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Nadholta P, Kumar K, Saha PK, Suri V, Singh A, Anand A. Mind-body practice as a primer to maintain psychological health among pregnant women-YOGESTA-a randomized controlled trial. Front Public Health 2023; 11:1201371. [PMID: 37766749 PMCID: PMC10520697 DOI: 10.3389/fpubh.2023.1201371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 07/28/2023] [Indexed: 09/29/2023] Open
Abstract
Objective The objective of this study was to investigate the impact of Gestational Yoga-YOGESTA (Gestational Yoga), on the neuropsychology, quality of life, and personality of pregnant women. Design Open label, randomized controlled trial, used allocation concealment to allocate the treatment. Setting Department of Obstetrics and Gynecology and Neuroscience Research Lab, Department of Neurology, Post Graduate Institute of Medical Education and Research, Chandigarh, India. Participants We recruited a total of 100 pregnant women visiting the Outpatient Department of Obstetrics and Gynecology. Participants were aged between 18 and 35 with uncomplicated pregnancies and they were randomly assigned to either the Yoga group (YG) or the usual care group (UCG). A total of 77 pregnant women completed both the pre- and post-survey, with 34 participants in the Yoga group and 43 in the Usual care group. Intervention Pregnant women in their second and third trimesters were provided with a 16-week online Prenatal Yoga intervention. The intervention began after enrollment in the 2nd trimester, specifically between the 16th and 20th week, and was conducted 5 days a week until delivery, with an average intervention period of 47.18 ± 2.031 (mean ± SEM) days. Chief outcome measures We measured Perceived stress, Depression, Anxiety, Stress, and quality of life by using standard questionnaires. Results A total of 77 participants were included in the analysis, with 34 assigned to the Yoga group and 43 assigned to the control group. Most of the measured parameters demonstrated significant changes. The Yoga group exhibited a noteworthy decrease in perceived stress, depression, anxiety, and psychological stress, as well as an improvement in the psychological and environmental domains of QOL-BREF. Conversely, the control group demonstrated a significant increase in perceived stress, depression, anxiety, and psychological stress, along with a reduction in the physical, psychological, and social domains of QOL-BREF at the follow-up stage. Although the two groups were similar at baseline, the Yoga group showed substantial enhancements in perceived stress, depression, anxiety, physiological stress, and overall quality of life when compared to the control group at follow-up. Conclusion The study's findings indicate that stress, anxiety, and depression are more likely to occur as gestational age progresses during pregnancy. Nevertheless, practicing Prenatal Yoga can effectively manage these changes and enhance the quality of life for expectant mothers.Clinical trial registration: Clinical Trials Registry-India, Identifier CTRI/2021/01/030827.
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Affiliation(s)
- Pooja Nadholta
- Department of Neurology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Krishan Kumar
- Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Pradip Kumar Saha
- Department of Obstetrics and Gynecology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Vanita Suri
- Department of Obstetrics and Gynecology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Amit Singh
- Division of Yoga and Life Science, Swami Vivekananda Yoga Anusandhana Samsthana, Bengaluru, India
| | - Akshay Anand
- Department of Neurology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
- CCRYN-Collaborative Centre for Mind Body Intervention, PGIMER, Chandigarh, India
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Kowalska J. The Level of Stress and Anxiety in Pregnant Women Depending on Social Support and Physical Activity. J Clin Med 2023; 12:jcm12093143. [PMID: 37176585 PMCID: PMC10179597 DOI: 10.3390/jcm12093143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 04/14/2023] [Accepted: 04/25/2023] [Indexed: 05/15/2023] Open
Abstract
Social support and physical activity are mentioned among the numerous factors affecting the emotional state of pregnant women. Therefore, the aim of the study was to assess the level of perceived stress and anxiety in pregnant women depending on social support and their physical activity both before and during pregnancy and find the factors that affected the level of perceived stress. METHODS A total of 373 pregnant women were qualified for the study. The Perceived Stress Scale (PSS-10), the State-Trait Anxiety Inventory (STAI), and a self-administered questionnaire were used. RESULTS In the study group, a high level of stress and anxiety were noted. A comparative analysis showed that physically active women before pregnancy, women attending childbirth classes and remaining in a relationship, were characterized by a lower level of stress and anxiety compared to physically inactive women, women who did not participate in childbirth classes and were single. A multiple linear regression analysis showed that participation in childbirth classes, physical activity before pregnancy, the level of anxiety as a trait, and women's age had the most significant impact on the stress level of surveyed women. CONCLUSIONS Further research among pregnant women and women in the postpartum period is needed to confirm the benefits of physical activity and to identify as many factors as possible that may affect the emotional state of pregnant women.
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Affiliation(s)
- Joanna Kowalska
- Faculty of of Physiotherapy, Wroclaw University of Health and Sport Sciences, 51-612 Wroclaw, Poland
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Jiang T, Tuxunjiang X, Wumaier G, Li X, Li L. Path analysis of influencing factors for prenatal depressive symptoms in pregnant women. J Affect Disord 2022; 317:397-402. [PMID: 36029871 DOI: 10.1016/j.jad.2022.08.076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 05/20/2022] [Accepted: 08/22/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To explore the influencing factors and relationships associated with prenatal depressive symptoms in pregnant women. METHODS This study was a survey based cross-sectional investigation conducted on 750 pregnant women who underwent pregnancy and delivery examinations in a third class hospital in Urumqi City, and their general information was collected and a patient health questionnaire using a depression scale (Patients' Health Questionnaire Depression Scale - 9 item, PHQ - 9). Spss25.0 was used to compare the differences between the maternal depressive symptoms group and the non-depressed group, and Amos23.0 was used to construct a structural equation model to explore the influencing factors. RESULTS The incidence of depressive symptoms in 750 pregnant women was 13.6 % (102/750) and maternal prenatal depressive symptoms was related to occupation, total monthly income, physical exercise, psychological preparation for pregnancy, residence status, couple relationship, knowledge about pregnancy and other factors (P < 0.05). Binary logistic regression analysis showed that the independent risk factors for prenatal depressive symptoms in pregnant women included occupation (OR = 2.492), monthly gross income (OR = 1.293), psychological preparation for pregnancy (OR = 1.882), residential status (OR = 1.831), knowledge about pregnancy (OR = 2.028), prenatal anxiety (OR = 1.415), and pregnancy stress (OR = 4.590). The constructed path analysis model had good a fit (x2/DF = 3.805, GFI = 0.976, AGFI = 0.946, NFI = 0.902, CFI = 0.924, RMSEA = 0.061) and the path analysis showed that pregnancy stress had only a direct effect on prenatal depressive symptoms (effect value 0.169). DISCUSSION The binary logistic regression model showed that knowledge about pregnancy had the greatest influence on prenatal depressive symptoms, and the popularization of pregnancy knowledge reduced prenatal depressive symptoms.
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Affiliation(s)
- Ting Jiang
- Department of Public Health, Xinjiang Medical University, Urumqi, China
| | | | | | - Xue Li
- Department of Public Health, Xinjiang Medical University, Urumqi, China
| | - Ling Li
- Obstetrics Department, The First Affiliated Hospital of Xinjiang Medical University, Urumqi 830011, China.
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Efficacy of Prenatal Yoga in the Treatment of Depression and Anxiety during Pregnancy: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095368. [PMID: 35564762 PMCID: PMC9105819 DOI: 10.3390/ijerph19095368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 04/22/2022] [Accepted: 04/26/2022] [Indexed: 12/10/2022]
Abstract
Women commonly suffer from depression during pregnancy. For reducing depression, yoga seems to be more suitable for pregnant women than other physical activities because of its low exercise intensity. The objective of this study was to assess the efficacy of prenatal yoga on the treatment of depression during pregnancy. Three electronic databases were searched for relevant articles from their inception to May 2021, including PubMed, Cochrane Library, and ScienceDirect. Pre- and post-test outcomes were adopted to estimate standardized mean difference with a 95% confidence interval for assessing the efficacy of yoga. Heterogeneity among articles was detected using I2 value. A total of 13 articles that contained 379 subjects were included for meta-analysis. No significant improvement in depression scores after practicing yoga was observed for women without depression (p = 0.09) but significant improvement was observed for women with depression (p = 0.001). Although significant improvement in anxiety scores after yoga was observed for women without depression (p = 0.02), the results of the sensitivity analysis were not consistent, while significant improvement in anxiety scores after yoga was also observed for women with depression (p < 0.00001). The current evidence has suggested that yoga had significant improvement in depression and anxiety scores in pregnant women with depression. However, the level of evidence of this study was not high. More articles with high levels of evidence should be conducted to confirm our conclusion in the future.
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Weigensberg MJ, Wen CKF, Spruijt-Metz D, Lane CJ. Effects of Group-delivered Stress-reduction Guided Imagery on Salivary Cortisol, Salivary Amylase, and Stress Mood in Urban, Predominantly Latino Adolescents. Glob Adv Health Med 2022; 11:21649561211067443. [PMID: 35223195 PMCID: PMC8874194 DOI: 10.1177/21649561211067443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 11/30/2021] [Indexed: 11/30/2022] Open
Abstract
Objectives To determine acute effects of stress-reduction guided imagery delivered in group format on stress biomarkers salivary cortisol and salivary amylase, and on self-reported stress mood, in healthy, predominantly Latino adolescents. Study Design 111 adolescent participants (94% Latino), a subset from a large, randomized controlled lifestyle intervention to improve obesity-related health behaviors, received either 4 weekly lifestyle education sessions (Lifestyle group; LS) or the same weekly lifestyle education sessions plus an additional weekly stress-reduction guided imagery session delivered in group format (Guided imagery group; GI). Salivary cortisol, salivary amylase, and self-reported stress moods were assessed before and after sessions on intervention weeks 3 and 4. Statistics: Linear mixed effects models examined within- and between-session and group differences in pre- to post-session changes. Results Both groups showed decreases in salivary cortisol, 5% decrease in LS group and 32% in GI group (within-group differences all P < .05), with between-group difference in salivary cortisol of moderate size (P = .05; Cohen’s d = .44). Within the GI group alone, salivary cortisol decrease was similar following either the lifestyle or GI sessions (P = .64). There were no statistically significant amylase changes within or between groups. All 5 individual stress moods declined by 27% to 46% in the GI group (all P < .05), while only 1 of the 5 declined in LS group. Conclusions Group stress-reduction guided imagery reduces the stress biomarker salivary cortisol, as well as reducing subjective stress mood states, making it a viable modality for large scale stress-reduction interventions.
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Affiliation(s)
- Marc J Weigensberg
- Department of Pediatrics, (USC) Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | | | - Donna Spruijt-Metz
- Department of Psychology, USC Dornsife Center for Economic and Social Research, Los Angeles, CA, USA.,Department of Preventive Medicine, USC Keck School of Medicine, Los Angeles, CA, USA
| | - Christianne Joy Lane
- Division of Biostatistics, Department of Preventive Medicine, USC Keck School of Medicine, Los Angeles, CA, USA
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Stress and Psychopathology Reduction in Pregnant Women through Online Cognitive Behavioural Therapy during COVID-19: A Feasibility Study. Behav Sci (Basel) 2021; 11:bs11070100. [PMID: 34356717 PMCID: PMC8301144 DOI: 10.3390/bs11070100] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 06/23/2021] [Accepted: 07/06/2021] [Indexed: 11/16/2022] Open
Abstract
Background: The global pandemic has affected the psychological health of the population, including pregnant women. Due to the difficulty of offering conventional therapies to reduce stress in this population, studies are needed to show the effect of online therapies. Therefore, the objective was to test the effect of online cognitive behavioural therapy in pregnant women during the pandemic on the main variables of stress and psychopathology. Methods: The sample consisted of 16 pregnant women who participated in a weekly cognitive behavioural intervention for 8 weeks. Prenatal concerns, general stress, stress vulnerability, resilience and psychopathology were assessed. Results: The results show a reduction in prenatal concerns, perceived stress, stress vulnerability and psychopathology, as well as an increase in resilience. Conclusions: Online cognitive behavioural intervention may be effective in pregnant women, so it is important to conduct a randomised controlled trial to certify these findings.
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Veronica PA, Enggar, Lastri GH, Rafiah S. The effect of prenatal yoga on the anxiety level of pregnant women. ENFERMERIA CLINICA 2021. [PMID: 33040934 DOI: 10.1016/j.enfcli.2020.06.074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE This study was to determine the effect of prenatal yoga on the anxiety level of third trimesters pregnant women in the Singgani Health Center before and after being given yoga pregnancy. METHOD The method in this study is a type of pre-experimental research that uses the one group pre-test - post-test approach. The samples in this study were 48 subjects using a purposive sampling technique. Prenatal yoga was given to third trimesters pregnancy gestational weeks 30-37 age; the level of anxiety of pregnant women was measured by Interviews using questionnaires. Analysis in the study used the Wilcoxon test. RESULTS Before the intervention of yoga, pregnancy has severe anxiety that is equal to 58.3%, mothers who are not anxious 2.1%, mild anxiety levels 2.1%, mothers who have moderate anxiety levels of 37.5%. After pregnancy yoga, most mothers had a mild anxiety level of 54.1%, mothers who did not have the anxiety of 16.7%, and mothers who had moderate and severe anxiety levels of 14.6% each. Wilcoxon test showed significant statistics. CONCLUSION This study indicated that prenatal yoga could influence the anxiety level of pregnant women.
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Affiliation(s)
| | - Enggar
- Akademi Kebidanan Palu, Sulawesi Tengah, Indonesia
| | | | - Sitti Rafiah
- Department of Midwifery, Graduate School, Hasanuddin University, Indonesia.
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Makhija A, Khatik N, Raghunandan C. A randomized control trial to study the effect of integrated yoga on pregnancy outcome in hypertensive disorder of pregnancy. Complement Ther Clin Pract 2021; 43:101366. [PMID: 33765549 DOI: 10.1016/j.ctcp.2021.101366] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 01/01/2021] [Accepted: 03/13/2021] [Indexed: 11/19/2022]
Abstract
OBJECTIVE The study aimed to evaluate the effects of integrated yoga on blood pressure and pregnancy outcome in hypertensive disorder of pregnancy. METHODS Seventy-nine patients were randomized into study and control groups. The study group received the intervention in the form of integrated yoga for 4 weeks. Final analysis was done on 30 patients each of study and control group. RESULTS The mean systolic BP declined by 7.43 ± 5.86 mmHg in the study group as compared to 2.50 ± 5.21 mm Hg in the control group (p value 0.002). The mean diastolic BP prior to delivery was 88.00 ± 3.71 mmHg in the study group and 92.20 ± 5.02 mmHg in the control group (p = 0.001). The maternal comfort in labor was significantly higher and the duration of labor significantly reduced in the study group. CONCLUSION Integrated yoga effectively reduced systolic and diastolic blood pressures and increased maternal comfort during labor in hypertensive disorder of pregnancy.
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Affiliation(s)
- Amrita Makhija
- Department of Obstetrics and Gynecology, Lady Hardinge Medical College, New Delhi, India.
| | - Neha Khatik
- Department of Obstetrics and Gynecology, Lady Hardinge Medical College, New Delhi, India
| | - Chitra Raghunandan
- Department of Obstetrics and Gynecology, Lady Hardinge Medical College, New Delhi, India
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Shiraishi M, Matsuzaki M, Kurihara S, Iwamoto M, Shimada M. Post-breastfeeding stress response and breastfeeding self-efficacy as modifiable predictors of exclusive breastfeeding at 3 months postpartum: a prospective cohort study. BMC Pregnancy Childbirth 2020; 20:730. [PMID: 33238937 PMCID: PMC7687691 DOI: 10.1186/s12884-020-03431-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2020] [Accepted: 11/16/2020] [Indexed: 11/25/2022] Open
Abstract
Background The rate of exclusive breastfeeding at 3 months postpartum is only 50% in Japan. In order to increase this rate, we aimed to examine modifiable factors related to exclusive breastfeeding at 3 months postpartum by focusing on breastfeeding-related and psychosocial variables at 1 month postpartum. Methods This prospective cohort study was conducted at a secondary medical care center in Osaka, Japan from February 2017 to October 2018. Demographic variables, infant feeding modality, breastfeeding-related variables, and psychosocial variables were obtained using questionnaires at 1 month postpartum. Daytime salivary cortisol levels before and after breastfeeding at 1 month postpartum were measured as a biological marker for stress responses associated with breastfeeding. Each infant’s feeding modality was re-assessed at 3 months postpartum. Multiple logistic regression analyses were performed to examine factors affecting exclusive breastfeeding at 3 months postpartum. Results Of the 104 participants, 61 reported exclusive breastfeeding at 3 months postpartum. The following factors were significantly associated with exclusive breastfeeding at 3 months postpartum: multiparity (adjusted odds ratio, 95% confidence interval: 11.13, 2.08–59.59), having a university degree (5.25, 1.04–26.53), no plan to return to work by 6 months postpartum (0.02, 0.00–0.46), and exclusive breastfeeding (42.84, 6.05–303.52), lower cortisol level after breastfeeding (0.00, 0.00–0.02), and higher breastfeeding self-efficacy scale score (1.07, 1.00–1.14) at 1 month postpartum. In parity-specific analyses, exclusive breastfeeding (25.33, 4.75–134.98) and lower cortisol level after breastfeeding (0.00, 0.00–0.21) at 1 month postpartum in primiparous women, and lower cortisol level after breastfeeding (0.00, 0.00–0.94), higher breastfeeding self-efficacy score (1.18, 1.05–1.32), and absence of breast complications (0.09, 0.01–0.82) at 1 month postpartum in multiparous women were associated with exclusive breastfeeding at 3 months postpartum. Conclusions Stress levels after breastfeeding, breastfeeding self-efficacy, and the presence of breast complications could be modifiable factors associated with subsequent exclusive breastfeeding. Further research is needed to examine whether approaches to reducing breastfeeding-related stress, improving breastfeeding self-efficacy, and preventing breast complications during lactation are effective to increase exclusive breastfeeding practices.
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Affiliation(s)
- Mie Shiraishi
- Department of Children and Women's Health, Division of Health Sciences, Graduate School of Medicine, Osaka University, 1-7, Yamadaoka, Suita, Osaka, 565-0871, Japan.
| | - Masayo Matsuzaki
- Department of Children and Women's Health, Division of Health Sciences, Graduate School of Medicine, Osaka University, 1-7, Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Shoko Kurihara
- Department of Children and Women's Health, Division of Health Sciences, Graduate School of Medicine, Osaka University, 1-7, Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Maki Iwamoto
- Department of Children and Women's Health, Division of Health Sciences, Graduate School of Medicine, Osaka University, 1-7, Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Mieko Shimada
- Department of Children and Women's Health, Division of Health Sciences, Graduate School of Medicine, Osaka University, 1-7, Yamadaoka, Suita, Osaka, 565-0871, Japan.,Graduate Program of Midwifery, Dokkyo Medical University, Tochigi, Japan
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Guo P, Zhang X, Liu N, Wang J, Chen D, Sun W, Li P, Zhang W. Mind-body interventions on stress management in pregnant women: A systematic review and meta-analysis of randomized controlled trials. J Adv Nurs 2020; 77:125-146. [PMID: 33048358 DOI: 10.1111/jan.14588] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Revised: 07/29/2020] [Accepted: 08/07/2020] [Indexed: 12/17/2022]
Abstract
AIM To quantify the effect of mind-body interventions on stress in pregnant women. DESIGN A systematic review and meta-analysis of randomized controlled trials was performed. DATA SOURCES PubMed, Embase, CENTRAL, Web of Science and PsycINFO were searched from each database inception to January 2020. REVIEW METHODS Randomized controlled trials regarding mind-body interventions for stress in pregnant women were included. Methodological quality was evaluated using the Cochrane Collaboration 'Risk of Bias' tool and meta-analysis was performed via RevMan 5.3. Subgroup analysis and publication bias assessment were conducted. Post hoc sensitivity analysis was performed to investigate the source of heterogeneity. RESULTS In total, 28 studies comprising 1944 participants were included. The overall meta-analysis showed that antenatal stress of pregnant women in the mind-body interventions groups showed significant high improvements (SMD=-0.94; 95% CI [-1.25, -0.63]; p < .00001) compared with the control groups. Results of subgroup analyses indicated that all types of mind-body interventions including mindfulness intervention, cognitive behavioural therapy, relaxation techniques and yoga were beneficial to antenatal stress. Both groups and individual formats mind-body interventions were effective. 4-8 weeks mind-body interventions were seemed as the optimal choice. Moreover, mind-body interventions were concomitant with reducing antenatal anxiety and depression. CONCLUSION Mind-body interventions are promising approaches for stress reduction in pregnant women. Nevertheless, the results should be interpreted with caution because of high heterogeneity and publication bias. Further high-quality studies are needed to verify the findings. IMPACT Mind-body interventions have been widely implemented to ameliorate antenatal stress, but conflicting results were found across studies. This systematic review and meta-analysis suggested that mind-body interventions are relatively safe and convenient and can successfully promote antenatal stress. The suggestions proposed in this review may be useful for developing a scientific mind-body interventions regimen and encouraging the application of mind-body interventions in pregnant women, thereby managing antenatal stress effectively.
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Affiliation(s)
- Pingping Guo
- School of Nursing, Jilin University, Changchun, Jilin, China
| | - Xuehui Zhang
- School of Nursing, Jilin University, Changchun, Jilin, China
| | - Na Liu
- School of Nursing, Jilin University, Changchun, Jilin, China
| | - Jie Wang
- School of Nursing, Jilin University, Changchun, Jilin, China
| | - Dandan Chen
- School of Nursing, Jilin University, Changchun, Jilin, China
| | - Weijia Sun
- School of Nursing, Jilin University, Changchun, Jilin, China
| | - Ping Li
- Department of Developmental Pediatrics, Second Hospital of Jilin University, Changchun, Jilin, China
| | - Wei Zhang
- School of Nursing, Jilin University, Changchun, Jilin, China
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Abstract
In recent years, research in behavioral medicine has become increasingly focused on understanding how chronic and acute exposure to stress impacts health outcomes. During stress, the body’s physiological stress systems are activated. These systems closely interact with the immune system and are, thus, importantly implicated in the onset and maintenance of disease states. While much of the research in behavioral medicine that has investigated the effects of stress on disease has focused on the role of the hypothalamic-pituitary-adrenal axis and its downstream biomarker, cortisol, it is evident that the autonomic nervous system (ANS) also plays a crucial role in both the biological stress process and the manifestation and maintenance of stress-related symptoms. In recent years salivary alpha-amylase (sAA) has emerged as a valid and reliable marker of ANS activity in stress research and is therefore an important biomarker to consider in behavioral medicine. In this commentary, we will highlight research relevant for behavioral medicine that has utilized sAA measurements, both basally, and in response to stress, to examine ANS function in clinical populations. We will additionally summarize findings from studies that have examined the effects of various targeted interventions on changes in sAA levels. Through this, our aim is to present evidence that sAA can serve as a feasible biomarker of ANS (dys)function in health and disease. To this end, we will also highlight important methodological considerations for readers to keep in mind when including sAA assessments in their own studies. The overarching goal of this brief commentary is to highlight how a multidimensional approach toward physiological stress measurement can allow researchers to develop a better understanding of physical health and disease states.
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Romero-Gonzalez B, Puertas-Gonzalez JA, Strivens-Vilchez H, Gonzalez-Perez R, Peralta-Ramirez MI. Effects of cognitive-behavioural therapy for stress management on stress and hair cortisol levels in pregnant women: A randomised controlled trial. J Psychosom Res 2020; 135:110162. [PMID: 32485622 DOI: 10.1016/j.jpsychores.2020.110162] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 05/19/2020] [Accepted: 05/24/2020] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To demonstrate the effectiveness of a cognitive behavioural therapy for stress management in pregnant women in the reduction of psychological stress and hair cortisol levels. METHODS The trial was controlled and randomised, with a total of 78 pregnant women: control group (n-39) and Cognitive Behavioural Therapy group (n-39). To test the therapy's efficacy, an evaluation of the primary outcome (hair cortisol levels) and secondary outcomes (psychological stress, psychopathological symptomatology and resilience) was conducted before and after the treatment. The therapy was conducted during 8 sessions (one per week) in a group setting. The study was registered as a Randomised Controlled Trial with the code NCT03404141. RESULTS The results showed a group time interaction between hair cortisol levels, psychological stress (perceived and pregnancy-specific), and in the exacerbation and severity of psychopathological symptoms. These variables presented reductions after treatment only in the Cognitive Behavioural Therapy group. CONCLUSIONS Using a novel way of assessing chronic stress (psychological and objective measures as hair cortisol levels), this is the first study that has shown a decrease in both the levels of cortisol in hair and in psychological stress. This decline could have implications for maternal and fetal health.
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Affiliation(s)
- Borja Romero-Gonzalez
- Brain, Mind and Behavior Research Center (CIMCYC), Faculty of Psychology, University of Granada, Granada, Spain; Department of Personality, Assessment and Psychological Treatment, University of Granada, Granada, Spain
| | - Jose A Puertas-Gonzalez
- Brain, Mind and Behavior Research Center (CIMCYC), Faculty of Psychology, University of Granada, Granada, Spain; Department of Personality, Assessment and Psychological Treatment, University of Granada, Granada, Spain
| | | | - Raquel Gonzalez-Perez
- Department of Pharmacology, CIBERehd, School of Pharmacy, Instituto de Investigación Biosanitariaibs.GRANADA, University of Granada, Granada, Spain.
| | - M Isabel Peralta-Ramirez
- Department of Personality, Assessment and Psychological Treatment, University of Granada, Granada, Spain
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Gallagher A, Kring D, Whitley T. Effects of yoga on anxiety and depression for high risk mothers on hospital bedrest. Complement Ther Clin Pract 2020; 38:101079. [DOI: 10.1016/j.ctcp.2019.101079] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Revised: 12/10/2019] [Accepted: 12/10/2019] [Indexed: 12/16/2022]
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Mooventhan A. A comprehensive review on scientific evidence-based effects (including adverse effects) of yoga for normal and high-risk pregnancy-related health problems. J Bodyw Mov Ther 2019; 23:721-727. [DOI: 10.1016/j.jbmt.2019.03.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Revised: 03/12/2019] [Accepted: 03/13/2019] [Indexed: 12/20/2022]
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Kołomańska D, Zarawski M, Mazur-Bialy A. Physical Activity and Depressive Disorders in Pregnant Women-A Systematic Review. MEDICINA (KAUNAS, LITHUANIA) 2019; 55:E212. [PMID: 31130705 PMCID: PMC6572339 DOI: 10.3390/medicina55050212] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/31/2019] [Revised: 05/05/2019] [Accepted: 05/21/2019] [Indexed: 12/12/2022]
Abstract
Background and Objectives: Pregnancy is a unique period in the life of every woman. The lifestyle of a pregnant woman has a significant impact on her and her child's health. Regular physical activity is one of the elements that help maintain normal mental and physical well-being. In pregnant women who regularly have moderate physical activity, there is a lower risk of developing obesity and overweight. Physical exercises have an impact on maintaining proper muscular tonus, reduce pain and prepare for the exertion during labour. Based on the available literature, the aim of this study was to present the impact of physical activity on depressive disorders in pregnant women. Materials and Methods: A review of the literature was carried out in the Medline PubMed database. The basic search terms were: "pregnancy" AND "physical activity AND depression". The work included only English-language publications published in the years 2000-2018. Results: A total of 408 references were found. On the basis of an analysis of titles, abstracts and the language of publication (other than English), 354 articles were rejected, and 54 articles were fully read, of which five were rejected due to lack of access to the full version. Finally, 17 references were included in the review. Conclusions: Physical activity, at least once a week, significantly reduces the symptoms of depression in pregnant women and may be an important factor in the prevention of depression in this period.
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Affiliation(s)
- Daria Kołomańska
- Department of Ergonomics and Exercise Physiology, Faculty of Health Science, Jagiellonian University Medical College, Grzegorzecka 20, 31-531 Krakow, Poland.
| | - Marcin Zarawski
- Department of Gynecology and Obstetrics with Gynecologic Oncology, Rydygier Hospital, Złotej Jesieni 1, 31-826 Krakow, Poland.
| | - Agnieszka Mazur-Bialy
- Department of Ergonomics and Exercise Physiology, Faculty of Health Science, Jagiellonian University Medical College, Grzegorzecka 20, 31-531 Krakow, Poland.
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Prenatal stress and models explaining risk for psychopathology revisited: Generic vulnerability and divergent pathways. Dev Psychopathol 2018; 30:1041-1062. [PMID: 30068410 DOI: 10.1017/s0954579418000354] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The present review revisits three hypothesized models that potentially could explain how prenatal maternal stress influences fetal development, birth outcomes, and subsequent developmental psychopathology. These models were mostly based on animal models, and new evidence for these models from human studies is evaluated. Furthermore, divergent trajectories from prenatal exposure to adversities to offspring affected outcomes are reviewed, including the comparison of studies on prenatal maternal stress with research on maternal substance use and maternal malnutrition during pregnancy. Finally, new directions in research on the mechanism underlying prenatal stress effects on human offspring is summarized. While it is concluded that there is abundant evidence for the negative associations between prenatal maternal stress and offspring behavioral, brain, and psychopathological outcomes in humans, there is no consistent evidence for specific mechanisms or specific outcomes in relation to stress exposure in utero. Rather, principles of multifinality and equifinality best describe the consequences for the offspring, suggesting a generic vulnerability and different pathways from prenatal adversities to developmental psychopathology, which complicates the search for underlying mechanisms. New and promising directions for research are provided to get a better understanding of how prenatal stress gets under the skin to affect fetal development.
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Prenatal stress and the development of psychopathology: Lifestyle behaviors as a fundamental part of the puzzle. Dev Psychopathol 2018; 30:1129-1144. [PMID: 30068418 DOI: 10.1017/s0954579418000494] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Maternal psychological stress, depression, and anxiety during pregnancy (prenatal stress; PNS) are thought to impact fetal development with long-term effects on offspring outcome. These effects would include physical and mental health, including psychopathology. Maternal sleep, diet, and exercise during pregnancy are lifestyle behaviors that are understudied and often solely included in PNS studies as confounders. However, there are indications that these lifestyle behaviors may actually constitute essential mediators between PNS and fetal programming processes. The goal of this theoretical review was to investigate this idea by looking at the evidence for associations between PNS and sleep, diet, and exercise, and by piecing together the information on potential underlying mechanisms and causal pathways through which these factors may affect the offspring. The analysis of the literature led to the conclusion that sleep, diet, and exercise during pregnancy, may have fundamental roles as mediators between PNS and maternal pregnancy physiology. By integrating these lifestyle behaviors into models of prenatal programming of development, a qualitatively higher and more comprehensive understanding of the prenatal origins of psychopathology can be obtained. The review finalizes by discussing some of the present challenges facing the field of PNS and offspring programming, and offering solutions for future research.
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Ng QX, Venkatanarayanan N, Loke W, Yeo WS, Lim DY, Chan HW, Sim WS. A meta-analysis of the effectiveness of yoga-based interventions for maternal depression during pregnancy. Complement Ther Clin Pract 2018; 34:8-12. [PMID: 30712750 DOI: 10.1016/j.ctcp.2018.10.016] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Revised: 10/18/2018] [Accepted: 10/26/2018] [Indexed: 01/12/2023]
Abstract
Prompt and effective treatment of maternal depression during pregnancy is important as it is an independent predictor of negative maternal and fetal outcomes. Yoga is an increasingly popular non-pharmacological modality. This study thus aimed to undertake a meta-analysis of the efficacy of yoga-based interventions for maternal depression during pregnancy. A total of 8 clinical studies were systematically reviewed, and 6 studies with a total of 405 pregnant mothers were included in the final meta-analysis. Applying per-protocol analysis and a random-effects model, the pooled standardized mean difference (SMD) from baseline depressive score was -0.452 (95% CI: -0.816 to -0.880, P = 0.015), supporting a statistically significant beneficial effect of yoga-based interventions on mood. Overall, yoga-based interventions are a promising non-pharmacological option, however, most trials examined were preliminary, recruited only participants with mild depression, did not blind study participants and had relatively small sample sizes. Larger randomized, controlled trials should be encouraged.
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Affiliation(s)
- Qin Xiang Ng
- National University Hospital, National University Health System, 119074, Singapore; MOH Holdings Pte Ltd, 1 Maritime Square, 099253, Singapore.
| | - Nandini Venkatanarayanan
- University of Nottingham Medical School, Queen's Medical Centre, Nottingham NG7 2UH, United Kingdom
| | - Wayren Loke
- MOH Holdings Pte Ltd, 1 Maritime Square, 099253, Singapore
| | - Wee-Song Yeo
- National University Hospital, National University Health System, 119074, Singapore
| | - Donovan Yutong Lim
- Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, 539747, Singapore
| | - Hwei Wuen Chan
- National University Hospital, National University Health System, 119074, Singapore
| | - Wen-Shan Sim
- KK Women's and Children's Hospital, 100 Bukit Timah Road, 229899, Singapore
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Matsuzaki M, Kusaka M, Sugimoto T, Shiraishi M, Kobayashi R, Watanabe S, Haruna M. The Effects of a Yoga Exercise and Nutritional Guidance Program on Pregnancy Outcomes Among Healthy Pregnant Japanese Women: A Study Protocol for a Randomized Controlled Trial. J Altern Complement Med 2018; 24:603-610. [PMID: 29443533 DOI: 10.1089/acm.2017.0119] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVES This report provides an experimental protocol for a study designed to verify the effects of yoga exercise and a nutritional guidance program during pregnancy on several key pregnancy and birth outcomes among Japanese women. DESIGN This is a study protocol of a randomized controlled trial. SETTING/LOCATION This intervention will be carried out in a university hospital in Tokyo. SUBJECTS Healthy primiparous women will be recruited at 18-23 gestational weeks in the hospital. A total of 400 participants will be randomly assigned to one of four groups in this trial, with 100 participants in each group-group with yoga exercise, with nutritional guidance, with both yoga and nutritional guidance, and with standard care alone, as the control group. Yoga exercise consists of yoga classes held at the hospital 3 or 5 days a month, duration 60 min, and home practice using a digital video disk, duration 30 or 60 min per session. We recommend participants do yoga at least 3 days a week for a total of 60 min per day. Nutritional guidance is based on individual dietary intake assessed using a brief-type diet history questionnaire. RESULTS The primary outcome is rate of pregnant women with adequate gestational weight gain. Secondary outcomes include physiologic and psychologic status assessed via biomarkers and health-related scales, dietary nutrition intake, and birth outcomes. CONCLUSIONS This study shows the effects of a yoga exercise and nutritional intervention. If the intervention is found to be effective, our results will be useful for healthcare providers and pregnant women.
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Affiliation(s)
- Masayo Matsuzaki
- 1 Division of Health Sciences and Nursing, Department of Midwifery and Women's Health, Graduate School of Medicine, The University of Tokyo , Tokyo, Japan .,2 Division of Health Science, Department of Children and Women's Health, Graduate School of Medicine, Osaka University , Osaka, Japan
| | - Momoko Kusaka
- 2 Division of Health Science, Department of Children and Women's Health, Graduate School of Medicine, Osaka University , Osaka, Japan
| | - Takashi Sugimoto
- 3 Health Technology Assessment and Public Policy, Graduate School of Public Policy, The University of Tokyo , Tokyo, Japan
| | - Mie Shiraishi
- 2 Division of Health Science, Department of Children and Women's Health, Graduate School of Medicine, Osaka University , Osaka, Japan
| | - Risa Kobayashi
- 2 Division of Health Science, Department of Children and Women's Health, Graduate School of Medicine, Osaka University , Osaka, Japan
| | - Sachi Watanabe
- 2 Division of Health Science, Department of Children and Women's Health, Graduate School of Medicine, Osaka University , Osaka, Japan
| | - Megumi Haruna
- 2 Division of Health Science, Department of Children and Women's Health, Graduate School of Medicine, Osaka University , Osaka, Japan
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20
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Abstract
Background In recent years, there have been an increasing number of older adults who suffer from mental disorders globally. Objective The objective of this study was to examine the effect of an intervention that consisted of an exercise program to improve the mental health of community-dwelling older adults. Participants and methods The recruited participants of this study were community-dwelling older adults aged ≥60 years who participated in a comprehensive health promotion program in Kakogawa, Japan. Participants in the intervention group received an exercise program that was developed for older adults using Thera-Band. To measure participants’ mental health status, a Japanese version of the short form of the Profile of Mood States (POMS-SF) was used. Stress markers were measured, such as salivary cortisol, alpha-amylase, and sIgA levels. All participants provided salivary samples and completed psychological questionnaires at baseline and 6-month follow-up. Results No significant differences were observed between the intervention and control groups with respect to POMS-SF score and salivary biomarker profile at baseline. After the intervention, the intervention group showed a significant decrease in the POMS-SF “fatigue” score and cortisol level. No significant changes were observed in the control group. Conclusion Simultaneous changes in feelings of fatigue and cortisol levels were observed among subjects who had received the intervention of regular exercise. Further research is needed to investigate the effectiveness of exercise intervention in improving mental health among older adults.
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Affiliation(s)
- Akio Tada
- Faculty of Health Science, Hyogo University, Kakogawa, Hyogo, Japan
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21
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Togher KL, Treacy E, O'Keeffe GW, Kenny LC. Maternal distress in late pregnancy alters obstetric outcomes and the expression of genes important for placental glucocorticoid signalling. Psychiatry Res 2017; 255:17-26. [PMID: 28511050 DOI: 10.1016/j.psychres.2017.05.013] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2016] [Revised: 03/13/2017] [Accepted: 05/07/2017] [Indexed: 12/18/2022]
Abstract
The experience of maternal distress in pregnancy is often linked with poorer obstetric outcomes for women as well as adverse outcomes for offspring. Alterations in placental glucocorticoid signalling and subsequent increased fetal exposure to cortisol have been suggested to underlie this relationship. In the current study, 121 pregnant women completed the Perceived Stress Scale, State Trait Anxiety Inventory and Edinburgh Postnatal Depression Scale in the third trimester of pregnancy. Placental samples were collected after delivery. Maternal history of psychiatric illness and miscarriage were significant predictors of poorer mental health in pregnancy. Higher anxiety was associated with an increase in women delivering via elective Caesarean Section, and an increase in bottle-feeding. Birth temperature was mildly reduced among infants of women with high levels of depressive symptomology. Babies of mothers who scored high in all stress (cumulative distress) measures had reduced 5-min Apgar scores. High cumulative distress reduced the expression of placental HSD11B2 mRNA and increased the expression of placental NR3C1 mRNA. These data support a role for prenatal distress as a risk factor for altered obstetric outcomes. The alterations in placental gene expression support a role for altered placental glucocorticoid signalling in the relationship between maternal prenatal distress and adverse outcomes.
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Affiliation(s)
- Katie L Togher
- Irish Centre for Fetal and Neonatal Translation Research (INFANT), Cork University Maternity Hospital, University College Cork, Cork, Ireland; Department of Obstetrics and Gynaecology, Cork University Maternity Hospital, University College Cork, Cork, Ireland; Department of Anatomy and Neuroscience, University College Cork, Cork, Ireland
| | - Eimear Treacy
- Irish Centre for Fetal and Neonatal Translation Research (INFANT), Cork University Maternity Hospital, University College Cork, Cork, Ireland; Department of Obstetrics and Gynaecology, Cork University Maternity Hospital, University College Cork, Cork, Ireland; Department of Anatomy and Neuroscience, University College Cork, Cork, Ireland
| | - Gerard W O'Keeffe
- Irish Centre for Fetal and Neonatal Translation Research (INFANT), Cork University Maternity Hospital, University College Cork, Cork, Ireland; Department of Anatomy and Neuroscience, University College Cork, Cork, Ireland.
| | - Louise C Kenny
- Irish Centre for Fetal and Neonatal Translation Research (INFANT), Cork University Maternity Hospital, University College Cork, Cork, Ireland; Department of Obstetrics and Gynaecology, Cork University Maternity Hospital, University College Cork, Cork, Ireland.
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Chen PJ, Yang L, Chou CC, Li CC, Chang YC, Liaw JJ. Effects of prenatal yoga on women's stress and immune function across pregnancy: A randomized controlled trial. Complement Ther Med 2017; 31:109-117. [PMID: 28434463 DOI: 10.1016/j.ctim.2017.03.003] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2016] [Revised: 12/18/2016] [Accepted: 03/06/2017] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE The effects of prenatal yoga on biological indicators have not been widely studied. Thus, we compared changes in stress and immunity salivary biomarkers from 16 to 36 weeks' gestation between women receiving prenatal yoga and those receiving routine prenatal care. DESIGN For this longitudinal, prospective, randomized controlled trial, we recruited 94 healthy pregnant women at 16 weeks' gestation through convenience sampling from a prenatal clinic in Taipei. Participants were randomly assigned to intervention (n=48) or control (n=46) groups using Clinstat block randomization. INTERVENTION The 20-week intervention comprised two weekly 70-min yoga sessions led by a midwife certified as a yoga instructor; the control group received only routine prenatal care. MAIN OUTCOME MEASURES In both groups, participants' salivary cortisol and immunoglobulin A levels were collected before and after yoga every 4 weeks from 16 to 36 weeks' gestation. RESULTS The intervention group had lower salivary cortisol (p<0.001) and higher immunoglobulin A (p<0.001) levels immediately after yoga than the control group. Specifically, the intervention group had significantly higher long-term salivary immunoglobulin A levels than the control group (p=0.018), and infants born to women in the intervention group weighed more than those born to the control group (p<0.001). CONCLUSION Prenatal yoga significantly reduced pregnant women's stress and enhanced their immune function. Clinicians should learn the mechanisms of yoga and its effects on pregnant women. Our findings can guide clinicians to help pregnant women alleviate their stress and enhance their immune function.
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Affiliation(s)
- Pao-Ju Chen
- Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, 11490, Taiwan, ROC; Department of Nursing, Hsin Sheng Junior College of Medical Care and Management, Taoyuan, 32544, Taiwan, ROC.
| | - Luke Yang
- Department of Social Welfare, Hsuan Chuang University, Hsinchu, 30092, Taiwan, ROC.
| | - Cheng-Chen Chou
- School of Nursing, Taipei Medical University, Taipei, 110, Taiwan, ROC.
| | - Chia-Chi Li
- School of Nursing, National Defense Medical Center, Taipei, 11490, Taiwan, ROC.
| | - Yu-Cune Chang
- Department of Mathematics, Tamkang University, New Taipei, 25137, Taiwan, ROC.
| | - Jen-Jiuan Liaw
- School of Nursing, National Defense Medical Center, Taipei, 11490, Taiwan, ROC.
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