Zaporožskij Medicinskij Žurnal (Feb 2020)
Hormonal and metabolic features of the placental complex in pregnant women-displaced persons
Abstract
Important factors that determine the physiology of pregnancy are psycho-emotional, micronutritive state of a pregnant woman and fetoplacental complex. Complicated socio-economic conditions, environmental problems, staying in conditions of persistent stress as a result of a military conflict in the east ofUkrainehave a negative impact on the health indicators of pregnant women and their children. The aim of this study was to determine the peculiarities of the psycho-emotional state and associated changes in the production of placental hormones and micronutrients in pregnant women-displaced persons for further improvement of the antenatal observation program. Materials and methods. To perform the tasks of the study, a dynamic prospective clinical and paraclinical examination of 96 pregnant women (the main group) – displaced persons and 39 pregnant women (the control group) living permanently in the territory controlled byUkraine, who were enrolled randomly in the period of gestation after 22 weeks. All pregnant women were examined (clinical-laboratory and special obstetrical examinations) according to the requirements of the quality standards as required by the Order of the Healthcare Ministry of Ukraine No 417 of 15.07.2011. The evaluation of psycho-emotional state of examined pregnant women was conducted with the help of screening by performing clinical interviews together with routine questioning. The questionnaires containing the questions of Spielberger’s tests in the modification of Khanin were developed in advance. The concentration of calcium, magnesium in blood serum was determined by colorimetric method, placental (estradiol, progesterone, placental lactogen) hormones were determined by solid-phase enzyme immunoassay. Results. It was found an increase in the concentration of estradiol and a decrease in progesterone and placental lactogen, shift in estrogen-progesterone equilibrium towards a relative hyperestrogenia; micronutritive imbalance with a significant shift in calcium-magnesium equilibrium towards calcium along with significant changes in the concentration of serum magnesium as well as anxiodepressive states with high levels of state and trait anxiety which were 3.9 and 2.2 times, respectively, higher than average statistical indices in the control group. Conclusions. The hormonal and metabolic disorders revealed in pregnant internally displaced persons are biochemical markers of placental dysfunction indicating the feasibility of comprehensive pre-conception training with a psychologist involvement and preventive measures inclusion as a long-term progesterone and magnesium support during pregnancy in the programs of such women antenatal monitoring.
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