Clinical features of the autonomic nervous system and their correlation with psycho-emotional disorders in women with hypertensive states during pregnancy

Abstract

The objective: to evaluate the clinical characteristics and correlation between signs of autonomic nervous system (ANS) dysfunction and psychoemotional disorders in pregnant women with gestational hypertension/preeclampsia and pregnant women with hypertensive states during the previous pregnancy. Materials and methods. The study involved 124 women pregnant women with gestational hypertension/preeclampsia (first group), 48 pregnant women with hypertensive states during the previous pregnancy (second group), and 35 women with a physiological pregnancy (control group). The study of ANS status was conducted by Wein questionnaires for subjective and objective assessment of autonomic status, the evaluation of the Kerdo informative index, and the study of psychoemotional state based on well-being, activity, and mood assessment questionnaire and Spielberger–Khanin scale of reactive and personal anxiety. Data were analyzed using Statistica 10.0 (StatSoft Inc., USA). Results. Сlinical characteristics of autonomic dysfunction were detected in all pregnant women of the first group with an increase of sympathetic activity in association with psycho-emotional disorders, which were proved based on increasing points on the scales of subjective (36,03±4,08) and objective assessment of autonomic status (44,28±5,45), a 6,1-fold increase in the percentage of patients with sympathicotonia due to Kerdo informative index compared to control, the presence of asthenic disorders was associated with a bad mood and an increased level of high anxiety. In the second group, significant autonomic dysfunction was diagnosed at an early stage, and asthenic disorders associated with high levels of situational anxiety were diagnosed in a higher percentage of patients compared to the control. A significant correlation was proved between the number of points of the Wein objective scale and the scores of well-being, activity, and mood assessment questionnaire(r= – 0,76; p<0,001), the levels of personal (r=0,33; p<0,001) and reactive anxiety (r=0,41; p<0,001). Conclusions. Therefore, hypertensive states during pregnancy are considered a syndrome of psycho-emotional and autonomic-vascular dysadaptation, caused by the personal characteristics of a woman before the onset of complications against the background of persistent insufficient autonomic support of pregnancy, which indicates the importance of studying the psychological status of a woman and the dysfunction of the ANS in the early stages of pregnancy to find out the expressiveness deviations for monitoring and optimization of treatment and preventive measures.