R esponse to Prenatal Y oga A Single Blinded Randomized Controlled Trial TRY Yoga Shilpa Babbar MD 1 James B Hill 2 MD Karen B Williams PhD 1 Suneet Chauhan MD 3 Dev Maulik MD ID: 679330
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Acute Fe
T
al Behavioral
Response to Prenatal Yoga: A Single Blinded, Randomized Controlled Trial (TRY Yoga)Shilpa Babbar, MD1, James B. Hill2, MD, Karen B. Williams, PhD1, Suneet Chauhan, MD3, Dev Maulik, MD11University of Missouri, Kansas City, MO, 2Eastern Virginia Medical School, Norfolk, VA, 3University of Texas, Houston, TX
INTRODUCTIONIn 2016, yoga was practiced by 36 million Americans, of whom 82% were womenYoga is a low impact, slow moving, and easily modifiable activity that makes it a suitable exercise for pregnant womenAim: to characterize the acute maternal and fetal response to prenatal yoga exercise using common standardized tests to assess the well-being of the maternal-fetal unitPrimary objective: to evaluate changes in fetal blood flow via umbilical Doppler studies in response to yoga in new yoga practitioners
METHODS
Single blinded, randomized trial conducted at Truman Medical Center March to September 2014Inclusion criteria: 18 years of age, English literate, well-dated, low risk singleton pregnancy between 28 0/7 to 36 6/7 weeks, no prior experience with yogaExclusion criteria: cigarette smokers, illicits or narcotic abuse, congenital anomalies or medical contraindication to exercise1:1 randomization to 1 hour yoga class or 1 hour educational presentation
RESULTS
597 women assessed; 104 eligible; 52 randomized; 46 (88%) completed the studyBaseline demographics were comparableNo significant difference in umbilical artery Doppler indices (Table)No significant change in fetal positionPost intervention: absence of breathing 22% of each group; BPP 10/10 in 74% control, 61% yoga (p=0.35)No significant change in maternal heart rate, blood pressure and uterine artery DopplersPainless uterine contractions began in 9% of yoga vs 22% control group (p=0.41)No difference in delivery outcomes
CONCLUSION
Yoga is well tolerated by the fetus as assessed by standard fetal well-being indicesNo significant change in fetal blood flow or fetal behavior acutely after performing yoga for the first time in pregnancyYoga can be recommended for low risk women to begin during pregnancy
Variable
Yoga
(N =23)Control(N =23)P value^Umbilical artery systolic-to-diastolic ratio 0.34Pre2.9 + 0.72.7 + 0.5 Post2.8 + 0.52.8 + 0.4 Umbilical artery pulsatility index 0.53Pre1.1 + 0.21.1 + 0.2 Post1.1 + 0.21.1 + 0.2 Umbilical artery resistance index 0.66Pre0.7 + 0.10.7 + 0.1 Post0.7 + 0.10.7 + 0.1 Fetal heart rate (beats/min) 0.09Pre136.5 + 7.8137.8 + 11.7 Post134.8 + 9.0130.9 + 9.0
METHODS
Pre-post testing: Fetal: Umbilical artery Dopplers, Biophysical profile (BPP), Non-stress testMaternal: Uterine artery Doppler, heart rate, blood pressureDelivery data collectedMFM specialist blinded during data analysisSample size: 19 women per group (α =0.05, power 80%)Statistical analysis: Two-factor repeated measures ANOVA, independent t-test, chi squareP<0.05 = significant
Table: Fetal heart rate and Doppler indices before and after intervention
Data presented as mean
+
SD
^ Repeat measure ANOVA: main effects are for
group
by time interaction
.