Acute FeTal Behavioral Response to Prenatal Yoga: A Single Blinded, Randomized Controlled Trial (TRY Yoga) Shilpa Babbar, MD 1, James B. Hill 2, MD, Karen.

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Acute FeTal Behavioral Response to Prenatal Yoga: 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 1 1 University of Missouri, Kansas City, MO, 2 Eastern Virginia Medical School, Norfolk, VA, 3 University of Texas, Houston, TX INTRODUCTION In 2016, yoga was practiced by 36 million Americans, of whom 82% were women Yoga is a low impact, slow moving, and easily modifiable activity that makes it a suitable exercise for pregnant women Aim: 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 unit Primary 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 2014 Inclusion 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 yoga Exclusion criteria: cigarette smokers, illicits or narcotic abuse, congenital anomalies or medical contraindication to exercise 1:1 randomization to 1 hour yoga class or 1 hour educational presentation RESULTS 597 women assessed; 104 eligible; 52 randomized; 46 (88%) completed the study Baseline demographics were comparable No significant difference in umbilical artery Doppler indices (Table) No significant change in fetal position Post 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 Dopplers Painless 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 indices No significant change in fetal blood flow or fetal behavior acutely after performing yoga for the first time in pregnancy Yoga 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 0.34 Pre Post Umbilical artery pulsatility index 0.53 Pre Post Umbilical artery resistance index 0.66 Pre Post Fetal heart rate (beats/min) 0.09 Pre Post METHODS Pre-post testing: Fetal: Umbilical artery Dopplers, Biophysical profile (BPP), Non-stress test Maternal: Uterine artery Doppler, heart rate, blood pressure Delivery data collected MFM specialist blinded during data analysis Sample size: 19 women per group (α =0.05, power 80%) Statistical analysis: Two-factor repeated measures ANOVA, independent t-test, chi square P<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.