Could Bed Rest During Pregnancy Be Harmful?

Although doctors have recommended for centuries that women with high-risk pregnancies go on bed rest, and about one in five women in the U.S. are placed on bed rest every year, researchers are arguing that confining pregnant women to bed for long periods of time is not necessarily a practice based on good evidence, and may potentially be harmful, the New York Times reports.

In the new group of studies published in the latest issue of Obstetrics & Gynecology, researchers followed 657 pregnant women who were at risk of delivering preterm babies in one randomized study. Although about 250 of the at-risk pregnant women were ordered by their doctors to restrict their activities to lower their risks of preterm labor, the study found that 40 percent of those women ended up delivering preterm, which was about double the number of women that were not confined to bed rest.

Researchers concluded that activity restriction during pregnancy did not reduce the rate of preterm births, and noted the downsides of bed rest including "maternal weight loss, bone and muscle atrophy and an increased risk of blood clots."  

In another paper that reviewed data from many previous studies on the subject, evidence was not found to support the practice of restricting women's activity "in preventing miscarriage, pregnancy-induced hypertension or low birth weight." Due to the lack of evidence and potential for harm, "the American College of Obstetricians and Gynecologists advises against bed rest for the prevention of preterm deliveries."

Dr. Joseph R. Biggio Jr. of the University of Alabama at Birmingham, argued in a recent editorial that doctors should be limiting the use of bed rest until its benefits are proven by clinical trials.

"In obstetrics, we can often lack solid data upon which to base clinical recommendations for preventing pregnancy complications or for optimizing pregnancy outcomes after complications develop," he wrote.

He cited the origins of bed rest for pregnant women dating back to the time of Hippocrates, but wrote that the latter half of the 19th century showed an increase in the practice after the publication of a series of lectures on the subject.

"Bed rest remains one of the most commonly prescribed treatments to improve reproductive outcomes in complicated pregnancies," Dr. Biggio wrote, "despite a lack of evidence that it improves any obstetric or neonatal outcomes." He said that as many as 95 percent of obstetricians report recommending the practice of bed rest or restricted activity to their patients in some form in their practices.