.57 % in the yoga group and increased by 6.60 % in the control group ( P=0.001 ) . During a guided relaxation period in the yoga group , compared with values obtained before a practice session , the high-frequency b and of the heart rate variability spectrum ( parasympathetic ) increased by 64 % in the 20th week and by 150 % in the 36th week , and both the low-frequency b and ( sympathetic ) , and the low-frequency to high-frequency ratio were concomitantly reduced ( P<0.001 between the 2 groups ) . Moreover , the low-frequency b and remained decreased after deep relaxation in the 36th week in the yoga group . CONCLUSION Yoga reduces perceived stress and improves adaptive autonomic response to stress in healthy pregnant women Background . The increase in the numbers of women fearing childbirth and requesting cesarean sections call for new forms of antenatal treatment . Methods . Finnish nulliparous women experiencing severe fear of childbirth ( experimental group , n = 102 ) attended 5 group sessions with a psychologist , once together with a midwife , during the third trimester . One session was held 3 months after the delivery . Each session consisted of a discussion of fear and feelings towards the impending birth and parenthood in a psychotherapeutic atmosphere and of relaxation exercises focused on an imaginary childbirth . The results were compared with those of 85 women treated for fear of childbirth by 2 appointments with an obstetrician ( conventional treatment ) . Results . Before the sessions , among the women in the experimental group , scored fear of childbirth , on a scale of one to ten , was 6.9±2.0 ( SD ) , which is similar to the score of those receiving conventional treatment ( 6.0±1.6 ) . After the sessions , 84 women in the experimental group ( 82.4 % ) and 57 in the conventional treatment group ( 67.1 % ) chose to have a vaginal delivery ( p = 0.02 ) . The women in the experimental treatment group rated the helpfulness of the sessions 8.5±1.6 on a scale where 10 was maximum help and 1 no help at all , and mentioned “ sharing their feelings ” twice as often as “ receiving information ” as the most helpful factor in relieving fear . Conclusions . Group psychoeducation and relaxation exercises were well received and rated as very helpful . More cesarean section requests were withdrawn than in the comparison group and in previous studies The purpose of this study was to investigate the effect of applied relaxation training on reducing anxiety and perceived stress among pregnant women . A r and omized controlled trial with a prospect i ve pretest-posttest experimental design was used . One hundred ten primigravid women ( mean age = 23.8 years ) in their second trimester ( mean of gestational age = 17.8 weeks ) were r and omly assigned into experimental and control groups . The experimental group received routine prenatal care with applied relaxation training , and the control group received only routine prenatal care .  State/trait anxiety was measured with the Spielberger State-Trait Anxiety Inventory , and perceived stress was measured with the Cohen Perceived Stress Scale . There were significant reductions in state/trait anxiety and perceived stress for the experimental group compared with the control group after the intervention . The findings suggest beneficial effects of relaxation on reducing anxiety and perceived stress in pregnant women . Teaching relaxation techniques could serve as a re source for improving maternal psychological health Maternal anxiety and stress are found to be predictors of adverse pregnancy outcomes , including low birth weight and prematurity . Objective The aim of the study was to determine whether relaxation education in anxious pregnant Iranian women in their first pregnancy affects selected pregnancy outcomes , including birth weight , preterm birth , and surgical delivery rate . Subjects A total of 110 obstetrically and medically low-risk primigravid women in Iran with a high anxiety level demonstrated by Spielberger 's State-Trait Anxiety Inventory were r and omly assigned into experimental and control groups . Method In this r and omized controlled trial , the experimental group received routine prenatal care along with 7-week applied relaxation training sessions , while the control group received only routine prenatal care .  Anxiety and perceived stress were measured by preeducational and posteducational intervention . Data related to pregnancy outcomes include birth weight , gestational age at birth , and type of delivery . Results Significant reductions in low birth weight , cesarean section , and /or instrumental extraction were found in the experimental group compared with the control group . No significant differences were found in the rate of preterm birth . Conclusion The findings suggest beneficial effects of nurse-led relaxation education sessions during the prenatal period . This intervention could serve as a re source for improving pregnancy outcomes in women with high anxiety OBJECTIVE To examine the effect of relaxation on preterm labor outcome . DESIGN Quasi-experimental , with women who experienced preterm labor r and omly assigned to a control or experimental group . The experimental group was to do a daily relaxation exercise . A third group was added to the study : women who were originally assigned to the relaxation group but were unable to adhere to the daily practice . Final data were analyzed for three groups : control ( n = 40 ) , experimental ( n = 44 ) , and nonadherent ( n = 23 ) participants . SETTING Women were referred to the study from physician offices and a hospital-based obstetric triage clinic in the Northwest . PARTICIPANTS Total sample was comprised of 107 women with singleton gestations , documented contractions with cervical change , and intact membranes . INTERVENTIONS The experimental group was instructed in a progressive relaxation exercise . The participants were given tapes of the exercise and instructed to do it daily . OUTCOME MEASURES Study outcomes included gestational age at birth , rate of pregnancy prolongation , and birth weight . RESULTS The outcome variables were analyzed using analysis of covariance , with the preterm labor risk score entered as a covariate to compensate statistically for group differences . A positive response to the relaxation intervention was found : The experimental group had significantly longer gestations and larger newborns when compared to the control and nonadherent groups . CONCLUSIONS Relaxation therapy made a difference in preterm labor outcome . Women who practice d relaxation had larger newborns , longer gestations , and higher rates of pregnancy prolongation . Given the low cost of the intervention , it should be offered to all women at risk for preterm labor In this article the positive effects of massage therapy on biochemistry are review ed including decreased levels of cortisol and increased levels of serotonin and dopamine . The research review ed includes studies on depression ( including sex abuse and eating disorder studies ) , pain syndrome studies , research on auto-immune conditions ( including asthma and chronic fatigue ) , immune studies ( including HIV and breast cancer ) , and studies on the reduction of stress on the job , the stress of aging , and pregnancy stress . In studies in which cortisol was assayed either in saliva or in urine , significant decreases were noted in cortisol levels ( averaging decreases 31 % ) . In studies in which the activating neurotransmitters ( serotonin and dopamine ) were assayed in urine , an average increase of 28 % was noted for serotonin and an average increase of 31 % was noted for dopamine . These studies combined suggest the stress-alleviating effects ( decreased cortisol ) and the activating effects ( increased serotonin and dopamine ) of massage therapy on a variety of medical conditions and stressful experiences Prenatally depressed women ( N=47 ) were r and omly assigned to a group that received massage twice weekly from their partners from 20 weeks gestation until the end of pregnancy or a control group .  Self-reported leg pain , back pain , depression , anxiety and anger decreased more for the massaged pregnant women than for the control group women . In addition , the partners who massaged the pregnant women versus the control group partners reported less depressed mood , anxiety and anger across the course of the massage therapy period . Finally , scores on a relationship question naire improved more for both the women and the partners in the massage 
    Output:
    
1 ) Relaxation had a positive impact on women 's emotional state .
( 2 ) Pregnancy outcomes improved with fewer admissions to the hospital , fewer obstetric complications , longer gestation , reduction of caesarean sections , and fewer postpartum complications .
4 ) Higher-birth-weight and improved performance on the Neonatal Behavioral Assessment Scale was related to relaxation . (
5 ) Relaxation training was associated with reductions in maternal physiological and endocrine measures .
Relaxation during pregnancy is associated with salutogenic effects that include regulation of emotional states and physiology .
Relaxation is also associated with positive effects both on fetal behavior and on obstetric and neonatal outcomes .
Identifying pregnant women at risk and instituting treatment early in pregnancy could improve obstetric and developmental outcomes for both the mother and her fetus