The state of regulation of the autonomic nervous system of pregnant women with post-traumatic stress disorder




pregnancy, post-traumatic stress disorder, obstetric complications, autonomic nervous system, heart rate variability


Purpose - to assess the state of regulation of the autonomic nervous system of pregnant women with post-traumatic stress disorder (PTSD) based on heart rate variability data.

Materials and methods. 60 pregnant women were examined: a main group of 30 pregnant women with a confirmed diagnosis of PTSD and a control group of 30 somatically healthy women without a history of psychological trauma. The assessment of vegetative status was carried out by recording and analyzing generally accepted parameters of heart rate variability based on computer cardiointervalography.

Results. Women with PTSD have an increased incidence of obstetric and perinatal complications, placental insufficiency (43.3%), fetal distress (30.0%), fetal growth retardation (23.3%), preeclampsia (13.3%), premature birth (30.0%). Such complications may be caused by disorders of autonomic regulation, which is reflected by changes in heart rate variability. The state of autonomic regulation of pregnant women with PTSD is characterized by hypersympathicotonia (63,0%) with signs of stress, while some women (13.3%) have vagotonia, and the state of 6.7% of patients with a tension index of less than 15 conventional units. may indicate exhaustion and failure of adaptive capabilities. According to the integral indicator of regulatory systems activity (IRSA), the majority (66.7%) of patients fall into the tension zone, and the condition of 53.3% corresponds to a pronounced tension of adaptive systems. The most dangerous zone (red - hypoadaptation IRSA and disruption of adaptation) includes almost a quarter (23.3%) of women. In 2 (6.7%) women of the main group, the is 9 points (the maximum value), which indicates complete exhaustion (asthenia) of neurovegetative regulation.

Conclusions. In pregnant women with PTSD, it is advisable to analyze the state of autonomic regulation based on heart rate variability, which will help identify women at risk for obstetric and perinatal complications.

The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the participating institution. The informed consent of the patient was obtained for conducting the studies.

No conflict of interests was declared by the authors.


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