Assessment of a short-course yoga practice on cardiometabolic risks, fetomaternal outcomes and psychophysical health in gestational diabetes mellitus

Abstract

Introduction and Aim: Gestational diabetes mellitus (GDM), which is defined as diabetes diagnosed in the second and third trimesters of pregnancy, has emerged as a global public health concern. It has been associated with short-term and long-term adverse health outcomes for both mothers and their new-borns. Women with GDM are known to have decreased quality of life and increased risks of caesarean section, gestational hypertension, preeclampsia, and type 2 diabetes. In babies, GDM has been found to be associated with macrosomia or larger than normal gestational-aged infants, neonatal hypoglycemia, and type 2 diabetes mellitus later in life. Though yoga is known to improve the quality of life of diabetic patients, its role in the management of GDM has not been adequately assessed. Therefore, the present study was conducted to evaluate the effectiveness of Yoga on cardiometabolic parameters, psychophysical health and maternal and fetal outcomes in GDM patients at JIPMER hospital, Puducherry.
 
 Methods: Fifteen pregnant women diagnosed to have GDM, admitted to Obstetrics Ward of JIPMER Hospital were recruited for the study. The intervention package of a thirty minutes Yoga module consisting of Sukshma Vyayama (2 min), Tadasana (1 min), Utthitapadasana (1 min), Savasana in the left lateral posture (3 min), Nadisodhana or Anuloma-viloma pranayama (5 min), Chandranadi pranayama (5 min), Sheetali pranayama (5 min) and Bhramari pranayama (5 min) and Relaxation (3 min) was administered along with hospital routine treatment for 10 days during 35th/36th week (depending on the gestational week of admission to hospital), or until delivery. Cardiometabolic parameters including heart rate (HR), blood pressure (BP), rate pressure product (RPP) and glycemic status assessed by random blood sugar (RBS) were investigated. JIPMER hospital tool for the maternal and fetal outcome variables were used to assess the feto-maternal parameters. Perceived Stress Score (PSS) and Quality of Life Score (QoL) were used to assess the psychophysical health of the GDM patients. All the parameters were assessed before and after yoga intervention. Paired t test was used for statistical analysis of data. P value of <0.05 were considered to indicate significant statistical difference.
 Results: Statistically significant decrease in HR, BP, RPP, RBS, PSS, and increase in QoL, and improvement of fetomaternal outcomes (based on the normative data available in the department) were observed in GDM patients after yoga intervention for a period of seven to ten days during their hospital stay.
 Conclusion: A short-course yoga practice for 7-10 days is adequate to reduce cardiometabolic risks, psychological stress, and improve quality of life and feto-maternal outcomes in GDM patients. Antenatal mother with GDM can use yoga as an adjunct therapy in the later part of pregnancy to prevent or reduce the complications and to improve the maternal and fetal outcomes of gestational diabetes mellitus.

Inflammation and decreased cardiovagal modulation are linked to stress and depression at 36th week of pregnancy in gestational diabetes mellitus

“…It is important for healthcare workers to know the relationship between stress and depression with fetomaternal outcomes, and if the depression-associated problems can be prevented in the perinatal period. In a recently conducted pilot study at 36th week of gestation in 15 women having GDM, we observed that cardiometabolic risks, adverse fetomaternal outcomes and poor psychophysical health were improved by practice of short course of yoga 18 . But, in this study due to less sample size, we could not assess the enormity of cardiometabolic risks, the mechanisms that could lead to development of these risks and the link of depression to the risks and the maternal–fetal outcomes.…”

Retrograde Inflammation Contributes to Psychological Stress and Depression in Gestational Diabetes Mellitus

“…In a recently conducted pilot study at 36 th week of gestation in 15 women having GDM, we observed that cardiometabolic risks, adverse fetomaternal outcomes and poor psychophysical health were improved by practice of short course of yoga. [5] But, in this study due to less sample size, we could not assess the enormity of cardiometabolic risks, the mechanisms that could lead to development of these risks and the link of depression to the risks and the maternal-fetal outcomes.…”