The Effects of Prenatal Yoga on Birth Outcomes: A Systematic Review of the Literature
Importance There are limited data to demonstrate the potential impact of prenatal yoga on birth outcomes such as maternal comfort, labor duration, and infant gestational age and weight.
Objective To examine the published evidence on prenatal yoga, identify the gaps in this field of study, and to explore avenues for further research.
Design Two electronic databases, CIANHL and PubMed were searched using combinations of the keywords yoga, health, women, pregnant, and prenatal. Studies were included if they evaluated a yogic intervention in a sample of pregnant women. Both controlled and qualitative studies were included due to the limited body of research. A total of eleven studies were included for review.
Main Outcomes and Measures The most commonly measured variables were psychosocial outcomes, such as maternal depression, anxiety, and quality of life. However, several studies evaluated physical measurements such as pain, length of labor, infant birth weight, and gestational age.
Results All studies found that prenatal yoga provided significant benefits, and no adverse effects were reported. Significant findings from the randomized studies included an increase in infant birth weight, lower incidence of pregnancy complications, shorter duration of labor, and less pain among yoga practitioners. Significant findings from the non-randomized and qualitative studies included decrease in pain, improved quality of sleep, increased maternal confidence, and improved interpersonal relationships among pregnant women who practiced yoga.
Conclusions and Relevance Although the body of research is limited, preliminary studies suggest that yoga may be effective in improving a myriad of birth outcomes for both mother and infant. Clinicians should feel confident in recommending yoga as a safe, healthy practice to achieve the recommended 30 minutes of daily exercise during pregnancy. Further randomized controlled trials are needed to enhance our understanding of the benefits of yoga, and how to best incorporate the practice into prenatal care.
Beddoe, A. E., Lee, K. A., Weiss, S. J., Kennedy, H. P., & Yang, C. P. (2010). Effects of mindful yoga on sleep in pregnant women: A pilot study. Biological Research for Nursing, 11(4), 363-370.
Beddoe, A. E., Yang, C. P., Kennedy, H. P., Weiss, S. J., & Lee, K. A. (2009). The effects of mindfulness-based yoga during pregnancy on maternal psychological and physical distress. Journal of Obstetric, Gynecological, & Neonatal Nursing, 38, 310-319.
Bijlani, R. L., Vempati, R. P., Yadav, R. K., Ray, R. B., Gupta, V., Sharma, R., . . . Mahapatra, S. C. (2005). A brief but comprehensive lifestyle education program based on yoga reduces risk factors for cardiovascular disease and diabetes mellitus. Journal of Complementary and Alternative Medicine, 11, 267-274.
Chung, S. C., Brooks, M. M., Rai, M., Balk, J. L., & Rai, S. (2012). Effects of sahaja yoga meditation on quality of life, anxiety, and blood pressure control. Journal of Complementary and Alternative Medicine, 18(6), 589-596.
Chuntharapat, S., Petpichetchian, W., & Hatthakit, U. (2008). Yoga during pregnancy: Effects on maternal comfort, labor pain, and birth outcomes. Complementary Therapies in Clinical Practice, 14, 105-115.
Collins, C. (1998). Yoga: Intuition, preventative medicine, and treatment. Journal of Obstetric, Gynecological, & Neonatal Nursing, 27, 563-568.
Curtis, K., Weinrib, A., & Katz, J. (2012). Systematic review of yoga for pregnant women: Current status and future directions. Evidence-Based Complementary and Alternative Medicine, 2012 doi:10.1155/2012/715942
Doran, F., & Hornibrook, J. (2013). Women's experiences of participation in a pregnancy and postnatal group incorporating yoga and facilitated group discussion: A qualitative evaluation. Women and Birth, 26, 82-86.
Field, T., Diego, M., Hernandez-Reif, M., Medina, L., Delgado, J., & Hernandez, A. (2012). Yoga and massage therapy reduce prenatal depression and prematurity. Journal of Bodywork and Movement Therapies, 16, 204-209.
Field, T., Hernandez-Reif, M., Diego, M., Figueiredo, B., Schanberg, S., & Kuhn, C. (2006). Prenatal cortisol, prematurity, and low birth weight. Infant Behavior and Development, 29, 268-275.
Guarracino, J. L., Savino, S., & Edelstein, S. (2006). Yoga participation is beneficial to obesity prevention, hypertension control, and positive quality of life. Topics in Clinical Nutrition, 21(2), 108-113.
Javnbakht, M., Kenari, R. H., & Ghasemi, M. (2009). Effects of yoga on depression and anxiety of women. Complementary Therapies in Clinical Practice, 15, 102-104.
Kochanek, K. D., Kirmeyer, S. E., Martin, J. A., Strobino, D. M., & Guyer, B. (2012). Annual summary of vital statistics: 2009. Pediatrics, 129, 338-348.
Kristal, A. R., Littman, A. J., Benitez, D., & White, E. (2005). Yoga practice is associated with attenuated weight gain in healthy, middle-aged men and women. Alternative Therapies in Health and Medicine, 11(4), 28-33.
Kurki, T., Hiilesmaa, V., Raitasalo, R., Mattila, H., & Ylikorkala, O. (2000). Depression and anxiety in early pregnancy and risk for preeclampsia. Obstetrics and Gynecology, 95(4), 487-490.
Lee, K. A., & Gay, C. L. (2004). Sleep in late pregnancy predicts length of labor and type of delivery. American Journal of Obstetric and Gynecology, 191, 2041-2046.
Mancuso, R. A., Schetter, C. D., Rini, C. M., Roesch, S. C., & Hobel, C. J. (2004). Maternal prenatal anxiety and corticotropin-releasing hormone associated with timing of delivery. Psychosomatic Medicine, 66, 762-769.
Mulder, E. J. H., Robles de Medina, P. G., Huizink, A. C., Van den Bergh, B. R. H., Buitelaar, J. K., & Visser, G. H. A. (2002). Prenatal maternal stress: Effects on pregnancy and the (unborn) child. Early Human Development, 70, 3-14.
Muzik, M., Hamilton, S. E., Rosenblum, K. L., Waxler, E., & Hadi, Z. (2012). Mindfulness yoga during pregnancy for psychiatrically at-risk women: Preliminary results from a pilot feasibility study. Complementary Therapies in Clinical Practice, , 1-6. doi: http://dx.doi.org/10.1016/j.ctcp.2012.06.006
Narendran, S., Nagarathna, R., Narendran, V., Gunasheela, S., & Nagendra, H. R. R. (2005). Efficacy of yoga on pregnancy outcome. Journal of Complementary and Alternative Medicine, 11(2), 237-244.
Rakhshani, A., Maharana, S., Raghuram, N., Nagendra, H. R., & Venkatram, P. (2010). Effects of integrated yoga on quality of life and interpersonal relationship of pregnant women. Quality of Life Research, 19, 1447-1445.
Rakhshani, A., Nagarathna, R., Mhaskar, R., Mhaskar, A., Thomas, A., Gunasheela, S. (2012).
The effects of yoga in prevention of pregnancy complications in high-risk pregnancies: A randomized controlled trial. Preventative Medicine. 55(4), 333-340.
Satyapriya, M., Nagendra, H. R., Nagarathna, R., & Padmalatha, V. (2009). Effect of integrated yoga on stress and heart rate variability in pregnant women. International Journal of Gynecology and Obstetrics, 104, 218-222.
Saunders, T. A., Lobel, M., Veloso, C., & Meyer, B. A. (2006). Prenatal maternal stress is associated with delivery analgesia and unplanned cesareans. Journal of Psychosomatic Obstetrics and Gynecology, 27(3), 141-146.
Smith, C., Hancock, H., Blake-Mortimer, J., & Eckert, K. (2007). A randomised comparative trial of yoga and relaxation to reduce stress and anxiety. Complementary Therapies in Medicine, 15, 77-83.
Smith, J. A., Greer, T., Sheets, T., & Watson, S. (2011). Is there more to yoga than exercise? Alternative Therapies in Health and Medicine, 17(3), 22-29.
Sun, Y., Hung, Y., Chang, Y., & Kuo, S. (2010). Effects of a prenatal yoga programme on the discomforts of pregnancy and maternal childbirth self-efficacy in Taiwan. Midwifery, 26, 31-36.
Vempati, R. P., & Telles, S. (2002). Yoga-based guided relaxation reduces sympathetic activity judged from baseline levels. Psychological Reports, 90, 487-494.
Vieten, C., & Astin, J. (2008). Effects of a mindfulness-based intervention during pregnancy on prenatal stress and mood; results of a pilot study. Archives of Women's Mental Health, 11, 67-74.
Weinstock, M. (2005). The potential influence of maternal stress hormones on development and mental health of the offspring. Brain, Behavior, and Immunity, 19, 296-308.
Yang, C. C. H., Chao, T. C., Kuo, T. B. J., Yin, C. S., & Chen, H. I. (2000). Preeclamptic pregnancy is associated with increased sympathetic and decreased parasympathetic control of HR. American Journal of Physiology: Heart and Circulatory Physiology, 278, 1269-1273.