Reproductive effects of wartime stress and possibilities of their correction (Literature review)

The article presents modern literary data and data of own clinical observations regarding the effects of long-term chronic stress on reproductive processes with an emphasis on the effects of wartime. All stages of the reproductive cycle, from the regulation of the menstrual cycle, conception and implantation to the birth of a child, are energy-consuming and unprofitable for the body. All these processes require a lot of energy, but their purpose is to reproduce the species, not to maintain homeostasis. Therefore, the body temporarily slows down these processes, withdraws energy aimed at their support, and uses it to resist stress.The biological meaning of inhibition of reproductive function in stressful conditions is that if a woman becomes pregnant under unfavorable conditions, it is bad for her body, and for the offspring, and for the future prospects of the biological species as a whole. Therefore, from an evolutionary point of view, it is very beneficial to reduce the production of hormones, exclude ovulation and prevent implantation, and reduce libido during periods of high stress.Stress causes activation of the neuroendocrine and sympatho-adrenal systems, which leads to the release of such hormones as cortisol, adrenaline, norepinephrine into the blood. This helps to mobilize the body’s resources to overcome a threatening situation. However, prolonged stress depletes these systems and leads to maladjustment and increased risk of disease. Stress hormones affect all body systems, including the reproductive system. According to the literature, stress disorders occur three times more often in women than in men.In conditions of chronic stress, in particular during war, pregnancy complications can be caused by stress of various origins: metabolic, associated with micronutrient deficiency, psychological, physical, a combination of factors.Prenatal stress during wartime is a part of our existence, which reduces the quality of life of a pregnant woman and affects the intrauterine development of the fetus and the subsequent health of the child. Long-term chronic stress also leads to deterioration of the general state of health of the expectant mother: it reduces work capacity and appetite, causes lethargy, apathy, sleep disturbances, and increases the risk of obstetric complications.Stress negatively affects the state of immunity of the female population both before conception and during pregnancy, which can lead to the activation of latent infections, and makes the body of pregnant women more vulnerable to acute seasonal infections. This is also facilitated by the lack of necessary vitamins and trace elements with antioxidant properties in conditions of occupation, disruptions in the supply of medicines to certain problematic regions of the country, frequent changes of residence, etc.During pregnancy, all the negative effects of wartime can be realized in the form of major obstetric syndromes. In conditions of pronounced energy deficit caused by long-term stress, the body has to provide for itself to the detriment of the future child, which leads to ZRP, and in the most tragic cases – to intrauterine death. Violation of the psycho-emotional state of pregnant women today leads to the birth of “children of war” – insecure, low self-esteem, deeply ill babies with mental disorders.For the onset of pregnancy and its successful bearing, vitamins and micro/macroelements with antioxidant properties are needed in order to resist oxidant stress inherent in stressful conditions (vitamins of group B, vitamin D, iron, magnesium, omega-3 polyunsaturated fatty acids, L-arginine, L- carnitine). Rational management of pregnancy in today’s complex conditions should be complex and multi-vector. One of the promising directions in ensuring an uncomplicated course of pregnancy and successful perinatal outcomes is work with perinatal psychologists. At the same time, the use of additional psychosomatic effects of basic therapy should not be underestimated.