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- Lavender (Lavandula angustifolia, Lamiaceae)
- Pregnancy
- Anxiety and Stress
- Depression
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Date:
05-29-2015 | HC# 051551-521
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Re: Topical Lavender Cream Alleviates Anxiety, Stress, and Depression in Pregnant Women
Effati-Daryani
F, Mohammad-Alizadeh-Charandabi S, Mirghafourvand M, Taghizadeh M, Mohammadi A.
Effect of lavender cream with or without foot-bath on anxiety, stress and
depression in pregnancy: a randomized placebo-controlled trial. J Caring Sci. 2015;4(1):63-73.
Maternal
anxiety, stress, and/or depression during pregnancy have a negative effect on the
health of both mother and child. Lavender (Lavandula
angustifolia, Lamiaceae) flower
essential oil has been shown to decrease anxiety, stress, and depression. Foot bathing
has also been found to improve autonomic function, sleep quality, and
relaxation. The purpose of this randomized, double-blind, placebo-controlled
study was to compare the effect of lavender cream, foot bathing, and placebo treatment
on anxiety, stress, and depression in pregnant women.
Healthy
pregnant women (n=141, aged 18-40 years) at 25-28 weeks gestation participated
in this study conducted at Tabriz University of Medical Sciences; Tabriz, Iran.
Excluded patients had a history of any chronic disease; were taking any
medication (e.g., sedatives) that might interfere with the interventions;
smoked; had a history of infertility; had a recent unwanted pregnancy; had a history
of allergy to herbal medicines; had inflammation at the site of cream application;
had current severe depression, anxiety, or stress (score of ≥10 on the anxiety
sub-scale, ≥17 on the stress sub-scale, or ≥14 on the depression sub-scale of
the Depression
Anxiety Stress Scales-21 [DASS-21]); were obese (body mass index ≥30); were
illiterate; worked a night shift; or lived outside of Tabriz city. The sample
size was calculated to detect a reduction of at least 43% in mean anxiety score
and 40% in mean depression score on the DASS-21. P-values of <0.05 were
considered significant.
Patients
were randomly assigned into 3 groups as follows: placebo, lavender cream (Barij
Essence Pharmaceutical Company; Kashan, Iran), and lavender cream + foot bath. The
lavender cream contained 1.25% lavender essential oil; the placebo was the base
cream consisting of stearic acid, acetyl alcohol, Vaseline®, and
glycerin. Patients were instructed to rub 2 g of lavender or placebo cream on
their legs for 10-20 minutes, 1.5 hours before bedtime for 8 weeks. The lavender
+ foot bath group was told to soak their feet in 40-42°C tap water, at a depth
of 5 cm above the ankle, for 30 minutes after applying the cream. To facilitate
blinding, patients only knew that the effect of an herbal cream was being
investigated; the name of the plant was not mentioned.
The
patients completed the DASS-21 questionnaire at baseline, 4 weeks, and 8 weeks.
Based on their responses, anxiety, stress, and depression sub-scores were calculated.
To assess compliance, patients were asked to keep a daily diary of treatment
application and to return cream tubes at the week 4 and week 8 visits.
At
baseline, the groups had similar characteristics. Compliance was similar among
all 3 groups. No serious side effects were reported. One patient in the
lavender + foot bath group and 3 patients in the placebo group were lost to
follow-up.
At
4 weeks, a significant improvement in stress and anxiety scores (P<0.05 for
both) was observed in the lavender group compared to placebo. The lavender +
foot bath group had significantly improved stress scores compared to placebo (P<0.05).
At
8 weeks, there was a significant improvement in anxiety, stress, and depression
in the lavender group compared with the placebo group (P<0.05 for all), and
in the lavender + foot bath group compared with the placebo group (P<0.05
for all). There was no significant difference in DASS-21 scores between the
lavender group and the lavender + foot bath group.
Acknowledged limitations of the study include the lack of a placebo + foot bath
treatment arm, the lack of physiological measures of stress such as saliva
cortisol levels, and that the results cannot be generalized to pregnant women
with psychological disorders. In addition, this study only used one instrument (DASS-21)
to measure anxiety, stress, and depression.
The
authors conclude that lavender cream with or without foot bathing for 8 weeks significantly
improved anxiety, stress, and depression in pregnant women. They recommend
further studies to assess the effect of lavender on pregnant women with
psychological disorders and women with postpartum depression. It is important
to note that this study applies to the topical use of lavender essential oil.
Future studies should consider the use of a natural carrier oil rather than a
petroleum-based carrier.
—Heather S. Oliff,
PhD
Editorial Comment:
Although this article is marred with typographical and
grammatical errors, the reported methodology is rigorous.
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