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การแทรกแซงเช่นให้ผู้หญิงโดยการให้ข้อมูลเกี่ยวกับประโยชน์และความเสี่ยงทางกายภาพก่อนคลอดง่ายมากactivity motivates them to practice better health behaviors . Cognitive-behavioral intervention led to improvement in the biological stress response of pregnant women with sub clinically elevated stress, anxiety, or depressive symptoms . A controlled clinical trial on outpatient ante-partum women who met DSM-IV criteria for major depressive disorder, found significant improvement in mood after 16 weeks of Interpersonal psychotherapy .Massage therapy showed reduced anxiety, improved mood and better sleep with fewer complications during labor and postnatal period with lesser incidence of prematurity and low birth weight . Exercise in the third trimester was associated with lesser state-anxiety . Applied relaxation training showed significant reductions in state/trait anxiety and perceived stress . ‘Attending nurse-led relaxation education’ reduced the need for cesarean section, and/or instrumental extraction and also the number of infants with low birth weight . Yoga, with its holistic approach, has been used to promote positive health for centuries in India . Several clinical trials point to the beneficial effects of yoga in Asthma , Hypertension , Pain Managament , Diabetes , Cancer, and Mood Changes [32]. Yoga improves the Quality of life and reduces stress as evidenced by reduced anxiety levels , serum cortisol levels [36,37] with lower metabolic rate in yoga practitioners . To date there are a few publications on the effect of integrated approach of yoga (IAYT) on pregnancy outcome . In a case control study Narendran et al. showed the positive effects of IAYT on mode of delivery, birth weight of the infant and pregnancy complications. Again, in those pregnancies with abnormal flow in umbilical and uterine arteries (observed in ultrasound Doppler scanning), there was improvement in birth weight, decrease in preterm labor and intrauterine growth restriction . Sun et al. observed that 12e14 week yoga program produced lesser scores on Discomforts of Pregnancy (DoPQ) in 38e 40th week of gestation with higher self-efficacy and outcome expectancy in both the active and second stages of labor. It is known that Physiological stress reactivity is dampened during pregnancy . We demonstrated improved autonomic adaptability(in heart rate variability) with reduced perceived stress levels [43] that resulted in better quality of life (WHOQoL 100) andinterpersonal relationships (FIRO-B) after integrated yoga in pregnant women . We hypothesized that these observations could be due to reduced anxiety and depressive responses to perceived stress and planned to document these variables in the same cohort in which we observed the above changes which is reported here.
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