Clinical features of the autonomic nervous system and their correlation with psycho-emotional disorders in women with hypertensive states during pregnancy

Abstract

DOI: 10.52705/2788-6190-2023-02-1
УДК 618.3-06.612.817.3

The objective: to evaluate the clinical characteristics and correlation between signs of autonomicnervous system (ANS) dysfunction and psychoemotional disorders in pregnant womenwith gestational hypertension/preeclampsia and pregnant women with hypertensive states duringthe previous pregnancy.

Materials and methods. The study involved 124 women pregnant women with gestational hypertension/preeclampsia (first group), 48 pregnant women with hypertensive states during theprevious pregnancy (second group), 35 women with a physiological pregnancy (control group).The study of ANS status was conducted by Wein questionnaires for subjective and objective assessmentof autonomic status, the evaluation of Kerdo informative index and the study of psychoemotionalstate based on well-being, activity and mood assessment questionnaire and Spielberger–Khanin scale of reactive and personal anxiety.Data was analyzed using Statistica 10.0 (StatSoft Inc., USA).

Results. Сlinical characteristics of autonomic dysfunction were detected in all pregnant womenof the first group with increase of sympathetic activity in association with psycho-emotional disorders,which were proved based on increasing points on the scales of subjective (36,03±4,08) andobjective assessment of autonomic status (44,28±5,45), a 6,1-fold increase in the percentage ofpatients with sympathicotonia due to Kerdo informative index compared to control, the presenceof asthenic disorders was associated with bad mood and an increased level of high anxiety.In the second group, significant autonomic dysfunction was diagnosed at an early stage, asthenicdisorders associated with high level of situational anxiety were diagnosed in a higher percentage ofpatients compared to control. A significant correlation was proved between the number of points ofthe Wein objective scale and the scores of well-being, activity and mood assessment questionnaire(r= – 0,76; p<0,001), the levels of personal (r=0,33; p<0,001) and reactive anxiety (r=0,41; p<0,001).

Conclusions. Therefore, hypertensive states during pregnancy are considered as a syndrome ofpsycho-emotional and autonomic-vascular dysadaptation, caused by the personal characteristicsof a woman before the onset of complications against the background of persistent insufficientautonomic support of pregnancy, which indicate the importance of studying the psychologicalstatus of a woman and the dysfunction of the ANS in the early stages of pregnancy to find out theexpressiveness deviations for monitoring and optimization of treatment and preventive measures.