Improving the health of mother and child

through Yoga and exercise

 Terminology
• Gestation- Period of time between conception and birth.
• Fetus-  unborn offspring that develops from an embryo( after 9th week).
• GDM- Gestational Diabetes Mellitus
• Gestational hypertension- High blood pressure during pregnancy
• Pre-eclampsia- Hypertension + proteinuria.
• Stillbirth- Loss of a baby at or after 20 weeks of pregnancy.
• GDNF- glial cell line-derived neurotrophic factor
• T/S ratio is the relative amount of telomeric DNA (T) to the beta-globin single copy gene
(S)
• Electroencephalography (EEG)- Measure electrical activity in brain
• Event Related Potential(ERP) is the measured brain response that is the direct result of a
specific sensory, cognitive, or motor event
• SPMMR - slow positive mismatch response- An automatic response of the temporal cortex
 Introduction to pregnancy
• Pregnancy also known as gestation, during which one or more fetus develop inside
woman’s womb.
• Three trimester- 3 month each
• <37 weeks – preterm
• 37-39weeks – early term
• >39 weeks- at term
• 40-42weeks- late term
• >42 weeks – post term
Pregnancy Signs and symptoms
Three Trimesters
Physiological Changes
Metabolic Changes
Complications during pregnancy
Pregnancy and exercise
 Develop strength and
Tone pelvic floor muscles
stamina Relieve muscular tension

Calm mind and reduce

stress and anxiety
Pregnancy Yoga Connect to fetus

Mental and physical

Balance maintenance Increased lung capacity

Posture improvement Normal breathing

Improve circulation

Improve sleep quality Enhance Flexibility

Pregnancy Yoga
Pregnancy Yoga
• Brain development is plastic process and begins in the embryonic period and continues until late
adolescence.
• Peripheral stimuli as maternal physical activity may lead to better brain growth.
• Dosed physical activity during pregnancy affect fetal health and improves cognitive functions in the
offspring.
• In humans, offspring born of mothers physically active during pregnancy show better performance in
general intelligence tests and linguistic skills than those born of mothers inactive during pregnancy.
• This study investigate the effects of aerobic exercise (AX) during pregnancy on neurobehavioral
functions of adult male mice offspring with emphasis on serum levels of GDNF.
 Methods

Pregnancy
stabilization

20 days
Warmup(3 min)- 8 m/min 10 min
First sessions(10 min)- 10 m/min
Training days ( 30 min )- 12 m/min
Exercis Control
e 90th day post-birth
50 Adult male
offspring/each group

MWM NORT HPT RBT Grip strength

The cognitive function, motor coordination, forelimb grip strength, and pain
tolerability

• sGDNF - ELISA technique.

 Results

Effects of AX during Pregnancy on Morris water maze test –Average Morris water maze test -Time spent
Cognitive Performance of Adult Male time by mice to rescue stage (1- by mice to reach the platform
Offspring Object Recognition Task. control, 2- exercise)

MWM & NORT -Recognition performance and cognition

 Results

Muscle Coordination- Raised-beam task Pain tolerability- hot plate tests

 Results

Mean serum GDNF levels, pg/ml, in adult male offspring

 Discussion

• Moderate intensity AX could have long-term effects on the neurobehavioral

functions and serum level of GDNF (Previous study on BDNF).
• GDNF decrease apoptosis during neurodegeneration, improve cognition and
neural plasticity, helps in neuroprotection of dopaminergic neurons, enhance
motor neron functions.
• GDNF is mainly involved in pain modulation in the spinal cord and primary
sensory neurons
• Pregnancy-related back pain is a significant health problem affecting a large majority of
women worldwide.
• Gestational low back pain (LBP) is likely caused by physiologic changes during
pregnancy, including maternal weight gain, spinal lordosis, decreased abdominal muscle
strength.
• Gestational LBP is associated with insomnia, impaired daily activity, loss of work,
depression, pain medication use, and chronic recurrent back pain.
• The objective of this study is to assess the feasibility of a prenatal yoga randomized
controlled trial (RCT) for gestational low back pain (LBP), mobility, and maternal well-
being.
 Uncomplicated pregnancy- 12-16 weeks (18-39
y/o)

Prenatal yoga program (11) Educational attention control(9)

For 12 Weeks – 1 hour /Week

At baseline & every 4 weeks until delivery.

Clinical symptoms and psychosocial outcomes Mobility and biomechanics
• RMDQ - back pain-related disability. • Instrumented timed-up-and-go
• Visual analogue scale- measured back pain severity. test (iTUG),
• Pregnancy Symptom Inventory (PSI)- overall functional burden • 30-second standing sway test
such as urinary symptoms, fatigue, dizziness, sleep disturbance, leg,
(iSway)
and back pain
• Edinburgh Postnatal Depression Scale (EDPS)- prenatal
• 90-second walk test (iWalk).
depression screening. • Falls Efficacy Scale
• Short Form 12 questionnaire (SF12)- Quality of life International - Fear of falling
• Childbirth Self Efficacy Inventory - quantify maternal confidence
toward childbirth
 Results

Effect Estimates of Between-Group Differences at 8 and 12Weeks.

Results

Gait Analyses
• The developing fetus responds to the conditions in the internal or external environment
during cellular proliferation, differentiation, and maturation which results in structural and
functional changes in cells, tissues, and organ systems for longer term.
• Exposure to psychosocial stress and/or biological stress mediators during gestation has
been identified as one salient condition that may underlie the long-term programming
effects of the intrauterine environment.
• Stress exposure during fetal development is an important factor shaping adult health and
has been linked to adverse outcomes including, but not limited to, immune, endocrine, and
metabolic dysregulation and related disorders.
• Objective of the present study was to test the hypothesis that maternal psychosocial stress
exposure during pregnancy is associated with shorter telomeres in their offspring ,
 Methods
A quasi experimental design

Psychological stress group Control group (49)

(45)

Measurement of Potential Postnatal Confounders

Telomere Length Assay

Measurement of relative telomere lengths (i.e., T/S ratios) by quantitative PCR

telomere repeat copy number-to-single gene copy number – T/S ratio

Results
Results
 Discussion

• Finding suggests that cellular aging in humans may be influenced by prenatal

stress, thereby potentially increasing the susceptibility of prenatally stressed
individuals for complex, common age-related diseases.
• Magnitude of the observed difference in LTL between PSG and CG was 178 bp
shorter than that of individuals in the CG (and 295 bp shorter in female subjects).
• One of the major paradigms to explain variation in susceptibility for complex,
common adverse health disorders in adult life is the fetal or developmental origins
model, which is believed to act through “biological embedding”—the ability of
early life experience to change biology.
• The predicted decrease in LTL was unchanged after adjusting for several key
potential confounding factors and was particularly pronounced in women.
• Randomized controlled trial (n = 18) and measured the impact of exercise during
pregnancy on the neuroelectric response of the neonatal brain with
electroencephalography (EEG)
• The human brain benefits from the regular engagement in aerobic exercise.
• Animal studies show that these benefits can be transferred from the exercising
pregnant rat to her fetus.
• Event related potentials (ERPs), the averaging of the brain’s neuroelectric
response to a set of stimuli. Also, to avoid confounds related to an eventual auto
selection bias, we randomly assigned women to exercise or to be sedentary during
pregnancy.
 Methods

• Recruited 29 women in the first trimester.

• The final sample consisted of 18 participants: 10 in the active group and 8 in
the sedentary group.
• Exercise - at least 20 min at 55% of their maximal aerobic capacity
• Intensity of the exercise was quantified with the 6–20 Borg perceived
exertion scale as well as with heart rate monitors provided to the participants.
• The intensity of each exercise session was converted into METs (metabolic
equivalent of task)
• Electroencephalography (EEG) of offspring was acquired between 8 and 15
days after delivery.
Results
Results
 Results

Average event-related responses to the rare and frequent sounds for the neonates born to mothers
in the exercise and sedentary groups for each of the six regions of interest- FL = frontal left; FR =
frontal right; CL = central left; CR = central right; PL = parietal left; PR = parietal right.
 Results

Topographical maps for the difference between the two waveforms for the area covering 50
ms around the peak. The difference was more focused over the frontal region of the left
hemisphere for the active group, while it was stronger and more diffuse in the sedentary
group.
Amplitude of the response to the rare sound was significantly amplitudes were also 1.2 to 1.8 times lower in
lower for the active group than for the sedentary group in the right the other regions for the active group than for
frontal region the sedentary group
 Results
• Amplitude of the SPMMR decreases as the brain matures.
• Neonates born to mothers who exercised during pregnancy presented a more
mature brain response associated to sound discrimination and auditory memory.
• The amplitude of the ERP waveform with age is the result of synaptic pruning
(number of synapses in the brain is reduced) therefore allowing for more efficient
neuronal configurations and more localized brain responses, and ultimately
leading to less topographical spreading of the ERP.
• It is possible that the fetus of an active woman receives a greater supply of oxygen
and nutriments. In addition, an increase in the fetus’s supply of brain-derived
neurotrophic factor (BDNF) could explain the observed results.
• BDNF can pass through placenta and exercised mother have more circulatory
BDNF so it can be passed to the infants.
Thank you