Assessment of the risks of recurrent pregnancy loss in patients with post-traumatic stress disorder

Background. Recurrent pregnancy loss (RPL) is a pressing issue in women’s reproductive health, often accompanied by post-traumatic stress disorder (PTSD). The traumatic experiences arising from repeated reproductive losses not only exhaust a woman’s mental health but also impact endocrine and immunological regulation, which can complicate pregnancy or make it impossible to sustain.Objective of the study: to identify risk factors for RPL in women with PTSD, specifically in endocrine, immunological, and psycho-emotional dysfunctions that may trigger RPL.Materials and methods. The study spanned three years (2021–2024) and involved 150 women with RPL, PTSD, or a combination of both. The study was conducted using the parallel group method: the main group (STD and PTSD) with two subgroups consisted of 100 women, the comparison group (STD without PTSD) included 30 women, and the control group (PTSD with a previous successful pregnancy) included 20 women. A thorough clinical examination, laboratory diagnosis of endocrine and immunological parameters was investigated, the psycho-emotional state was determined according to the PCL-C scale and Beck’s questionnaire. For statistical analysis was used the Student’s t-test, calculation of relative measures, mean values, and standard error of the mean.Results. It was demonstrated elevated levels of thyroid-stimulating hormone and antiphospholipid antibodies in women with combined PTSD and RPL, as well as significantly higher depression and PTSD scores. An increase in NK cells (CD3-CD16/CD56+) indicated the presence of immunological imbalance.Conclusions. Taking into account the obtained data, the algorithm for RPL prevention in women with PTSD should include the interdisciplinary approach, which contains not only gynecological screening, but also a comprehensive examination of the genetic, endocrine, immunological and mental state of patients with such diagnosis, as well as the provision of specialized psychological assistance.