Table 1 Characteristics of studies according to FITT principle
Study ID | Country | Study type | Sample size | Gestation (weeks) | Intervention | Control | Outcome of interest | Main results | Frequency | Intensity | Timing | Type |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
Babbar et al. 2016 | USA | RCT uncomplicated pregnancy | 46 (23/23) | 28–36 weeks | Yoga session | PowerPoint presentation | Mode of birth | NVB 65% yoga and 61% control | One time | One | 60 mins | Poses, breathing, shavasana |
Balaji et al. 2017 | India | RCT gestational diabetes | 151 (75/76) | 24 weeks | Yoga sessions | Routine treatment | Mode of birth | NVB 84% yoga 26% control | Daily | 3 months taught if practiced daily availability of 91 sessions | 60 mins | Loosening exercises, postures, deep relaxation technique, pranayama |
Bershadsky et al. 2014 | USA | Non-randomised control trial normal pregnancy | 50 (38/12) | 12–19 weeks | Yoga sessions | Usual activity | Depression Physiological stress | Cortisol levels lower post yoga and fewer depressive symptoms in yoga group | No information | No information taught sessions | 90 mins | Hatha yoga |
Bhartia et al. 2019 | India | RCT low risk pregnant women | 78 (38/40) | 18–20 weeks | Yoga therapy | Routine physical activity | Perceived stress Mode of birth | Perceived stress reduced 31.75% in yoga group and increased 6.60% in control (p < 0.001). NVB 92% yoga and 90% control | Tri-weekly | 36 sessions – 12 taught & 24 self-practice | 50 mins | Loosening exercises, breathing, postures, deep relaxation |
Bolanthakodi et al. 2018 | India | RCT normal pregnancy | 150 (75/75) | 30 weeks | Yoga therapy | Standard antenatal care | Mode of birth Pain management | More NVB in yoga group (p < 0.037), duration of labour was significantly shorter (p < 0.001) Significant reduction in intravenous analgesic in yoga group (p < 0.045) and tolerance of pain was higher as shown by NPIS (p < 0.001) and PBOS scores (p < 0.0001) | Bi-weekly for 4 sessions and weekly for three sessions and self-practice tri-weekly | 7 taught sessions & availability of 24–36 self- practice sessions | 30 mins | Integrated approach to yoga therapy (IAYT) |
Chen et al. 2017 | China | RCT healthy pregnant women | 94 (48/46) | 16 weeks | Yoga sessions | Routine prenatal care | Physiological stress | Prenatal yoga significantly reduced cortisol (p < 0.001) | Bi-weekly | 40 taught sessions | 70 mins | Postures, deep breathing, guided imagery, deep relaxation |
Chuntharapat et al. 2008 | Thailand | RCT normal pregnancy | 74 (37/37) | 26–28 weeks | Yoga sessions | Routine nursing care | Pain management Duration of labour | No differences between groups for pethidine usage. Shorter duration of labour in yoga group | Bi-weekly taught and tri-weekly self-practice | 6 taught sessions & 30–36 available self-practice sessions | 60 mins | Education, postures, chanting om, breath awareness, dhyana, yoga nidra |
Davis et al. 2015 | USA | RCT symptoms anxiety/depression | 46 (23/23) | 28 weeks | Yoga sessions | TAU | Depression Anxiety | Prenatal yoga was associated with reductions in symptoms of anxiety and depression | Weekly | 8 taught sessions and self-practice DVD | 75 mins | Ashtanga Vinyasa system of yoga modified for pregnancy |
Deshpande et al. 2013 | India | RCT high-risk pregnancies | 68 (30/38) | 12 weeks | Yoga therapy | Standard antenatal care/prenatal stretching exercises | Perceived stress | RMANOVA showed a significant decrease (P = 0.02) in the PSS scores of the yoga group compared to the control group | No information | 16 weeks | No information | No information |
Field et al. 2012 | USA | RCT depression | 56 (28/28) | 20 weeks | Yoga postures | Standard prenatal care | Depression Anxiety | Decreased depression scores (F = 82.40,p < 0.001) and decreased anxiety scores (F = 26.23, p < 0.001) in the yoga group | Bi-weekly | 24 taught sessions | 20 mins | Postures |
Field et al. 2013 | USA | RCT depression | 92 (46/46) | 22 weeks | Yoga postures | Social support | Depression Anxiety Physiological stress | Reduced anxiety and depression in both groups with no significant group difference and reduced cortisol pre/post yoga and pre/post social support | Weekly | 12 taught sessions | 20 mins | Postures |
Gallagher et al. 2020 | USA | RCT high-risk pregnancy on bedrest | 79 (48/31) | 23–31 weeks | Yoga sessions | Standard care and no yoga | Depression Anxiety | Perceived anxiety and depression overall scores lower in yoga group than in control group (p < 0.001) | Bi-weekly taught, video self-practice | Average of 7.46 (3–16) taught sessions, and 2 (0–24) self-practice video sessions | 30 mins | Breathing, visulisation, adapted yoga moves, yoga nidra |
Hayase et al. 2018 | Japan | Non-randomised control trial uncomplicated pregnancy | 91 (38/53) | 20–23 weeks | Yoga sessions | Standard antenatal care | Perceived stress Physiological stress | PSS scores lower in yoga group at 20–23 & 28–31 weeks’ gestation. Salivary α-amylase levels in yoga group significantly decreased immediately after yoga | Weekly taught and daily self- practice | Average of 4 to 19 taught sessions and all women practiced yoga for > 15 min at home, at least three times a week based on the self-report | 60 mins taught session and 15 mins self- practice | Warm-up, breathing exercises, postures, meditation |
Jahdi et al. 2017 | Iran | RCT normal pregnancy | 60 (30/30) | 26 weeks | Yoga sessions | Routine midwifery care | Mode of birth Duration of labour Pain management | Duration of the second and third stages of labour significantly shorter in yoga group (p = 0.04 and 0.01 respectively). Caesarean section rate 13.3% in yoga group compared to 50% in control group. Analgesic use during first stage of labour showed no difference between groups (p = 0.2) | Tri-weekly taught & daily self-practice | 33 taught sessions and possibility of 44 self- practice sessions | 60 mins | Postures, chanting om, breath awareness, yoga nidra, dhyana |
Kundarti et al. 2020 | Indonesia | RCT normal pregnancy | 59 (30/29) | 20–32 weeks | Yoga sessions | Standard antenatal care | Anxiety Physiological stress | Average anxiety in the intervention and control group after intervention (M = 13.16) vs (M = 35.30) and average cortisol levels (M = 16.50) vs (M = 9.91) | Weekly | 8 taught sessions | 90 mins | Postures, breathing, meditation shavasana |
Makhija et al. 2021 | India | RCT mild hypertensive disorder pregnancy | 60 (30/30) | Third trimester | Integrated yoga | Routine care | Duration of labour Mode of birth | Reduction in total duration of labour in yoga group (p = 0.011). 22 (73.3%) yoga group had vaginal delivery compared to 18 (60%) in control group | Tri-weekly | At least 4 weeks (12 sessions) | 40 mins | Postures, breathing, meditation |
Mitchell et al. 2012 | USA | RCT depression | 24 (12/12) | 20 weeks | Yoga postures | Parenting education sessions | Depression | Depressive symptoms reduced to subclinical levels in 55% of yoga group compared to 11% of control group | Bi-weekly | 24 taught sessions | 20 mins | Postures |
Mohyadin et al. 2020 | Iran | RCT normal pregnancy | 84 (42/42) | 26–37 weeks | Yoga sessions | Routine midwifery care | Anxiety Pain management Duration of labour Mode of birth | Anxiety lower in yoga group (p = 0.003). less pain at 4-5 cm in yoga group (p = 0.001). Shorter duration of labour in yoga group (p = 0.003) | Bi-weekly taught and tri-weekly home practice | 6 sessions | 60 mins | Postures, breathing, meditation |
Munirekha et al. 2019 | India | True-experimental post-test only control group design - uncomplicated pregnancy | 30 (15/15) | 24–32 weeks | Yoga sessions | Health education on antenatal care and future lactation | Mode of birth | NVB 80% yoga group compared to 40% control group | Weekly | Taught from 24 to 32 weeks until delivery | No information | Yogasanas |
Narendran et al. 2005 | India | Non-randomised control trial normal pregnancy | 335 (169/166) | 18–20 weeks | Yoga therapy | Walking 30 mins twice daily | Mode of birth | NVB 54% yoga group compared to 49% control group | Daily | Mean GA at delivery 38 weeks allowing for availability of 126 sessions | 60 mins | Integrated approach of yoga therapy (IAYT) Taught then self-practice |
Newham et al. 2014 | UK | RCT healthy pregnant women | 59 (31/28) | 20–24 weeks | Yoga sessions | TAU | Anxiety Depression Physiological stress | Greater reduction in both anxiety and depression in the yoga group. Significant decrease in cortisol after yoga (0.15 [0.11]μg/dL vs. 0.13[0.10]μg/dL P = 0.003) | Weekly | 8 taught sessions | 1.5 h | Hatha yoga |
Rakhshani et al. 2010 | India | RCT normal pregnancy | 102 (51/51) | 18–20 weeks | Integrated yoga | Standard antenatal exercises | Quality of life | Between groups analysis showed significant improvements in the yoga group in the physical (P = 0.001), psychological (P = 0.001), social (P = 0.003) environmental domains (P = 0.001) of the WHOQOL-100 | Tri-weekly | If until delivery estimated between 54 and 66 available taught sessions | 60 mins | Lectures, breathing exercises, postures, meditation, deep relaxation |
Rakhshani et al. 2012 | India | RCT high-risk pregnancy | 68 (30/38) | 12 weeks | Integrated yoga | Standard care plus walking for half an hour mornings and evenings | Mode of birth | Lower rate of emergency c-section in yoga group 51.7% compared to 57.9% in control | Tri-weekly | 28 taught sessions | 60 mins | Breathing exercises, yogic postures, meditative exercises |
Rong et al. 2021 | China | RCT normal healthy pregnancy | 64 (32/32) | 18–27 weeks | Yoga sessions | Routine prenatal care | Anxiety Depression Duration of labour Mode of birth | No statistically significant difference in post anxiety and depressions scores. Higher rate of vaginal birth (p = 0.039) and shorter duration of labour (p = 0.002) in yoga group | Tri-weekly | 12 weeks (up to 36 sessions) | 60 mins | Warm-up, postures, meditation |
Ruqaiyah et al. 2020 | India | Quasi-experimental pre/post with control | 24 (12/12) | Third trimester | No information | No information | Anxiety | Lower anxiety in the yoga group post intervention (p = 0.002) | No information | No information | No information | No information |
Satyapriya et al. 2009 | India | RCT normal pregnancy | 90 (45/45) | 18–20 weeks | Integrated yoga | Standard prenatal exercise | Perceived stress | Perceived stress decreased by 31.57% in the yoga group and increased by 6.60% in the control group (P = 0.001) | Tri-weekly for first month then daily self- practice | 1 month taught then self- practice, refresher every 4 weeks until 28 weeks then 2 weeks until 36 weeks. 16-week programme with availability of up to 92 sessions | 120 mins taught, 60 mins self-practice | Lectures, breathing exercises, poses, meditation, deep relaxation |
Satyapriya et al. 2013 | India | RCT normal pregnancy | 96 (51/45) | 18–20 weeks | Integrated yoga | Standard antenatal exercises | Anxiety Depression Perceived stress | Anxiety and Depression reduced with improvement in pregnancy experience in the yoga group (P < 0.001) | Tri-weekly for first month then daily self- practice | 16-week programme estimated up to 92 available sessions | 120 mins taught, 60 mins self-practice | Lectures, breathing exercises, poses, deep relaxation, meditation |
Uebelacker et al. 2016 | USA | RCT depression | 20 (12/8) | 12–26 weeks | Yoga sessions | Mom-baby wellness workshops | Depression | Although both groups had reduced depression scores, yoga was preferred. | Weekly | 9 taught sessions & self- practice | 75 mins | Breathwork, warm-up, poses, relaxation, homework |
Yekefallah et al. 2021 | Iran | RCT normal pregnancy | 70 (35/35) | 26–37 weeks | Yoga sessions | Routine prenatal care | Duration of labour Mode of birth | Mean duration of labour was shorter in yoga group (p < 0.0001). 82.9% of the women in the yoga group and 65.7% in the control group had a natural delivery | Bi-weekly | Attended for 9–11 weeks (up to 22 sessions) | 75 mins | Hatha yoga |
Yulianti et al. 2018 | Indonesia | RCT normal pregnancy | 102 (51/51) | 22–32 weeks | Yoga sessions | Not treated | Depression Anxiety | Mean level of anxiety and depression were lower in the yoga group at both two- and four-weeks post intervention (p < 0.001) | No information | 1 month | No information | No information |
Yuvarani et al. 2020 | India | Quasi-experimental pre/pots with control depression and anxiety | 30 (15/15) | 16–20 weeks | Yoga sessions | Aerobic exercise | Depression | Aerobic exercise and yoga showed significant effect for reducing the symptoms of depression (P ≤ 0.001) | Weekly | 3 months (up to 13 sessions) | 20 mins | Breathing, postures |