Effects of yoga on cardiometabolic risks and fetomaternal outcomes are associated with serum nitric oxide in gestational hypertension: a randomized control trial

Abstract

Gestational hypertension (GH) is associated with adverse cardiometabolic and pregnancy outcomes. Though yoga is known to be beneficial in pregnancy, the effects of yoga rendered for twenty weeks starting from 16th week of gestation in pregnant women having risk of GH on the incidence of hypertension, cardiometabolic risks and fetomaternal outcomes have not been studied. A randomized control trial was conducted on 234 pregnant women having risk of GH receiving standard antenatal care (Control group, n = 113), and receiving standard care + yoga (Study group, n = 121). Interventions were given for twenty weeks starting at 16th week of gestation. Baroreflex sensitivity (BRS), heart rate variability (HRV), insulin resistance, lipid-risk factors, and markers of inflammation, oxidative stress and vascular endothelial dysfunction (VED) were assessed before and after intervention. Incidence of new-onset hypertension, level of cardiometabolic risks at 36th week, and fetomaternal-neonatal outcomes in the perinatal period, were noted. The link of hypertension, pregnancy outcomes and cardiometabolic risks with nitric oxide (NO), the marker of VED was assessed by analysis of covariance, Pearson’s correlations, and multilinear and logistic regressions. In study group, 6.61% women developed hypertension compared to 38.1% in the control group following 20-week intervention and there was significant decrease in risk of developing GH (RR, 2.65; CI 1.42–4.95). There was less-painful delivery, decreased duration of labor, increased neonatal birthweight and Apgar score in study group. Increase in total power of HRV (β = 0.187, p = 0.024), BRS (β = 0.305, p < 0.001), and decrease in interleukin-6 (β = − 0.194, p = 0.022) had significant association with increased NO. Twenty weeks of practice of yoga during pregnancy decreases the incidence of hypertension, improves fetomaternal outcomes, and reduces cardiometabolic risks in pregnant women having risk of GH. Decreased blood pressure, increased HRV, BRS and birth weight and decreased inflammation were associated with improved endothelial function. Trial registration: Clinical Trials Registry of India (CTRI), registration number: CTRI/2017/11/010608, on 23.11.2017.

Influence of Physical Activity during Pregnancy on Birth Weight: Systematic Review and Meta-Analysis of Randomized Controlled Trials

“…There were a total of 61 studies that were incorporated in this analysis [ 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , 81 , 82 ,…”

Does Yoga impact during Pregnancy: Systematic Review

“…Yoga is a bene cial intervention for both pregnant women and their babies. Yoga intervention groups consistently had a decreased incidence of pregnancy-induced hypertension [11,24], and preeclampsia labour [10,11,22], lower levels of discomfort (p = 0.001) lower levels of stress (p < 0.001) Labor anxiety and depression, scores on relationship quality and a decreased frequency of babies born at a young gestational age. Lumbopelvic discomfort, stress, anxiety, and depression as well as high-risk pregnancy can be reduced by using yoga therapy [9,14,17,18].…”

“…Three studies on high-risk pregnant women have been done [10][11][12], and one study on pregnant women who suffered pelvic pain [14]. During pregnancy, two studies on hypertension [23,24], were conducted. The rest of the studies focused on normal pregnant women.…”

“…Prenatal abnormalities, labour pain [17,18,20,24], and neonatal outcomes. Prenatal illnesses such as fetal growth restriction (FGR), pregnancy-induced hypertension [23,24], low immunoglobulin, and low platelet count are some of the more frequent problems that may impact pregnancies in both developing and developed nations [16,26].…”

Increased respiratory modulation of cardiovascular control reflects improved blood pressure regulation in pregnancy

“…A failure in this poorly understood mechanism could cause elevated BP in hypertensive pregnant women. Kuzhanthaivelu et al (Karthiga et al, 2021) reported a significant correlation between decreased NO levels and cardiovagal modulation using spectral analysis of heart rate variability. Therefore, hypertensive pregnancy disorders seem to reflect disruptions in the interaction of systems related to BP control that can be studied from a dynamic approach.…”