Нейроімунологія стресової вагітності

Abstract

Nowadays, almost every woman is at high risk because of stress during pregnancy, but their nature, intensity, duration of exposure are different for each woman. Extremely high-risk groups are pregnant women living in conditions of military aggression, social and humanitarian crises. The period of reactive adaptation to stress in them is rapidly changing maladaptation. This is due to neuro-immunological mechanisms, which are further implemented in the complicated pregnancy and childbirth. The objective: is to establish the stressors effects on the function of the immune system of pregnant women and their possible role in the occurrence of complications of gestation. Materials and methods. To achieve this goal, we surveyed 78 pregnant women in the third trimester of pregnancy. They were divided into 2 groups: 1 group (main) – 42 pregnant women, displaced from Lugansk and Donetsk regions, 2 group – 36 pregnant women with physiological pregnancy. General clinical studies, psychological testing (Spielberger–Hanin scale) and immunological studies: population and subpopulation composition of blood lymphocytes using the method of indirect immunofluorescence using monoclonal antibodies CD3+, CD4+, CD4+, CD8+, CD8+ CD20 + and CD16 +, study of lymphocyte functional activity and determination of CIC were conducted. Results. Total lymphopenia and significant increase in the level of circulating immune complexes (CIC) were found in pregnant women of the 1 group (forcibly displaced). This indicates a state of marked suppression of immunity (lymphopenia), complicated pregnancy, susceptibility to infectious-inflammatory processes, severe course and prolonged convalescence. The number of lymphocytes was within the normative parameters in pregnant women of the second group. Activation of the number of T cells (CD4+, CD8+, CD16+), as well as their functional activity (RBTL) were found. Which points at the activation of the T-cells immunity type. Conclusions. The results of the study prove the immunosuppressive role of psychosocial factors in internally displaced women and the presence of stress-induced decompensation of the psychoneuroendocrine system in them. Keywords: psychoneuroimmunology, pregnancy, anxiety, women–forcibly displaced, stress.