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

Elaine Cristina Fontes de Oliveira, Sara de Pinho Cunha Paiva, Enrrico Bloise, Fernando Marcos Dos Reis

Stress and Health October 1, 2026 DOI: 10.1002/smi.70228 (opens in new tab)

Study at a glance

AI-extracted from the abstract
Characteristics Randomized clinical trial Peer reviewed
Sample size 35
Population Women with recurrent pregnancy loss (RPL)
Intervention Mindfulness-Based Intervention (MBI)
Duration 8-week intervention with weekly one-hour sessions; assessments before and after the intervention
Measures Depression, Anxiety and Stress Scale-21 (DASS-21), Psychological General Well-Being Index (PGWB-I), salivary cortisol, salivary alpha-amylase, salivary Immunoglobulin A (IgA)
Topics Meditation
Key findings The mindfulness-based intervention produced no significant time-by-group changes in salivary cortisol, alpha-amylase, or IgA. Participants in the intervention group showed significant reductions in total DASS-21, depression, and stress scores, but not anxiety, and improvements in overall well-being and multiple PGWB-I domains. The authors caution that because the primary biomarker outcomes were null, these psychological findings are exploratory and hypothesis-generating.

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.

Comparable studies

Other randomized controlled trials on meditation, most cited first.

Study Year Design Participants
Alterations in Brain and Immune Function Produced by Mindfulness Meditation Healthy employees in a work environment 2003 Randomized controlled trial n = 41
Prevention of relapse/recurrence in major depression by mindfulness-based cognitive therapy. Recovered recurrently depressed patients 2000 Randomized controlled trial n = 145
Open hearts build lives: Positive emotions, induced through loving-kindness meditation, build consequential personal resources. Working adults 2008 Randomized controlled trial n = 139
Short-term meditation training improves attention and self-regulation Undergraduate Chinese students 2007 Randomized controlled trial n = 40
Mindfulness-Based Cognitive Therapy for Depression: Replication and Exploration of Differential Relapse Prevention Effects. Recovered recurrently depressed patients 2004 Randomized controlled trial n = 73

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