Effects of Mindfulness Therapy on Stress Biomarkers and Psychological Symptoms in Women With Recurrent Pregnancy Loss: A Randomized Clinical Trial.

Abstract

Women with recurrent pregnancy loss (RPL) exhibit high levels of depression, anxiety, and stress, which negatively impact their quality of life. This randomized clinical trial evaluated the effects of an eight-week online Mindfulness-Based Intervention (MBI), with weekly one-hour sessions, on psychological and biological markers of stress in 35 women with RPL. Participants were randomly assigned to either the MBI or standard care (control group) and assessed before and after the intervention through salivary biomarkers (cortisol, alpha-amylase, and Immunoglobulin A-IgA) and the validated questionnaires Depression, Anxiety and Stress Scale-21 (DASS-21) and Psychological General Well-Being Index (PGWB-I). No significant time × group interactions were observed for salivary biomarkers, including cortisol (p = 0.672), alpha-amylase (p = 0.342), and IgA (p = 0.148). Participants in the MBI group showed significant reductions in total DASS-21 (p = 0.018), depression (p = 0.026), and stress (p = 0.015) scores, whereas anxiety did not differ significantly between groups (p = 0.121). They also showed robust improvements in overall well-being (p < 0.001) and multiple PGWB-I domains. These findings suggest that MBI may improve self-reported psychological well-being in women with RPL; however, as no significant effects were observed in the primary biomarker outcomes, these secondary psychological findings should be considered exploratory and hypothesis-generating. TRIAL REGISTRATION: https://ensaiosclinicos.gov.br/rg/RBR-4xc76cr.