Bed rest may not be the best option for preventing preterm labor and may even cause harm to the mother and baby, according to an integrative literature review in a special issue on "Women's Health Across the Lifespan" in Biological Research for Nursing (published by SAGE).

Bed rest or activity restriction, prescribed for up to 1 million women in the U.S. annually to treat pregnancy complications, is based on the assumptions that it is (a) effective in preventing preterm birth and (b) safe for both the mother and fetus. According to the study, however, research over more than two decades has failed to support these assumptions.

Author Judith A. Maloni, PhD, RN, FAAN, Professor in the Bolton School of Nursing, Case Western Reserve University has been conducting research on pregnancy bed rest for more than two decades. In this article, Dr. Maloni reviewed all known research about bed rest, high-risk pregnancy, preterm labor, and how those relate to the side-effects of bone loss, thrombosis, depression, stress, and other symptoms.

In addition to the impact of an overall negative pregnancy experience for the mother, which has largely been ignored by medical professionals, the researcher found a number of troubling issues with bed rest, including such concerns as:

-- Loss of muscle function, muscle atrophy, sore muscles

-- Bone loss

-- Maternal weight loss, lower fetal weight

-- Fatigue, sleep cycle changes, boredom

-- Both antepartum and postpartum depression, mood changes

-- Nasal congestion, reflux, indigestion, back and muscle aches

"Nurses can challenge bed-rest treatment by functioning as advocates for women and educating them about the evidence for bed-rest treatment as well as the risks and benefits," writes the author. "If research does eventually uncover convincing evidence of the efficacy of bed rest, investigators and care providers must pay strict attention to the prevention and treatment of adverse maternal and infant side effects. Success in the effort to reduce preterm birth may only come about when we, as researchers and providers, reconceptualize prenatal care as only one part of a lifelong effort to optimize women's health, beginning at birth."

Sources: SAGE Publications, AlphaGalileo Foundation.