The effect of aromatherapy with Citrus aurantium essential Oil on anxiety in women at risk of preterm labor

Document Type : Original Article

Authors

1 M.Sc. student of Midwifery, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran.

2 Assistant Professor, Department of Midwifery, Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.

3 Instructor, Department of Nursing, Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.

4 Assistant Professor, Department of Pharmacology, School of Traditional Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

5 PhD in Psychologic Nursing, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran.

6 Assistant Professor, Department of Obstetrics and Gynecology, Nursing and Midwifery Care Research Center, Jiroft University of Medical Sciences, Jiroft, Iran.

Abstract

Introduction: Psychological disorders such as anxiety can increase preterm labor by hormonal stimulation, so this study was performed with aim to determine the effect of aromatherapy with Citrus aurantium essential oil on anxiety in women at risk of preterm labor.
Methods: This two-group semi-experimental interventional study was conducted in 2020 on 65 pregnant women at risk of preterm delivery referred to the health centers in Jiroft. Eligible women who received a score of ≥10 in the Holbrook Pregnancy Screening Questionnaire and met other inclusion criteria received Citrus aurantium essential oil or placebo twice daily for two weeks. Anxiety was assessed before and after the intervention (end of the first week and end of the second week) with the Spielberger Anxiety Inventory. Data were analyzed using SPSS software (version 21) and independent t-test and paired t-test, analysis of variance and Friedman test. P<0.05 was considered statistically significant.
Results: In the intervention group, changes in overt and covert anxiety scores of the stages (before, 1 week and 2 weeks after the intervention) were significant (p = 0.001), but in the placebo group, based on the results of repeated measures test, the difference between these changes between stages was not significant in the two groups of overt anxiety (p = 0.836) and covert anxiety (P = 0.575).
Conclusion: The use of aromatherapy with Citrus aurantium led to a decrease in anxiety scores in pregnant women at risk of preterm labor. Therefore, it can be effective as an easy, cheap and non-invasive intervention in reducing the anxiety of women at risk of preterm labor.

Keywords


  1. Momayyezi M, Farzaneh F, Lotfi MH. Mental Health Status (Depression, Anxiety and Stress) of Employed and Unemployed Women in Yazd, Iran, 2015. Health and Development Journal 2020; 7(3):239-49.
  2. Parker KM, Smith SA. Aquatic-aerobic exercise as a means of stress reduction during pregnancy. The Journal of Perinatal Education 2003; 12(1):6.
  3. Azizi S, Molaeinezhad M. Anxiety status in pregnant mothers at third trimester of pregnancy and its related factors in referrals to Bandar Abbas Hospitals in 2012. Iran J Obstet Gynecol Infertil 2014; 17(122):8-15.
  4. Ebrahimi A, Ghodrati F. Investigation of the effectiveness of some complementary medicine and techniques based on religious approach and Islamic spirituality therapy in reducing prenatal and delivery anxiety. Women’s Health Bulletin 2020; 7(1):1-10.
  5. Rahimi F, Ahmadi M, Rosta F, Alavimajd H, Valiani M. Investigating the effect of progressive muscle relaxation training on infants outcome in high risk pregnant women. scientific journal of ilam university of medical sciences 2018; 25(6):10-20.
  6. Mirzakhani K, Hejazinia Z, Golmakani N, Mirteimouri M, Sardar MA, Shakeri MT. The effect of execution of exercise program with birth ball during pregnancy on anxiety rate in nulliparous women. Iran J Obstet Gynecol Infertil 2014; 17(117):8-16.
  7. Neshat R, Majlesi F, Rahimi A, Shariat M, Pourreza A. Investigation the relationship between preterm delivery and prevalence of anxiety, stress and depression in pregnant women of dorrod health center, Iran in 2010. Iran J Obstet Gynecol Infertil 2013; 16(67):16-24.
  8. Azh N, Ghasemi M, Khani M, Mafi M, Ranjkesh F. Relationship between maternal stress and pregnancy outcomes: A prospective study. Iran J Obstet Gynecol Infertil 2019; 22(5):27-36.
  9. Moghadasi M, Soltanahmadi Z, Azizzadeh FM, Mahdizadeh A, Jahani Y. The Effect of Supportive Counseling on Reducing Theanxiety of Women at Risk of Preterm Birth. The Journal of Urmia Nursing and Midwifery Faculty 2016; 14(2):151-8.
  10. Shobeiri F, Manoucheri B, Parsa P, Roshanaei G. Effects of counselling and sole reflexology on fatigue in pregnant women: a randomized clinical trial. Journal of clinical and diagnostic research: JCDR 2017; 11(6):QC01.
  11. Rich-Edwards JW, Grizzard TA. Psychosocial stress and neuroendocrine mechanisms in preterm delivery. American journal of obstetrics and gynecology 2005; 192(5):S30-5.
  12. Amiri N, Salmalian H, Hajiahmadi M, Ahmadi AM. Association between prenatal anxiety and spontaneous preterm birth. Journal of Babol University of Medical Sciences 2009; 11(4):42-8.
  13. Imanparast R, Bermas H, Danesh S, Ajoudani Z. The effect of cognitive behavior therapy on anxiety reduction of first normal vaginal delivery. SSU_Journals 2014; 22(1):974-80.
  14. Orr ST, James SA, Blackmore Prince C. Maternal prenatal depressive symptoms and spontaneous preterm births among African-American women in Baltimore, Maryland. American journal of epidemiology 2002; 156(9):797-802.
  15. Bodaghi E, Alipour F, Bodaghi M, Nori R, Peiman N, Saeidpour S. The role of spirituality and social support in pregnant women's anxiety, depression and stress symptoms. Community Health Journal 2017; 10(2):72-82.
  16. Bastani F, Haghani H. Effectiveness of foot reflexology on maternal post C-section fatigue: a non-randomized clinical trial. Evidence Based Care 2015; 5(3):51-62.
  17. Sharifipour F, Bakhteh A, Mirmohammad Ali M. Effects of Citrus aurantium aroma on post-cesarean anxiety. Iran J Obstet Gynecol Infertil 2015; 18(170.16):12-20.
  18. Namazi M, Akbari SA, Mojab F, Talebi A, Majd HA, Jannesari S. Effects of citrus aurantium (bitter orange) on the severity of first-stage labor pain. Iranian journal of pharmaceutical research: IJPR 2014; 13(3):1011.
  19. Gholamalian F, Tadayon M, Abedi P, Haghighizadeh MH. The effect of lavender aromatherapy on sleep quality in postmenopausal women. Iran J Obstet Gynecol Infertil 2015; 18(157):18-25.
  20. Abbasnia VS. The effect of Citrus Aurantium flowers aqueous extract on sleeping time and the level of anxiety in mice. Journal of Birjand University of Medical Sciences 2016; 23(4):307-14.
  21. Banaiyan G, Rasti Boroujeni E, Shirmardi M. Comparison of the effect of Citrus aurantium and diazepam on preoperative anxiety. Journal of Shahrekord Uuniversity of Medical Sciences 2009; 10(4):13-18.
  22. Setayesh VP, Kheirkhah M, Neisani L, Haghani H. Comparison of the effects of aromatherapy with essential oils of damask rose and hot footbath on the first stage of labor anxiety in Nulliparous women 2012; 5(7):390-5.
  23. de Moraes Pultrini A, Galindo LA, Costa M. Effects of the essential oil from Citrus aurantium L. in experimental anxiety models in mice. Life sciences 2006; 78(15):1720-5.
  24. Akhlaghi M, Shabanian G, Rafieian-Kopaei M, Parvin N, Saadat M, Akhlaghi M. Citrus aurantium blossom and preoperative anxiety. Revista brasileira de anestesiologia 2011; 61:707-12.
  25. Igarashi T. Physical and psychologic effects of aromatherapy inhalation on pregnant women: a randomized controlled trial. The journal of alternative and complementary medicine 2013; 19(10):805-10.
  26. Rezaeean SM, Abedian Z, Latifnejad-Roudsari R, Mazloum SR, Abbasi Z. The effect of prenatal self-care based on orem's theory on preterm birth occurrence in women at risk for preterm birth. Iranian journal of nursing and midwifery research 2020; 25(3):242.
  27. Roohy GR, Rahmany A, Abdollahy AA, GhR M. The effect of music on anxiety level of patients and some of physiological responses before abdominal surgery. Journal of Gorgan university of medical sciences 2005; 7(1):75-8.
  28. Bastard J, Tiran D. Aromatherapy and massage for antenatal anxiety: its effect on the fetus. Complementary Therapies in Clinical Practice 2006; 12(1):48-54.
  29. Lehrner J, Marwinski G, Lehr S, Johren P, Deecke L. Ambient odors of orange and lavender reduce anxiety and improve mood in a dental office. Physiology & Behavior 2005; 86(1-2):92-5.
  30. Moslemi F, Alijaniha F, Naseri M, Kazemnejad A, Charkhkar M, Heidari MR. Citrus aurantium aroma for anxiety in patients with acute coronary syndrome: a double-blind placebo-controlled trial. The Journal of Alternative and Complementary Medicine 2019; 25(8):833-9.
  31. Kalani Z, Emtiazy M, Lotfi MH, Dehghan K. Comparison of citrus aurantium and oxazepam tablets efficacy on preoperative anxiety in patients undergoing coronary artery bypass graft surgery. SSU_Journals. 2015; 23(3):1968-75.
  32. González-Mas MC, Rambla JL, López-Gresa MP, Blázquez MA, Granell A. Volatile compounds in citrus essential oils: A comprehensive review. Frontiers in plant science 2019; 10:12.
  33. Lehrner J, Eckersberger C, Walla P, Pötsch G, Deecke L. Ambient odor of orange in a dental office reduces anxiety and improves mood in female patients. Physiology & behavior 2000; 71(1-2):83-6.
  34. Holm L, Fitzmaurice L. Emergency department waiting room stress: can music or aromatherapy improve anxiety scores?. Pediatric emergency care 2008; 24(12):836-8.