Prenatal massage in pregnant women in the third trimester to improve maternal sleep quality: quasi-experimental study 10.55131/jphd/2026/240118
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Abstract
The third trimester of pregnancy is marked by significant physiological and psychological changes that often lead to sleep disturbances and adversely affect maternal and fetal well-being. This study explored the potential of prenatal massage as a non-pharmacological intervention to improve sleep quality among expectant mothers during this critical period. This Framework employed a quasi-experimental design utilizing a pretest-posttest control group to investigate the effects of prenatal massage on third-trimester pregnant women in Bima City, conducted from July 2024 to January 2025. A total of 448 participants were selected through cluster sampling and divided equally into an intervention group receiving prenatal massage and a control group following routine health service programs. Data collection involved skilled midwives administering a validated questionnaire, consisting of 10 questions with high content validity (i-CVI > 0.83) and reliability (Cronbach's alpha = 0.82). The Wilcoxon signed-rank test was used for within-group comparisons and the Mann-Whitney test was used for between-group differences. Results indicated a significant improvement in sleep quality within the intervention group, where 96.4% reported good sleep quality post-intervention compared to only 7.1% pre-intervention. In contrast, the control group showed minimal changes, with only 5.4% reporting good sleep quality after the same period. Statistical analyses showed P values (0.000 and 0.002 respectively), confirming the significant effectiveness of the intervention. These findings suggest that integrating prenatal massage with prenatal care can enhance the well-being of pregnant women. Overall, this study underscores the importance of addressing sleep quality in prenatal care.
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References
Mei X, Du P, Li Y, et al. Fear of childbirth and sleep quality among pregnant women: a generalized additive model and moderated mediation analysis. BMC Psychiatry 2023;23(1): 1–11; doi: 10.1186/s12888-023-05435-y.
Peltonen H, Paavonen EJ, Saarenpää-Heikkilä O, et al. Sleep disturbances and depressive and anxiety symptoms during pregnancy: associations with delivery and newborn health. Arch Gynecol Obstet 2022;307(3):715–728; doi: 10.1007/s00404-022-06560-x.
Rahayu SW. The Effect of Loving Pregnancy Massage on Sleep Quality of Trimester III Pregnant Mother. Midwifery and Nursing Research 2020;2(2):65–68; doi: 10.31983/ manr.v2i2.5131.
Pachtman Shetty SL, Fogarty S. Massage During Pregnancy and Postpartum. Clin Obstet Gynecol 2021;64(3):648–660; doi: 10.1097/ GRF.0000000000000638.
Nadholta P, Kumar K, Saha PK, et al. Mind-body practice as a primer to maintain psychological health among pregnant women–YOGESTA–a randomized controlled trial. Front Public Health 2023;11(9):1–11; doi: 10.3389/fpubh.2023.1201371.
Meier M, Unternaehrer E, Dimitroff SJ, et al. Standardized massage interventions as protocols for the induction of psychophysiological relaxation in the laboratory: a block randomized, controlled trial. Sci Rep 2020;10(1):1–12; doi: 10.1038/s41598-020-71173-w.
Maghami M, Shariatpanahi SP, Habibi D, et al. Sleep disorders during pregnancy and postpartum depression: A systematic review and meta‐analysis. International Journal of Developmental Neuroscience 2021;81(6):469–478; doi: 10.1002/jdn.10118.
Amyx M, Xiong X, Xie Y, et al. Racial/Ethnic Differences in Sleep Disorders and Reporting of Trouble Sleeping Among Women of Childbearing Age in the United States. Matern Child Health J 2017;21(2):306–314; doi: 10.1007/s10995-016-2115-9.
Makmun I. Effectiveness of Massage Therapy and Gentle Yoga with Prenatal Depression. EMBRIO 2023;15(2):248–254; doi: 10.36456/embrio.v15i2.7662.
Venugopal L, Rajendran P, V. P. A study on assessment of sleep quality in south Indian pregnant women. Int J Res Med Sci 2018;6(10):3197–3201; doi: 10.18203/2320-6012.ijrms20183825.
Zhang L, Wang L, Cui S, et al. Prenatal Depression in Women in the Third Trimester: Prevalence, Predictive Factors, and Relationship With Maternal-Fetal Attachment. Front Public Health 2021;8(1):1–8; doi: 10.3389/fpubh.2020.602005.
Chompoopan W, Eungpinichpong W, Chompoopan W, et al. The Effect of Traditional Thai Massage on Quality of Sleep in Adults with Sleep Problem. Trends in Sciences 2022;19(7):1–8; doi: 10.48048/tis.2022.3063.
Polo‐Kantola P, Aukia L, Karlsson H, et al. Sleep quality during pregnancy: associations with depressive and anxiety symptoms. Acta Obstet Gynecol Scand 2017;96(2):198–206; doi: 10.1111/aogs.13056.
Makmun I. Effectiveness of Massage Therapy and Gentle Yoga with Prenatal Depression. EMBRIO 2023;15(2):248–254; doi: 10.36456/embrio.v15i2.7662.
Okun ML, Schetter CD, Glynn LM. Poor Sleep Quality is Associated with Preterm Birth. Sleep 2011;34(11): 1493–1498; doi: 10.5665/sleep.1384.
Mueller SM, Grunwald M. Effects, Side Effects and Contraindications of Relaxation Massage during Pregnancy: A Systematic Review of Randomized Controlled Trials. J Clin Med 2021;10(16):1–17; doi: 10.3390/ jcm10163485
Slovin. Siovin’s Formula for Sampling Technique. 1960.
Gao CX, Dwyer D, Zhu Y, et al. An overview of clustering methods with guidelines for application in mental health research. Psychiatry Res 2023;327(9):1–28; doi: 10.1016/ j.psychres.2023.115265.
van Breukelen GJ, Candel MJ. Efficient design of cluster randomized and multicentre trials with unknown intraclass correlation. Stat Methods Med Res 2015;24(5):540–556; doi: 10.1177/0962280211421344.
Arafah D, Thomas B, Fenton TR, et al. Validity and reliability of the Arabic version of Muller’s prenatal attachment inventory. Journal of Psychosomatic Obstetrics & Gynecology 2021;42(3): 212–220; doi: 10.1080/0167482X. 2020.1713083.
Hereibi MJ, Arthur JP, Mantovani M de F, et al. Construct validity and reliability of the Brazilian version of Hypertension Knowledge-Level Scale. Rev Gaucha Enferm 2021;42(1):1–9; doi: 10.1590/1983-1447.2021.201904 29.
Zhang H, Li P, Fan D, et al. Prevalence of and Risk Factors for Poor Sleep During Different Trimesters of Pregnancy Among Women in China: A Cross-Sectional Study. Nat Sci Sleep 2021;13(6):811–820; doi: 10.2147/ NSS.S303763.
Peiris MSK, Sundarapperuma TDarshi. Determinants of sleep quality among pregnant women in a selected institution in the Southern province, Sri Lanka. PLoS One 2024;19(7):1–13; doi: 10.1371/journal.pone.0305388.
Turkmen N, Alanya Tosun S, Ayraler A, et al. Sleep hygiene education program during pregnancy: a prospective randomized controlled study. Arch Gynecol Obstet 2024; 310(2):1071–1080; doi: 10.1007/ s00404-024-07471-9.
Wang W-L, Chen K-H, Pan Y-C, et al. The effect of yoga on sleep quality and insomnia in women with sleep problems: a systematic review and meta-analysis. BMC Psychiatry 2020;20(1):1–19; doi: 10.1186/s12888-020-02566-4.
Song B, Wang D, Yan X, et al. Physical activity and sleep quality among pregnant women during the first and second trimesters are associated with mental health and adverse pregnancy outcomes. BMC Womens Health 2024;24(1):1–10; doi: 10.1186/s12905-024-03126-8.
Hajipour M, Soltani M, Safari-Faramani R, et al. Maternal Sleep and Related Pregnancy Outcomes: A Multicenter Cross-sectional Study in 11 Provinces of Iran. J Family Reprod Health 2021;1(4):1–11; doi: 10.18502/ jfrh.v15i1.6078.
Yang C-L, Jansen EC, Dunietz GL, et al. Sleep Disparities Across Pregnancy: A Michigan Cohort Study. Women’s Health Reports 2023;4(1):219–231; doi: 10.1089/whr.2023.0009.
Ertmann RK, Nicolaisdottir DR, Siersma V, et al. Factors in early pregnancy predicting pregnancy‐related pain in the second and third trimester. Acta Obstet Gynecol Scand 2023;102(10):1269–1280; doi: 10.1111/aogs.14670.
Tang Y, Zhang J, Dai F, et al. Poor sleep is associated with higher blood pressure and uterine artery pulsatility index in pregnancy: a prospective cohort study. BJOG 2021;128(7):1192–1199; doi: 10.1111/1471-0528.16591.
Facco FL, Chan M, Patel SR. Common Sleep Disorders in Pregnancy. Obstetrics & Gynecology 2022;140(2): 321–339; doi: 10.1097/AOG.000000 0000004866.
Flor-Alemany M, Nestares T, Alemany-Arrebola I, et al. Influence of Dietary Habits and Mediterranean Diet Adherence on Sleep Quality during Pregnancy. The GESTAFIT Project. Nutrients 2020;12(11):1–11; doi: 10.3390/nu12113569.
Zendehdel M, Elyasi F, Jahanfar S, et al. Effectiveness of progressive muscle relaxation technique on anxiety caused by Covid‐19 in pregnant women: A randomized clinical trial. Neuropsychopharmacol Rep 2022; 42(2):158–165; doi: 10.1002/npr2. 12241.
Wulandari A, Kostania G. Soaking Feet Hydrotherapy Using Warm Water to Improve Quality of Sleeping Among Pregnant Women. Jurnal Kebidanan dan Kesehatan Tradisional 2021; 6(3):16–23; doi: 10.37341/jkkt.v0i0. 232.
Fu T, Wang C, Yan J, et al. Relationship between antenatal sleep quality and depression in perinatal women: A comprehensive meta-analysis of observational studies. J Affect Disord 2023;327(4):38–45; doi: 10.1016/ j.jad.2023.01.125.
Madan Jha V. The prevalence of sleep loss and sleep disorders in young and old adults. Aging Brain 2023;3(12):1–13; doi: 10.1016/j.nbas.2022.100057.
Mengistie Zeleke A, Chekol Tassew W, Melkie Bayeh G, et al. Poor sleep quality and associated factors among pregnant women in Ethiopia: A systematic review and meta-analysis. Clin Epidemiol Glob Health 2024; 29(9):1–7; doi: 10.1016/j.cegh.2024. 101755.
Huang Y, Yang L, Liu Y, et al. Effects of perceived stress on college students’ sleep quality: a moderated chain mediation model. BMC Psychol 2024;12(1):1–11; doi: 10.1186/s40359-024-01976-3.
Salamung N, Elmiyanti NK. Effect of Aromatherapy on Sleep Quality: A Systematic Review. International Journal of Nursing and Health Services (IJNHS) 2023;6(5):292–302; doi: 10.35654/ijnhs.v6i5.728.
Simão S, Höring AC, Lima B de O, et al. Immediate effect of quick massage on muscle tension and pressure pain threshold. Brazilian Journal Of Pain 2021;4(3):221–224; doi: 10.5935/2595-0118.20210048.
