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.
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