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Effect of six-week pranayama training on serum levels of cortisol and blood pressure in pregnant women in the third trimester

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Abstract

Introduction: The elevation of stress hormones at the end of pregnancy will cause many problems, including a change in blood pressure. The extreme enhancement of gestational hypertension is associated with dangers, such as intrauterine growth restriction, preterm birth, placental abruption, and stillbirth. The purpose of this study was to evaluate the effect of six weeks of pranayama training during the third trimester of pregnancy on serum cortisol and blood pressure levels in pregnant women. Methods: This randomized clinical trial was conducted on 18 women in the third trimester of pregnancy referring to a specialized gynecological clinic in Babol, Iran. The subjects were randomly divided into two groups of pranayama (n = 8) and control (n = 10). The pranayama group performed relaxation and respiratory exercises for 6 weeks (two 60-minute sessions a week). Fasting blood pressure measurement and blood sampling (using median cubital vein) were performed in resting conditions 48 h before and after the implementation of the intervention. The data were analyzed in SPSS software (version 23) using Shapiro-Wilk test, as well as independent and paired sample t-tests. P value less than 0.05 was considered significant. Results: The results showed that pranayama training significantly decreased serum cortisol levels (P = 0.035). Furthermore, diastolic blood pressure in the pranayama group showed a significant decrease compared with that in the control group (P = 0.001). However, there was no significant difference between pranayama training and control groups in terms of systolic blood pressure (P = 0.079). Conclusion: Given the importance of the third trimester of pregnancy, pranayama exercises can be used to control blood pressure and other stress complications in case of high stress in pregnant women. © 2018, Mashhad University of Medical Sciences. All rights reserved.
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 
M.avandi@semnan.ac.ir
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-
IJOGI, Vol. 21, No. 6, pp. 55-63, Aug 2018
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       
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       
     
     
 




     

      

       
      
      
-


        

 

        
       


 


      
   

       




       







        
 












       
        

     

       


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

        

       

        

       

       



     
       

        
±      
±     

      

 
     

       






      
       
       
      











       

       
      
     

       
±   
±
  
    
 


        
        
       




 


ZELLBIO     
     
       

58
     


       


      ±


       
      
 
      

       

      

        
      
       
        
       

      

      


        
     
      
       
 

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       
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      
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       
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      

     
     
      
    
   


 



       

      
-


     
    ACTH



       
     






        

        

      
       



      






-
         



       


      


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      
      
    
      


      



  
         



         
      
       

      
 
       
  
  
         


      


 
      

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
      

       
        
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 
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 
       

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       
       
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       
       
       

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
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
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

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  
        
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1. Oken E, Ning Y, Rifas-Shiman SL, Radesky JS, Rich-Edwards JW, Gillman MW. Associations of physical
activity and inactivity before and during pregnancy with glucose tolerance. Obstet Gynecol 2006;
108(5):1200-7.
2. Salari P, Alavian F, Habibi Rad A, Tara F. The relationship between stress, anxiety and pain with salivary
cortisol levels in first stage of labor in primiparous women. Iran J Obstet Gynecol Infertil 2013; 16(55):14-21.
3. Lavoie S, Steullet P, Kulak A, Preitner F, Do KQ, Magistretti PJ. Glutamate cysteine ligase-modulatory
subunit knockout mouse shows normal insulin sensitivity but reduced liver glycogen storage. Front Physiol
2016; 7:142.
4. Turecki G, Meaney MJ. Effects of the social environment and stress on glucocorticoid receptor gene
methylation: a systematic review. Biol Psychiatry 2016; 79(2):87-96.
5. Jacobson D, Bursch M, Lajiness-O'Neill R. Potential role of cortisol in social and memory impairments in
individuals with 22q11. 2 deletion syndrome. J Pediatr Genet 2016; 5(3):150-7.
6. Seth S, Lewis AJ, Galbally M. Perinatal maternal depression and cortisol function in pregnancy and the
postpartum period: a systematic literature review. BMC Pregnancy Childbirth 2016; 16(1):124.
7. Beijers R, Jansen J, Riksen-Walraven M, de Weerth C. Maternal prenatal anxiety and stress predict infant
illnesses and health complaints. Pediatrics 2010; 126(2):e401-9.
8. Schwartz J, Evers AW, Bundy C, Kimball AB. Getting under the skin: report from the international psoriasis
council workshop on the role of stress in psoriasis. Front Psychol 2016; 7:87.
9. Perales M, Santos-Lozano A, Ruiz JR, Lucia A, Barakat R. Benefits of aerobic or resistance training during
pregnancy on maternal health and perinatal outcomes: a systematic review. Early Hum Dev 2016; 94:43-8.
10. Sorensen TK, Williams MA, Lee IM, Dashow EE, Thompson ML, Luthy DA. Recreational physical activity
during pregnancy and risk of preeclampsia. Hypertension 2003; 41(6):1273-80.
11. Skrypnik D, Ratajczak M, Karol-Musialik D, Hansdorfer-Korzon R, et al. Effects
of endurance and endurancestrength exercise on biochemical parameters of liver function in women with
abdominal obesity. Biomed Pharmacother 2016; 80:1-7.
12. Chuntharapat S, Petpichetchian W, Hatthakit U. Yoga during pregnancy: effects on maternal comfort, labor
pain and birth outcomes. Complement Ther Clin Pract 2008; 14(2):105-15.
13. Clements V, Leung K, Khanal S, Raymond J, Maxwell M, Rissel C. Pragmatic cluster randomised trial of a
free telephone-based health coaching program to support women in managing weight gain during pregnancy:
the Get Healthy in Pregnancy Trial. BMC Health Serv Res 2016; 16(1):454.
14. Tsuda H, Kotani T, Sumigama S, Mano Y, Hayakawa H, Kikkawa F. Efficacy and safety of daikenchuto (TJ-
100) in pregnant women with constipation. Taiwanese J Obstet Gynecol 2016; 55(1):26-9.
15. Mahishale A, Borkar SS. Determining the prevalence of patterns of pregnancy-induced pelvic girdle pain and
low back pain in urban and rural populations: a cross-sectional study. J Sci Soc 2016; 43(2):70.
16. Deschamps Perdomo AD, Tomé-Bermejo F, Piñera AR, Alvarez L. Misdiagnosis of sacral stress fracture: an
underestimated cause of low back pain in pregnancy? Am J Case Rep 2015; 16:60-4.
17. Sehati Shasaei F, Sheibaei F. Lifestyle and its relation with pregnancy outcomes in pregnant women referred
to Tabriz Teaching hospitals. Iran J Obstet Gynecol Infertil 2015; 17(131):13-9. (Persian).
18. Gong H, Ni C, Shen X, Wu T, Jiang C. Yoga for prenatal depression: a systematic review and meta-analysis.
BMC Psychiatry 2015; 15(1):14.
19. Han S, Middleton PF, Tran TS, Crowther CA. Assessing use of a printed lifestyle intervention tool by women
with borderline gestational diabetes and their achievement of diet and exercise goals: a descriptive study.
BMC Pregnancy Childbirth 2016; 16(1):44.
20. Dallaspezia S, Locatelli C, Lorenzi C, Pirovano A, Colombo C, Benedetti F. Sleep homeostatic pressure and
PER3 VNTR gene polymorphism influence antidepressant response to sleep deprivation in bipolar depression.
J Affect Disord 2016; 192:64-9.
21. Haakstad LA, Edvardsen E, Bø K. Effect of regular exercise on blood pressure in normotensive pregnant
women. A randomized controlled trial. Hypertension Pregnancy 2016; 35(2):170-80.
22. Naveen S, Lenka BN, Nayak AK. A clinical study of secondary haemorrhoids and its management. J
Pharmaceut Biomed Sci 2016; 6(4):238-40.
23. Rampalliwar S, Rajak C, Arjariya R, Poonia M, Bajpai R. The effect of bhramari pranayama on pregnant
women having cardiovascular hyper-reactivity to cold pressor. Natl J Physiol Pharm Pharmacol 2013;
3(2):137.

63
24. Jayashree R, Malini A, Rakhshani A, Nagendra HR, Gunasheela S, Nagarathna R. Effect of the integrated
approach of yoga therapy on platelet count and uric acid in pregnancy: a multicenter stratified randomized
single-blind study. Int J Yoga 2013; 6(1):39-46.
25. Guardino, c. M., Dunkel Schetter, C.,Bower, J.E., Lu, C., & Smalley, S. L. Randomised controlled pilot trial
of mindfulness training for stress reduction during pregnancy. Psychology & health,2014. 29(3), 334-349.
26. Piccione G, Arfuso F, Abbate F, Giannetto C, Panzera M, Rizzo M, et al. Adrenocorticotrophic hormone and
cortisol levels during late pregnancy and post-foaling period in mares. Animal Sci Papers Rep 2017;
35(2):173-80.
27. Valsamakis G, Papatheodorou DC, Chalarakis N, Vrachnis N, Sidiropoulou EJ, Manolikaki M, et al. In
pregnancy increased maternal STAI trait stress score shows decreased insulin sensitivity and increased stress
hormones. Psychoneuroendocrinology 2017; 84:11-6.
28. Howland LC, Jallo N, Connelly CD, Pickler RH. Feasibility of a relaxation guided imagery intervention to
reduce maternal stress in the NICU. J Obstet Gynecol Neonatal Nurs 2017; 46(4):532-43.
29. Rahimi F, Ahmadi M, Rosta F, Majd HA, Valiani M. Effect of relaxation training on pregnancy anxiety in
high risk women. Saf Promot Injury Prev 2015; 2(3):180-8.
30. Bastani F, Hidarnia A, Kazemnejad A, Vafaei M, Kashanian M. A randomized controlled trial of the effects of
applied relaxation training on reducing anxiety and perceived stress in pregnant women. J Midwifery Womens
Health 2005; 50(4):e36-40.
31. Unger CA, Busse D, Yim IS. The effect of guided relaxation on cortisol and affect: Stress reactivity as a
moderator. J Health Psychol 2017; 22(1):29-38.
32. Newham JJ, Wittkowski A, Hurley J, Aplin JD, Westwood M. Effects of antenatal yoga on maternal anxiety
and depression: a randomized controlled trial. Depress Anxiety 2014; 31(8):631-40.
33. Hagins M, Selfe T, Innes K. Effectiveness of yoga for hypertension: systematic review and meta-analysis.
Evid Based Complement Alternat Med 2013; 2013:649836.
34. Sindhu P. Yoga Untuk Kehamilan. Qanita: Sehat, Bahagia & Penuh Makna; 2009.
35. Hagins M, Rundle A, Consedine NS, Khalsa SB. A randomized controlled trial comparing the effects of yoga
with an active control on ambulatory blood pressure in individuals with prehypertension and stage 1
hypertension. J Clin Hypertens 2014; 16(1):54-62.
36. Aalami M, Jafarnejad F, ModarresGharavi M. The effects of progressive muscular relaxation and breathing
control technique on blood pressure during pregnancy. Iran J Nurs Midwifery Res 2016; 21(3):331-6.
37. Dhameja K, Singh S, Mustafa MD, Singh KP, Banerjee BD, Agarwal M, et al. Therapeutic effect of yoga in
patients with hypertension with reference to GST gene polymorphism. J Altern Complement Med 2013;
19(3):243-9.
38. Corbijn van Willenswaard K, Lynn F, McNeill J, McQueen K, Dennis CL, Lobel M, et al. Music interventions
to reduce stress and anxiety in pregnancy: a systematic review and meta-analysis. BMC Psychiatry 2017;
17(1):271.
39. Everly Jr GS, Lating JM. A clinical guide to the treatment of the human stress response. New York: Springer
Science & Business Media; 2012.
40. اگEdouard DA, Pannier BM, London GM, Cuche JL, Safar ME. Venous and arterial behavior during normal
pregnancy. Am J Physiol 1998; 274(5 Pt 2):H1605-12.
41. Misra VK, Hobel CJ, Sing CF. Placental blood flow and the risk of preterm delivery. Placenta 2009;
30(7):619-24.
42. 
birth weight: a review. Eur J Obstet Gynecol Reprod Biol 2004; 116(1):3-15.
... Other studies also support the positive effects of PYB on lowering ADS(Brown & Maheshkumar et al. (2022) found that yoga participants had higher salivary cortisol responses initially but showed reduced levels (p=0.03) over time due to practice of PYB. Similarly, other studies back up our findings in positive effect of PYB on cortisol(Abedi Amiri et al., 2018;Balaji & Varne, 2017;Kamei et al., 2000;Ma et al., 2017).Sahu and Kishore (2015) found significant impacts (p<0.001) of Bhramari PYB and Jyoti Dhyan on Hb levels and alpha EEG in college students, suggesting improved blood circulation and oxygen delivery. ...
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