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anxiety, pregnancy outcomes, relaxation



  1. Bastani, Farideh PhD
  2. Hidarnia, Alireza PhD
  3. Montgomery, Kristen S. PhD
  4. Aguilar-Vafaei, Maria E. PhD
  5. Kazemnejad, Anoshirvan PhD


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 randomly assigned into experimental and control groups.


Method: In this randomized 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 resource for improving pregnancy outcomes in women with high anxiety.