Study: Pregnant Women Unaided by Bed Rest

Doctors tell nearly one in five pregnant women to stay in bed for a week or more, but a study has found little evidence that the prescription does any good.

Bed rest disrupts women’s lives and costs more than $1 billion a year in lost wages, lost productivity around the home and hospital costs, the study said. It may also present its own medical risks, such as blood clots, researchers said.

Prescribed for a variety of conditions, bed rest is usually done at home and can last several months.

“In nearly every case when it’s been studied, there is no proof of benefit,” said Dr. Robert Goldenberg, a professor of obstetrics and gynecology at the University of Alabama at Birmingham.

He and his co-authors conclude in the July issue of the journal Obstetrics and Gynecology that doctors should cut down sharply on ordering bed rest and that further studies should be done to see if it really helps.

The researchers used results of a 1988 national survey to calculate that more than 700,000 women a year, or about 18% of pregnant women who deliver after 20 weeks of pregnancy, are advised by their doctors to rest in bed for at least a week during pregnancy.

The researchers also did a computerized search of studies that evaluated bed rest.

They found no evidence that it reduces the rate of first-trimester miscarriage, even though it is sometimes prescribed for women who have slight bleeding called spotting.

Similarly, although obstetrics textbooks generally recommend bed rest for women at risk of premature delivery, researchers found no sign that it lowers that risk in women carrying a single fetus.

The findings for high blood pressure were more complex. For a dangerous form called proteinuric hypertension or pre-eclampsia, women should be hospitalized so they can be closely monitored, the researchers said.

For other women, those whose high blood pressure began before they became pregnant, there’s little evidence bed rest will lead to a healthier baby, they said.

Dr. John Larsen, a professor of obstetrics and gynecology at George Washington University who was familiar with the study results, said some pregnant women with high blood pressure can benefit from bed rest in which they lie on their sides.