Zaporožskij Medicinskij Žurnal (Dec 2024)
The effect of anxiety levels in women with hypertensive disorders on the pregnancy course and outcome
Abstract
Aim. To analyze the influence of anxiety levels in women with hypertensive disorders on the pregnancy course and outcome in order to identify the relationship between the psycho-emotional state of pregnant women and the probability of developing complications or adverse consequences. Materials and methods. 120 pregnant women were examined and divided into three groups: group 1 – pregnant women with chronic arterial hypertension (CAH), n = 40; group 2 – pregnant women who developed gestational hypertension, n = 40; group 3 – pregnant women without hypertensive disorders, n = 40. The women underwent specialized psychometric testing to assess anxiety/stress levels. The analysis was carried out using the Spielberger–Hanin Scale, the Psychological Stress Scale (PSM-25) and the Impact of Traumatic Event Rating Scale (IES-R). Statistical processing of the results and graphic design were performed using a Microsoft Excel 2016 spreadsheet and the comprehensive data analysis program Statistica 10 for Windows. Results. An elevated level of state and trait anxiety according to the Spielberger–Hanin scale prevailed in pregnant women with CAH, which was an additional stress factor and required continuous monitoring even before the pregnancy onset. Evaluating the IES-R scale results, high levels of the intrusion subscale in all studied groups could be caused directly by pregnancy as a stressful factor. According to the avoidance subscale, we have seen similar results, so, pregnancy contributed to overstraining psychological defense mechanisms. However, the predominance in the group of women with gestational hypertension have suggested that high blood pressure after 20 weeks of pregnancy was one of the contributory factors in the activation of mechanisms for avoiding anxiety. The results of the hyperarousal subscale have demonstrated that the presence of hypertensive disorders (before or during pregnancy) caused the autonomic nervous system activation with the body hyperreactivity. The absence of a high level of stress according to the PSM-25 in all studied groups has demonstrated that women did not experience mental discomfort, which required the use of a wide range of methods to reduce it. Cesarean section was the prevailing delivery mode, the highest percentage was among women with CAH. This group also had the highest number of premature births and the maximum proportion of complications in newborns, indicating the influence of CAH as a negative factor in pregnancy outcomes. Conclusions. The results of this study have demonstrated that an increased level of anxiety in pregnant women could negatively affect their health, as well as the fetal development. In addition, concomitant hypertensive disorders in pregnancy could significantly complicate the pregnancy course, increasing the risk for premature birth and complications in newborns. Therefore, in today’s realities, it is extremely necessary to assess the psycho-emotional state of women in advance, involve specialist physicians, develop and implement a set of psycho-prophylactic measures to increase the neuropsychological stability of pregnant women and reduce the number of negative perinatal outcomes.
Keywords
