Associations Of Yoga As A Form Of Leisure-time Physical Activity With Adverse Pregnancy Outcomes

Regular leisure-time physical activity (LTPA) reduces the risk of adverse pregnancy outcomes (APO) such as hypertensive disorders of pregnancy (HDP). Yoga, LTPA with additional mind body benefits, may especially reduce APOs, but data from large representative cohorts is lacking. PURPOSE: To determine if yoga participation during pregnancy was associated with a reduced risk of APOs compared to no yoga participation. METHODS: The nuMoM2b study was a prospective cohort of 10,038 nulliparous women enrolled in their first trimester of pregnancy and followed through delivery. LTPA was determined each trimester in min/wk from an interview querying usual participation in up to three activities. Min/wk were averaged across trimesters to generate moderate-vigorous LTPA categories based on physical activity guidelines: none, insufficient (<150 min/wk), sufficient (150-299 min/wk), or high (≥300 min/wk). Further, participants were classified into the yoga group if they self-reported yoga as one of their three activities in any trimester. APOs were abstracted from medical records and included HDP, gestational diabetes mellitus (GDM), preterm birth (PTB), and small-for-gestational age infants (SGA). Generalized linear models calculated the risk ratio of APOs among those in the yoga vs. non yoga group adjusted for age, BMI, income, smoking, insurance, race, and LTPA level. RESULTS: Participants (n = 8,922) had mean age 27.0 years, early pregnancy BMI of 26.3 kg/m2, 60.7% were white, and 16.0% participated in yoga. The yoga group differed from the non-yoga group in that they were older, had a lower BMI, had higher incomes, were less likely to smoke, were more likely to have private insurance, were more likely to be non-Hispanic white, and engage in LTPA (all <0.01). Yoga participation was associated with lower risk of APOs that reached significance for PTB, SGA, and a composite of all APOs (Table). CONCLUSIONS: Yoga as a form of LTPA may uniquely reduce the risk of APOs. Table. - Relative Risk Ratios for APOs Comparing Yoga (n = 1,413) versus Non-yoga (n = 7,333) Overall n Events in the Ever Yoga Group(n and percent) Events in the Never Yoga Group(n and percent) Relative Risk Ratio (95% CI) p-value HDP 8,619 282 (20.2) 1,736(24.0) 0.91(0.81-1.02) 0.108 GDM 8,746 41 (2.9) 334 (4.6) 0.73(0.52-1.02) 0.066 PTB 8,910 81 (5.7) 658(8.8) 0.78(0.62-0.99) 0.039 SGA 8,827 114 (8.1) 833(11.2) 0.81(0.67-0.99) 0.040 Composite APO 8,922 443 (31.0) 2,884(38.5) 0.75(0.69-0.81) <0.001 Adjusted for age, BMI, income, smoking, insurance, race, and LTPA level. Bold values indicated statistical significance. Abbreviations: HDP = hypertensive disorders of pregnancy, GDM = gestational diabetes mellitus, PTB = preterm birth; SGA = small-for-gestational age infants