FEATURES OF THE PSYCHOLOGICAL STATUS AND QUALITY OF LIFE OF WOMEN WITH HYPERTENSIVE DISORDERS DURING PREGNANCY UNDER CONDITIONS OF AUTONOMIC NERVOUS SYSTEM DYSFUNCTION
DOI:
https://doi.org/10.11603/24116-4944.2025.1.15236Keywords:
gestational hypertension, preeclampsia, autonomic nervous system dysfunction, quality of life, psychological status, anxiety, depressionAbstract
The aim of the study – to diagnose the psychological status and quality of life in women with hypertensive disorders during pregnancy and the autonomic dysfunction.
Materials and Methods. 207 pregnant women were examined, who were divided into groups: the first group – 124 women, of whom 109 (87.9 %) had gestational hypertension, while 15 (12.1 %) – had mild preeclampsia, the second group – 48 pregnant women with a high risk of developing hypertensive disorders during pregnancy, the control group – 35 women with a physiological course of pregnancy. Subjective and objective assessment of autonomic nervous system status questionnaires were used; the Kerdo vegetative index, the hospital anxiety and depression scale HADS, the multidimensional fatigue assessment scale MAF, and the SF-36 quality of life assessment questionnaire were calculated. Statistical analysis was performed using Statistica 12 (Serial Number: STA999K347150-W) and MEDCALC®. The difference between the values was considered statistically significant at p<0.05.
Results and Discussion. It was proven that the development of hypertensive disorders is closely associated with pronounced autonomic dysfunction in women during pregnancy in the direction of increased sympathetic activity (OR=6.47; 95 % CI: 3.72–11.24; p<0.001); the presence of a 4.1-fold higher frequency of individuals with subclinical anxiety disorders and a 6.3-fold higher percentage of pregnant women with subclinical depression compared to the control group (p<0.05); high odds of low quality of life assessment in both the physical (OR=7.53; 95 % CI: 2.74–20.68; p<0.001) and psychological components of health (OR=6.18; 95 % CI: 2.06–18.56; p<0.001). In the group of women at high risk of developing hypertensive disorders during pregnancy, a 4.3-fold higher frequency of individuals with subclinical anxiety disorders was diagnosed, and high odds of low quality of life assessment in the psychological component of health (OR=4.39; 95 % CI: 1.15–16.73; p<0.05). The presence of both gestational hypertension/ preeclampsia and preeclampsia in the anamnesis was accompanied by moderate asthenic syndrome.
Conclusions. Identification of mental abnormalities, high levels of fatigue, and decreased level of quality of life in women with hypertensive states during pregnancy and pregnant at high risk group of developing of hypertensive disorders is necessary to improve the treatment and prevention program during and after pregnancy.
References
1. Mahini, E., Hakimi, S., Shahrokhi, H., Salahi, B., Bani-adam, K. O., & Ranjbar, F. (2023). Evaluation of factors related to maternal anxiety during pregnancy among women referred to Tabriz primary care centers BMC Psychiatry, 23(1), 329. https://doi.org/10.1186/s12888-023-04823-8
2. Fawcett, E. J., Fairbrother, N., Cox, M. L., White, I. R., & Fawcett, J. M. (2019). The prevalence of anxiety disorders during pregnancy and the postpartum period: A multivariate Bayesian meta-analysis The Journal of Clinical Psychiatry, 80(4), 18r12527. https://doi.org/10.4088/JCP.18r12527
3. Bayrampour, H., Vinturache, A., Hetherington, E., Lorenzetti, D. L., & Tough, S. (2018). Risk factors for antenatal anxiety: A systematic review of the literature Journal of Reproductive and Infant Psychology, 36(5), 476–503. https://doi.org/10.1080/02646838.2018.1492097
4. Jalal, S. M., Alsebeiy, S. H., & Alshealah, N. M. J. (2024). Stress, anxiety, and depression during pregnancy: A survey among antenatal women attending primary health centers Healthcare, 12(22), 2227. https://doi.org/10.3390/healthcare12222227
5. Thombre, M. K., Talge, N. M., & Holzman, C. (2015). Association between pre-pregnancy depression/anxiety symptoms and hypertensive disorders of pregnancy Journal of Women's Health, 24(3), 228–236. https://doi.org/10.1089/jwh.2014.4902
6. James, K. A., Stromin, J. I., Steenkamp, N., & Combrinck, M. I. (2023). Understanding the relationships between physiological and psychosocial stress, cortisol and cognition Frontiers in Endocrinology, 14, 1085950. https://doi.org/10.3389/fendo.2023.1085950
7. Sikkema, J. M., Robles de Medina, P. G., Schaad, R. R., Mulder, E. J., Bruinse, H. W., Buitelaar, J. K., … & Franx, A. (2001). Salivary cortisol levels and anxiety are not increased in women destined to develop preeclampsia Journal of Psychosomatic Research, 50(1), 45–49. https://doi.org/10.1016/S0022-3999(00)00208-7
8. Dachew, B., & Alati, R. (2021). The impact of hypertensive disorders during pregnancy on maternal perinatal depressive and anxiety symptoms European Psychiatry, 64(Suppl. 1), S182. https://doi.org/10.1192/j.eurpsy.2021.483
9. Tov, W., Keh, J. S., Tan, Y. Q., Tan, Q. Y. J., Indra, A. S., & Bin, A. (2022). Assessing subjective well-being: A review of common measures. In Handbook of Positive Psychology Assessment. Hogrefe.
10. Çetin, U. G. (2024). Gestational hypertension and obesity affecting quality of life: Benefits of DASH diet during pregnancy American Journal of Health Behavior, 48(5), 1204–1212. https://doi.org/10.5993/AJHB.48.5.2
11. Chmaj-Wierzchowska, K., Rzymski, P., Wojciechowska, M., Parda, I., & Wilczak, M. (2022). Health-related quality of life (Nottingham Health Profile) of women with normal and pathological pregnancy and during delivery Journal of Maternal-Fetal & Neonatal Medicine, 35, 1825–1833. https://doi.org/10.1080/14767058.2021.1910665
12. Zakour Khadari, M., Zainal, H., Athirah Daud, N. A., & Sha’aban, A. (2024). Health-related quality of life in pregnant women with gestational hypertension: A systematic review Cureus, 16(5), e61340. https://doi.org/10.7759/cureus.61340
13. Konkov, D., Bevz, G., Piskun, A., & Bodnarchuk, O. (2022). Prospective directions for creating a strategy for effective medicine prevention of preeclampsia (Literature review). Reproductive Health of Woman, (3), 49–61. https://doi.org/10.30841/2708-8731.3.2022.262376
14. Shaikh, N., Nahid, S., Ummunnisa, F., Fatima, I., Hilani, M., Gul, A., & Al Khelaifi, M. (2022). Preeclampsia: From etiopathology to organ dysfunction. In IntechOpen. https://doi.org/10.5772/intechopen.101240
15. Yousif, D., Bellos, I., Penzlin, A. I., Hijazi, M. M., Illigens, B. M., Pinter, A., & Siepmann, T. (2019). Autonomic dysfunction in preeclampsia: A systematic review Frontiers in Neurology, 10, 816. https://doi.org/10.3389/fneur.2019.00816
16. Demydas, O.V., & Tkachenko, O.V. (2022). Clinical characteristics of the state of the autonomic nervous system and their correlations with psychometric indicators in patients with duodenal ulcer in the stage of exacerbation and remission. Ukrainian Medical Journal, 4(150).DOI: 10.32471/umj.1680-3051.150.232312
17. Boryak, K. R. (2020). Relationship between the cardiovascular system and the autonomic nervous system during physical load in persons with different body mass. Actual Problems of Modern Medicine: Bulletin of Ukrainian Medical Stomatological Academy, 20(2), 108–113. https://doi.org/10.31718/2077-1096.20.2.108
18. Vdovychenko, O. V., Asieieva, Y. O., & Ponianska, D. O. (2023). Features of perception of the quality of life and social consequences of depressive disorders during martial state. Habitus, 52, 266–270. https://doi.org/10.32782/2663-5208.2023.52.45
19. Oros, M. M. (2020). Asthenia – a companion of nervous disorders in comorbid patients. Zdorovia Ukrainy. Nevrolohiia, Psykhiatriia, Psykhoterapiia, 2(53), 47. [In Ukrainian].Effati-Daryani, F., Mohammad-Alizadeh-Charandabi, S., Mohammadi, A., Zarei, S., & Mirghafourvand, M. (2021). Fatigue and sleep quality in different trimesters of pregnancy Sleep Science, 14(Spec. 1), 69–74. https://doi.org/10.5935/1984-0063.20200091
20. Hall, W. A., Moynihan, M., Bhagat, R., & Wooldridge, J. (2017). Relationships between parental sleep quality, fatigue, cognitions about infant sleep, and parental depression pre and post-intervention for infant behavioral sleep problems BMC Pregnancy and Childbirth, 17(1), 104. https://doi.org/10.1186/s12884-017-1284-x
21. Weng, S. S., Lee, Y. H., & Chien, L. Y. (2020). Physical activity, sitting time and sleep duration before and during pregnancy and pregnancy outcomes Journal of Clinical Nursing, 29(17–18), 3494–3505. https://doi.org/10.1111/jocn.15388
22. Kucher, S. V., Vorontsova, T. O., Smachylo, I. V., Vereshchahina, N. Ya., Hanberher, I. I., & Horishnyi, I. M. (2024). Assessment of quality of life using the SF-36 questionnaire: Literature review. Perspectives and Innovations of Science (Series "Pedagogy", Series "Psychology", Series "Medicine"), 4(38), 1313–1324. https://doi.org/10.52058/2786-4952-2024-4(38)-1313-1324
23. Ministry of Health of Ukraine. (2022). Hypertensive disorders during pregnancy, childbirth and the postpartum period: Order of the Ministry of Health of Ukraine No. 151, January 24, 2022. Kyiv, Ukraine.
24. Ministry of Health of Ukraine. (2022). Normal pregnancy: Order of the Ministry of Health of Ukraine No. 1437, August 9, 2022Favrat, B., & Cornuz, J. (2017). Fatigue measurement. BMJ Best Practice Manual, 71.
25. Horokhovatskyi, V.O., & Hadetska, S.V. (2020). Statistical Processing and Data Analysis in Structural Methods of Image Classification (Monograph). Kharkiv: FOP Panov A.N., 128 p. https://doi.org/10.30837/978-617-7859-69-6
26. Gaugler-Senden, I. P., Duivenvoorden, H. J., Filius, A., De Groot, C. J., Steegers, E. A., & Passchier, J. (2012). Maternal psychosocial outcome after early onset preeclampsia and preterm birth Journal of Maternal-Fetal & Neonatal Medicine, 25(3), 272–276. https://doi.org/10.3109/14767058.2011.573829
27. Yushchenko, M.I., & Duka, Yu.M. (2022). Modern view on the etiology and pathogenesis of preeclampsia as the main cause of perinatal losses. Ukrainian Journal Health of Woman, 9–26(161), 58–68. https://doi.org/10.15574/HW.2022.161.58
28. Ostafiichuk, S., Drohomyretska, N., Motsyuk, Y., Neіko O., & Henyk, N. (2021). THE ROLE OF HYPERLEPTINEMIA IN THE GENESIS OF GESTATIONAL HYPERTENSION AND PREECLAMPSIA. Problems of Endocrine Pathology, 77(3), 65–70. https://doi.org/10.21856/j-PEP.2021.3.09
29. Lee, L. L., Mulvaney, C. A., Wong, Y. K. Y., Chan, E. S., Watson, M. C., & Lin, H. H. (2021). Walking for hypertension Cochrane Database of Systematic Reviews, 2(2), CD008823. https://doi.org/10.1002/14651858.CD008823.pub2
30. Shay, M., MacKinnon, A. L., Metcalfe, A., Giesbrecht, G., Campbell, T., Nerenberg, K., … & Tomfohr-Madsen, L. (2020). Depressed mood and anxiety as risk factors for hypertensive disorders of pregnancy: A systematic review and meta-analysis Psychological Medicine, 50(13), 2128–2140. https://doi.org/10.1017/S0033291720003062
Downloads
Published
Issue
Section
License
Copyright (c) 2025 Я. С. Задорожний, С. О. Остафійчук
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish in this journal agree to the following terms:
1. The authors reserve the right to authorship of the work and pass the journal right of first publication of this work is licensed under a Creative Commons Attribution License, which allows others to freely distribute the work published with reference to the authors of the original work and the first publication of this magazine.
2. Authors are entitled to enter into a separate agreement on additional non-exclusive distribution of work in the form in which it was published in the magazine (eg work place in the electronic repository institution or publish monographs in part), provided that the reference to the first publication of this magazine.
3. Policy magazine allows and encourages authors placement on the Internet (eg, in storage facilities or on personal websites) manuscript of how to submit the manuscript to the editor and during his editorial processing, since it contributes to productive scientific discussion and positive impact on the efficiency and dynamics of citing published work (see. The Effect of Open Access).
