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Pregnancy and Weight Gain Prenatal yoga is a systematized technique, where at the loftiest level, it is ethereal, at the betwixt it is psycho-physical and at the nethermost level, it’s strictly physical. Uncountable modifications ensue, whenever any professional demonstrates yoga, with the angle of absolute self-restrain, tenacious follow, subjection trouncing lethargic attribute, resentment, misinterpretations. Human body is a composition of sophisticated however, marvalously framed mechanism. If we precisely perceive, why our body concern for heterogeneous poses, we will place our sincere endeavour for accomplishment. The endocrine system, which plays a critical role in functioning and maintenance of body system, has recently been undertook by medical sciences. These 8 sets of secretory organ, manage the major aspects of body such as growth, weight, size, metabolism energy, health. Different trimesters tend to have varied weight gain among women. On an average 12.6 kg increase in the weight has been notified, as weight gain and welfare go hand in hand during pregnancy. The 1st trimester is considered very crucial as the amount of weight fall may be from the range of 0.5 kg to 14 kg, due to nausea and loss of appetite. The process of weight gaining commenced around 12th week of pregnancy, when nausea naturally vanishes and the appetite returns. Till 20th week of gestation, weight gain is not much recognized, but from 20th to 30th week, the changes are quite visible. The higher incidence of pre-eclampsia, leads to weight gain during this peculiar period of time. The tendency of weight gain get steady during that particular week and simultaneously deprecate until the 39th week the most, of pregnancy and later it falls. • Ideal Weight Gain The increase in the body mass, is generally the summation of increase in the size of various organs, during pregnancy including breast, uterus, placenta and amniotic fluid as a major genesis. The circulation of oxygenated blood naturally increases by as much as 30% to counter the required demand of the uterus and the breast as well as the rest of the body. These factors all together comprises for approximately 8kg and a cumulative gain of 9kg in all, should be recommended all through the pregnancy. The summation of final weight gain in pregnancy itself includes the baby weight -3.2kg, the weight of placenta-0.67kg, the weight of the amniotic fluid-0.91kg, the increased weight of the uterus and breast-0.91kg and 0.67kg, and circulatory volume of blood-1.81kg, with the cumulative weight gain of 8.2kg approximately Gordon Bourne (1984). Any extra weight is due to either of fat or fluid retention. The scheme has been aimed at various trimesters and weeks on a certain scale differences, such as 0 to 14 weeks depicted nil weight fluctuation, 14 to 20week cumulative weight increase is of 2.3kg, 20 to 30week cumulative weight increase is of 4.5kg. This particular time period is considered as the most complicated period of pregnancy, with respect to restraining weight increase, that may hike due to pre-disposes to pre-eclampsia, 30 to 36week cumulative increase in a weight is of 2.3kg and during 36 to 40weeks, no increase in the weight is visible and indeed from 38th week onwards, a pregnant woman will very frequently start losing her weight Gordon Bourne (1984). It is completely false to recite that a pregnant woman must have meals for 2, in fact, she must only concentrate on adequate dietary regime and necessary supplements for wellbeing. Usually labor contractions and pains triggered around 7 to 10 days of weight declination. The major reason of weight loss at the end of pregnancy is often, due to a reduction of hormones.

The newly updated guidelines and suggestions recommended by the institution of medicine regarding gestational weight gain, underlines clinicians with practice procedures. Health care practitioners, initially must determine the BMI at the very beginning of 1^st trimester and individual clinical care and suggestions should be directed to a woman, whether she needs to reduce, gain or maintain the weight for the best pregnancy outcomes.  The American College of Obstetricians and Gynaecologists supports the Institute of Medicine’s have provided the guidelines on appropriate weight gaining.

Following are the recommendations for pregnancy [Modified from Institute of Medicine (US). Weight gain during pregnancy: reexamining the guidelines. Washington, Dc. National Academies Press;2009]:

Pregnancy weight category	Body Mass Index*	Recommended range of cumulative weight gain	Recommended rates of weight Gain# in the second and third trimesters (lb) (mean range [lb/wk])
Under weight	Less than 18.5	28-40	1 (1-1.3)
Normal	18.5-24.9	25-35	1 (0.8-1)
Overweight	25-29.9	15-25	0.6 (0.5-0.7)
Obese (includes all classes)	30 and greater	11-20	0.5 (0.4-0.6)

*Body mass index is calculated as weight in kilograms divided by height in meters squared or as weight in pound multiplied by 703 divided by height in inches.

^#Calculation assume a 1.1 - 4.4 lb weight in the first trimester.

According to a research analysis, a report by Obstetrics & Gynaecology (2019), in New York, presents 1.5 billion cases, where women, who have put up more than recommended weight, have come up with severe complications during delivery specially, those who gained over 9.072kgs, above recommendation, are found to have significantly high heart related risks.

Vicious arguments and contradictions have been raging upon the accurate amount of weight gain. In some cases, where women reduced their weight artificially prior pregnancy have gained weight at an alarming rate, hence making them problematic to control beyond 13kgs. Conversely, in other cases women, who were already obese and overweight, successfully maintained their weight with proper dietary schedule.  In an illustration, a woman weight cumulatively 115kgs during gestation. She gave birth to an absolutely normal child and approximately 4 weeks after her delivery, she reduced her weight to 108kgs. The little of her over gained weight was disseminated all over her major body parts. On the other side, one of the study performed by Clapp, III (2000) compared the randomized controlled trial of 46 women who had never performed any exercise prior pregnancy and who did. His result showcased that babies of mothers who were assigned to exercise during pregnancy, have an average 230g heavier weight than that of babies whose mothers did not exercised.  

Sun et al., (2009) evaluated the impact of prenatal yoga on weight gain, delivery associated experiences and infant’s birth weight, among 41 women. The selected subjects were absolutely normal with 20 weeks of gestational period and above, along with normal pre-pregnancy BMI. The total of 41 subjects were bifurcated into 21 experimented and the others as controlled. The prenatal yoga program was consisted of 90 minutes per day exertion, twice a week, continued for 12 weeks on regular basis. For the evaluation point of view, non-equivalent control group, pre-post-test design was inculcated. For final assessment, the data was evaluated applying SPSS 16.0 version. Thus, the result revealed a significant difference between yoga group and control group and therefore, it was concluded that, yoga during pregnancy, effectively managed the weight gain among mothers. Henceforth, yoga during pregnancy can be beneficial in maintaining healthy weight, diminishing labor pain and discomfort, after delivery among pregnant women and therefore, enhancing infant's birth weight.

Babbar S. et al., (2015) surveyed 500 pregnant women, by the means of 20 MCQ and 5 other questions, to testify the knowledge concerning pregnancy (ACOG Committee Opinion #267), on exercising yoga, exercises and a comparative examination among women with BMI<30kg V/S women with BMI<30kg. The total of 422 women responded in return. The result showcased that 85% of the women felt beneficial impacts, although 83% agreed on the concept of beginning of yoga prior to pregnancy and out of total, 64% of them are currently practicing. All amongst the 5 questions, 60-92% of them were very much aware about ACOG recommendations and suggestions and ½ of them had the BMI>30. In the overall result, 65% greatly believed on the benefits of yoga, while 40% had already attempted prior pregnancy.

Pawalia et al., (2016) gathered data from google scholar, from 2008-2015, to identify the impact of obesity on maternal and child birth conditions among Indian women. In the study, the pregnant women were categorized according to their BMI, and therefore, compared with prenatal, perinatal and immediate postnatal related complications. Cumulative of 37 articles were considered which met the study criterion. The result showed that, odd ratio of gestational diabetes, pregnancy induced hypertension, caesarean section, preeclampsia, and prenatal death as 4.62, 3.23, 2.88, 2.69 and 3.17 respectively. Moreover, it was also revealed that, the problems among obese women were either equal or above as compared to western counter parts.

Design of the Study

An experimental design would be implemented, to evaluate the effects of prenatal yogic exercises on pregnant women explicit during 2^nd and 3^rd trimesters. To serve the purpose, one group, with N=20, would be controlled and another group, with N=20, would be subjected prenatal yogic exercises for 2^nd and 3^rd trimesters. The data would be measured and evaluated, using ‘t’ test statistical technique. The final result would be compared and henceforth, can be used for the recommendation purpose for better pregnancy outcomes.

Selection of Subjects                                                   

To satisfy the purpose, 40 pregnant women were recruited with the age range between 25-35 years. Further, the total sample was equally bifurcated into 20 pregnant women, who does have prior yoga experience, were experimented with prenatal yogic exercises and other 20 pregnant women, were controlled. The purposive sampling technique was applied for selection criterion.

Body Mass Index- It would be measured using Stadiometer and weighing scale for height and weight of the subject from second and last trimester. The results will be measured using prescribed guidelines given by Institute of Medicine, committee on nutritional status during pregnancy and lactation (1990).

BMI between Pre (II-Trimester) & Post (III-Trimester) on yoga group.

PAIRED ‘t’ test
VARIABLE	PRE(II-TRIMESTER)		POST(III-TRIMESTER)		t-value	df	p-value
	Mean	SD	Mean	SD
BMI	23.9269	3.59512	25.5156	3.51895	11.162	19	0.00

Table-1

Table 1 displays the comparison of mean BMI within the yoga group before and after the intervention. The table indicates that the initial mean BMI was 23.9269, which increased to 25.5156 after the intervention. This change resulted in a t-value of 11.162, which is highly statistically significant (p < 0.01).

BMI between Pre (II-Trimester) & Post (III-Trimester) on Non-Yoga group.

PAIRED ‘t’ test
VARIABLE	PRE(II-TRIMESTER)		POST(III-TRIMESTER)		t-value	df	p-value
	Mean	SD	Mean	SD
BMI	24.6879	2.100	28.1992	2.85324	11.719	19	0.00

Table-2

In Table 2, the mean BMI in the non-yoga group is compared before and after the intervention. The initial mean BMI was recorded as 24.6879, and it showed an increase to 28.1992 after the intervention. This change resulted in t-values of 11.719, indicating a high level of statistical significance (p < 0.01).

Table-3

Table 3 displays the initial mean BMI comparison between the yoga and non-yoga groups. The table shows that before the intervention, the BMI scores for the yoga group and non-yoga group were 23.9269 and 24.6879, respectively. The resulting t-value of -0.841 was not statistically significant (p > 0.05).

Table-4

Table 4 presents the post-intervention mean BMI comparison between the yoga and non-yoga groups. The table illustrates that after the intervention, the mean BMI scores were 25.5156 for the yoga group and 28.1992 for the non-yoga group. This yielded a t-value of -2.61, signifying a highly significant outcome (p < 0.01). 

Testing of Hypothese

H:01 States that there would be no significant difference between the level of BMI among yoga and non-yoga groups during II trimester. At this point the hypothesis is accepted.

H:02 States that there would be no significant difference between the level of BMI among yoga and non-groups during III trimesters. At this point, the hypothesis is rejected.

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