Ioga pré-natal estruturado sobre a função endotelial em grávidas de alto risco de pré-eclâmpsia com foco na relação ET-1/NO

Autores

  • Hamimatus Zainiyah Doctoral Program of Medical Science, Faculty of Medicine, Universitas Airlangga (Indonesia) ; Department of Midwifery,Universitas Noor Huda Mustofa https://orcid.org/0000-0002-1682-363X
  • Bambang Purwanto Department of Physiology and Medical Biochemistry, Faculty of Medicine, Universitas Airlangga (Indonesia)
  • Ernawati Ernawati Department of Obstetric Gynecology, Faculty of Medicine, Universitas Airlangga (Indonesia)
  • Raden Argarini Department of Physiology and Medical Biochemistry, Faculty of Medicine, Universitas Airlangga (Indonesia)
  • Mukhoirotin Mukhoirotin Department of Nursing, Faculty of Health Science, Universitas Pesantren Tinggi Darul Ulum (Indonesia)

DOI:

https://doi.org/10.47197/retos.v70.116846

Palavras-chave:

Modulação de biomarcadores, pressão arterial, exercício prénatal, relaxamento

Resumo

Introdução: A disfunção endotelial, caracterizada por uma elevada relação ET-1/NO, desempenha um papel fundamental na pré-eclâmpsia. O ioga pré-natal pode melhorar a função endotelial, melhorando o fluxo sanguíneo e a regulação cardiovascular.

Objectivo: Este estudo foi conduzido para avaliar o efeito de um programa estruturado de ioga pré-natal na relação ET-1/NO em grávidas com elevado risco de desenvolver pré-eclâmpsia.

Metodologia: Foi realizado um estudo experimental com 46 grávidas com fatores de risco clínicos para pré-eclâmpsia, recrutadas entre as 9 e as 16 semanas de gestação. As participantes foram aleatoriamente atribuídas a um grupo de intervenção de ioga (n = 23) ou a um grupo de controlo (n = 23). Todas as participantes receberam tratamento padrão, composto por aspirina em dose baixa (80 mg/dia) e suplementos de cálcio (1 g/dia). O grupo de intervenção participou ainda em 20 sessões supervisionadas de ioga pré-natal, durante um período de quatro semanas. As concentrações séricas de ET-1 e NO foram medidas antes e depois da intervenção. O desfecho primário foi a alteração da relação ET-1/NO.

Resultados: O grupo de intervenção com ioga demonstrou uma redução significativa na relação ET-1/NO, de 1,13 ± 0,42 para 0,94 ± 0,38 ng/mL (p = 0,010), enquanto o grupo controlo apresentou um aumento significativo de 0,85 ± 0,29 para 1,01 ± 0,38 ng/mL (p = 0,049).

Discussão: Os resultados sugerem que o ioga pré-natal pode melhorar a função endotelial em gravidezes de alto risco, equilibrando os fatores vasoconstritores e vasodilatadores através da redução do stress e da regulação vascular.

Conclusões: O ioga pré-natal pode ser considerado uma abordagem complementar promissora para melhorar a função endotelial e potencialmente prevenir a pré-eclâmpsia em grávidas de alto risco.

Biografias do Autor

  • Hamimatus Zainiyah, Doctoral Program of Medical Science, Faculty of Medicine, Universitas Airlangga (Indonesia) ; Department of Midwifery,Universitas Noor Huda Mustofa

    Midwifery

  • Bambang Purwanto, Department of Physiology and Medical Biochemistry, Faculty of Medicine, Universitas Airlangga (Indonesia)

    Physiology and Medical Biochemistry

  • Ernawati Ernawati, Department of Obstetric Gynecology, Faculty of Medicine, Universitas Airlangga (Indonesia)

    Obstetric Gynecology

  • Raden Argarini, Department of Physiology and Medical Biochemistry, Faculty of Medicine, Universitas Airlangga (Indonesia)

    Physiology and Medical Biochemistry

  • Mukhoirotin Mukhoirotin, Department of Nursing, Faculty of Health Science, Universitas Pesantren Tinggi Darul Ulum (Indonesia)

    Nursing

Referências

Abdel-Razik, A., Mousa, N., Abdelsalam, M., Abdelwahab, A., Tawfik, M., Tawfik, A. M., Hasan, A. S., Elhelaly, R., El-Wakeel, N., & Eldars, W. (2020). Endothelin-1/nitric oxide ratio as a predictive factor of response to therapy with terlipressin and albumin in patients with type-1 hepatorenal syndrome. Frontiers in Pharmacology, 11. https://doi.org/10.3389/fphar.2020.00009

ACOG Committee Opinion No. 774: Opportunistic Salpingectomy as a Strategy for Epithelial Ovarian Cancer Prevention. (2019). Obstetrics & Gynecology, 133(4), e279–e284. https://doi.org/10.1097/AOG.0000000000003164

Corrigan, L., Moran, P., McGrath, N., Eustace-Cook, J., & Daly, D. (2022). The characteristics and effec-tiveness of pregnancy yoga interventions: a systematic review and meta-analysis. BMC Preg-nancy and Childbirth, 22(1). https://doi.org/10.1186/s12884-022-04474-9

Degjoni, A., Campolo, F., Stefanini, L., & Venneri, M. A. (2022). The NO/cGMP/PKG pathway in plate-lets: The therapeutic potential of PDE5 inhibitors in platelet disorders. In Journal of Throm-bosis and Haemostasis (Vol. 20, Issue 11, pp. 2465–2474). John Wiley and Sons Inc. https://doi.org/10.1111/jth.15844

Genovesi, S., Giussani, M., Orlando, A., Lieti, G., Viazzi, F., & Parati, G. (n.d.). Relationship between endo-thelin and nitric oxide pathways in the onset and maintenance of hypertension in children and adolescents. https://doi.org/10.1007/s00467-021-05144-2/Published

Santosa, I. G. N. P. E., Jawi, I. M., Lesmana, C. B. J., Kandarini, Y., Brahmantya, I. B. Y., & Adnyeswa-ri, I. G. A. A. I. (2025). Estudio piloto sobre la eficacia de la meditación Sidhakarya para reducir los niveles de malondialdehído: un enfoque experimental. Retos, 66, 803–809. https://doi.org/10.47197/retos.v66.111837

Hopkins, L. B., Medina, J. L., Baird, S. O., Rosenfield, D., Powers, M. B., & Smits, J. A. J. (2016). Heated hatha yoga to target cortisol reactivity to stress and affective eating in women at risk for obesi-ty-related illnesses: A randomized controlled trial. Journal of Consulting and Clinical Psycholo-gy, 84(6), 558–564. https://doi.org/10.1037/ccp0000091

Ives, C. W., Sinkey, R., Rajapreyar, I., Tita, A. T. N., & Oparil, S. (2020). Preeclampsia—Pathophysiology and Clinical Presentations: JACC State-of-the-Art Review. In Journal of the American College of Cardiology (Vol. 76, Issue 14, pp. 1690–1702). Elsevier Inc. https://doi.org/10.1016/j.jacc.2020.08.014

Jain, A. (2012). Endothelin-1: A key pathological factor in pre-eclampsia? In Reproductive BioMedicine Online (Vol. 25, Issue 5, pp. 443–449). https://doi.org/10.1016/j.rbmo.2012.07.014

Jung, E., Romero, R., Yeo, L., Gomez-Lopez, N., Chaemsaithong, P., Jaovisidha, A., Gotsch, F., & Erez, O. (2022). The etiology of preeclampsia. In American Journal of Obstetrics and Gynecology (Vol. 226, Issue 2, pp. S844–S866). Elsevier Inc. https://doi.org/10.1016/j.ajog.2021.11.1356

Karthiga, K., Pal, G. K., Dasari, P., Nanda, N., Velkumary, S., Chinnakali, P., Renugasundari, M., & Har-ichandrakumar, K. T. (2022). Effects of yoga on cardiometabolic risks and fetomaternal out-comes are associated with serum nitric oxide in gestational hypertension: a randomized con-trol trial. Scientific Reports, 12(1). https://doi.org/10.1038/s41598-022-15216-4

Kinshella, M. L. W., Omar, S., Scherbinsky, K., Vidler, M., Magee, L. A., von Dadelszen, P., Moore, S. E., & Elango, R. (2021). Effects of maternal nutritional supplements and dietary interventions on placental complications: An umbrella review, meta-analysis and evidence map. In Nutrients (Vol. 13, Issue 2, pp. 1–29). MDPI AG. https://doi.org/10.3390/nu13020472

Maeda, S., Tanabe, T., Miyauchi, T., Otsuki, T., Sugawara, J., Iemitsu, M., Kuno, S., Ajisaka, R., Yamagu-chi, I., & Matsuda, M. (2003). Aerobic exercise training reduces plasma endothelin-1 concen-tration in older women. J Appl Physiol, 95, 336–341. https://doi.org/10.1152/japplphysiol.01016.2002.-Endothelial

Mishra, B., Agarwal, A., George, J. A., Upadhyay, A. D., Nilima, N., Mishra, R., Kuthiala, N., Basheer, A., Vishnu, V. Y., & Srivastava, V. P. (2024). Effectiveness of Yoga in Modulating Markers of Im-munity and Inflammation: A Systematic Review and Meta-Analysis. Cureus. https://doi.org/10.7759/cureus.57541

Nishiyama, S. K., Zhao, J., Wray, D. W., & Richardson, R. S. (2017). Vascular function and endothelin-1: tipping the balance between vasodilation and vasoconstriction. Journal of Applied Physiology, 122(2), 354–360. https://doi.org/10.1152/japplphysiol.00772.2016

Patil, S. G., Aithala, M. R., & Das, K. K. (2015). Effect of yoga on arterial stiffness in elderly subjects with increased pulse pressure: A randomized controlled study. Complementary Therapies in Medicine, 23(4), 562–569. https://doi.org/10.1016/j.ctim.2015.06.002

Phipps, E. A., Thadhani, R., Benzing, T., & Karumanchi, S. A. (2019). Pre-eclampsia: pathogenesis, nov-el diagnostics and therapies. In Nature Reviews Nephrology (Vol. 15, Issue 5, pp. 275–289). Na-ture Publishing Group. https://doi.org/10.1038/s41581-019-0119-6

Rakhmawati, N., Wulandari, Y., Program Sarjana, K., & Kesehatan, I. (2021). The Factors Influencing Pre Eclamsia In Pregnant Women At Puskesmas (Public Health Center) In Banyuanyar Sura-karta. Jurnal Kesehatan Madani Medika, 12(01), 59–67.

Ray, A., Ch. Maharana, K., Meenakshi, S., & Singh, S. (2023). Endothelial dysfunction and its relation in different disorders: Recent update. Health Sciences Review, 7, 100084. https://doi.org/10.1016/j.hsr.2023.100084

Rolnik, D. L., Wright, D., Poon, L. C., O’Gorman, N., Syngelaki, A., de Paco Matallana, C., Akolekar, R., Cicero, S., Janga, D., Singh, M., Molina, F. S., Persico, N., Jani, J. C., Plasencia, W., Papaioannou, G., Tenenbaum-Gavish, K., Meiri, H., Gizurarson, S., Maclagan, K., & Nicolaides, K. H. (2017). Aspirin versus Placebo in Pregnancies at High Risk for Preterm Preeclampsia. New England Journal of Medicine, 377(7), 613–622. https://doi.org/10.1056/nejmoa1704559

Sandoo, A., Veldhuijzen Van Zanten, J. J. C. S., Metsios, G. S., Carroll, D., & Kitas, G. D. (2010). The Endo-thelium and Its Role in Regulating Vascular Tone. In The Open Cardiovascular Medicine Journal (Vol. 4). https://doi.org/10.2174/1874192401004010302

Satyapriya, M., Nagendra, H. R., Nagarathna, R., & Padmalatha, V. (2009). Effect of integrated yoga on stress and heart rate variability in pregnant women. International Journal of Gynecology and Obstetrics, 104(3), 218–222. https://doi.org/10.1016/j.ijgo.2008.11.013

Staff, A. C., Fjeldstad, H. E., Fosheim, I. K., Moe, K., Turowski, G., Johnsen, G. M., Alnaes-Katjavivi, P., & Sugulle, M. (2022). Failure of physiological transformation and spiral artery atherosis: their roles in preeclampsia. In American Journal of Obstetrics and Gynecology (Vol. 226, Issue 2, pp. S895–S906). Elsevier Inc. https://doi.org/10.1016/j.ajog.2020.09.026

Thirthalli, J., Naveen, G. H., Rao, M. G., Varambally, S., Christopher, R., & Gangadhar, B. N. (2013). Cor-tisol and antidepressant effects of yoga. Indian Journal of Psychiatry, 55(7). https://doi.org/10.4103/0019-5545.116315

Tranquilli, A. L., Dekker, G., Magee, L., Roberts, J., Sibai, B. M., Steyn, W., Zeeman, G. G., & Brown, M. A. (2014). The classification, diagnosis and management of the hypertensive disorders of preg-nancy: A revised statement from the ISSHP. In Pregnancy Hypertension (Vol. 4, Issue 2, pp. 97–104). Elsevier B.V. https://doi.org/10.1016/j.preghy.2014.02.001

Vianna, P., Bauer, M. E., Dornfeld, D., & Chies, J. A. B. (2011). Distress conditions during pregnancy may lead to pre-eclampsia by increasing cortisol levels and altering lymphocyte sensitivity to glucocorticoids. Medical Hypotheses, 77(2), 188–191. https://doi.org/10.1016/j.mehy.2011.04.007

Wang, Y., Wang, Y., Liu, T., Qin, Y., Tang, F., Zhang, X., & Li, Y. (2023). Association between endothelin-1, nitric oxide, and Gensini score in chronic coronary syndrome. BMC Cardiovascular Disorders, 23(1). https://doi.org/10.1186/s12872-023-03625-w

Yang, L., Li, X., Ni, L., & Lin, Y. (2025). Treatment of endothelial cell dysfunction in atherosclerosis: a new perspective integrating traditional and modern approaches. In Frontiers in Physiology (Vol. 16). Frontiers Media SA. https://doi.org/10.3389/fphys.2025.1555118

Zhao, Y., Vanhoutte, P. M., & Leung, S. W. S. (2015). Vascular nitric oxide: Beyond eNOS. In Journal of Pharmacological Sciences (Vol. 129, Issue 2, pp. 83–94). Japanese Pharmacological Society. https://doi.org/10.1016/j.jphs.2015.09.002

Zullino, S., Buzzella, F., & Simoncini, T. (2018). Nitric oxide and the biology of pregnancy. In Vascular Pharmacology (Vol. 110, pp. 71–74). Elsevier Inc. https://doi.org/10.1016/j.vph.2018.07.004

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Publicado

08/07/2025

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Artigos de caráter científico: trabalhos de pesquisas básicas e/ou aplicadas.

Como Citar

Zainiyah, H., Purwanto, B., Ernawati, E., Argarini, R., & Mukhoirotin, M. (2025). Ioga pré-natal estruturado sobre a função endotelial em grávidas de alto risco de pré-eclâmpsia com foco na relação ET-1/NO. Retos, 70, 1352-1359. https://doi.org/10.47197/retos.v70.116846