تأثیر شش هفته تمرین پرانایاما بر سطوح سرمی کورتیزول و فشارخون زنان باردار در سه ‌ماهه سوم بارداری

نوع مقاله : اصیل پژوهشی

نویسندگان

1 کارشناس ارشد فیزیولوژی ورزشی، دانشکده علوم انسانی، دانشگاه سمنان، سمنان، ایران.

2 استادیار گروه فیزیولوژی ورزشی، دانشکده‎ علوم انسانی، دانشگاه سمنان، سمنان، ایران.

3 استاد گروه زنان و مامایی، مرکز تحقیقات ناباروری، دانشکده پزشکی، دانشگاه علوم پزشکی بابل، بابل، ایران.

چکیده

مقدمه: افزایش بیش ‌از اندازه هورمون­ استرس در اواخر بارداری، مشکلات زیادی از جمله تغییر در فشارخون زن باردار را به همراه خواهد داشت. ابتلاء به افزایش بیش از اندازه فشارخون بارداری با خطراتی مانند عقب افتادن رشد جنین در داخل رحم، زایمان زودرس، جدا شدن جفت و مرده‌زایی همراه است. مطالعه حاضر با هدف بررسی تأثیر شش هفته تمرین پرانایاما در سه‌ ماهه سوم بارداری بر سطوح سرمی کورتیزول و سطوح فشارخون زنان باردار انجام شد.
روش‌کار: این مطالعه کارآزمایی بالینی تصادفی شده در سال 1395 بر روی 18 نفر از زنان سه‌ماهه سوم بارداری مراجعه‌کننده به یکی از مطب­های تخصصی زنان زایمان شهرستان بابل انجام شد. افراد به‌طور تصادفی به دو گروه پرانایاما (8 نفر) و کنترل (10 نفر) تقسیم شدند. گروه پرانایاما تمرینات آرام‌سازی و تنفسی را به‌مدت 6 هفته و به‌صورت 2 جلسه 60 دقیقه­ای در هفته انجام دادند. اندازه­گیری فشار­خون و نمونه­خونی به صورت ناشتا از ورید آرنجی در شرایط استراحت، 48 ساعت قبل و بعد از اجرای طرح انجام شد. تجزیه و تحلیل داده‌ها با استفاده از نرم‌افزار آماری SPSS (نسخه 23) و آزمون‌های شاپیروویک، تی مستقل و تی جفتی انجام شد. میزان p‌ کمتر از 05/0 معنی‌دار در نظر گرفته شد.
یافته­ها: بر اساس نتایج، تمرین پرانایاما باعث کاهش معنی‌دار سطوح سرمی کورتیزول گردید (035/0=p). همچنین سطوح فشارخون دیاستولیک در گروه تمرین نسبت به گروه کنترل کاهش معنی‌داری نشان داد (001/0=p). نتایج نشان داد که فشارخون سیستولیک در گروه تمرین نسبت به کنترل تغییر معنی‌داری نداشت (079/0=p).
نتیجه‌گیری: با توجه به اهمیت سه ماهه سوم بارداری، در صورت استرس بالای زنان باردار، جهت کنترل سطوح فشارخون و دیگر عوارض استرس می­توان از تمرینات پرانایاما بهره برد.

کلیدواژه‌ها

عنوان مقاله [English]

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

نویسندگان [English]

  • Marzieh Abedi Amiri 1
  • Seyed Mohsen Avandi 2
  • Sedigheh Esmaeilzadeh 3
1 M.Sc. in Sport Physiology, School of Humanities, Semnan University, Semnan, Iran.
2 Assistant Professor, Department of Sport Sciences, School of Humanities, Semnan University, Semnan, Iran.
3 Professor, Department of Obstetrics and Gynecology, Infertility Research Center, Babol University of Medical Sciences, Babol, Iran.
چکیده [English]

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 aim 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 gynecology clinic in Babol, Iran. The subjects were randomly divided into two groups of pranayama (n=8) and control (n=10). The pranayama group performed the 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 to 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 trimesters of pregnancy, pranayama exercises can be used to control blood pressure and other stress complications in case of high stress in pregnant women.

کلیدواژه‌ها [English]

  • Pranayama
  • stress
  • blood pressure
  • Third trimester of pregnancy

مراجع

  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, Karolkiewicz J, Mądry E, Pupek-Musialik D, Hansdorfer-Korzon R, et al. Effects of endurance and endurance–strength 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.
  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. گاEdouard 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. Valero De Bernabé J, Soriano T, Albaladejo R, Juarranz M, Calle ME, Martı́nez D, et al. Risk factors for low birth weight: a review. Eur J Obstet Gynecol Reprod Biol 2004; 116(1):3-15.
مجله زنان، مامایی و نازایی ایران
دوره 21، شماره 6
شهریور 1397
صفحه 55-63

فایل ها

هم رسانی

ارجاع به این مقاله

آمار