The effect of complex therapy on perinatal outcomes in pregnant women with sleep disorders

Aim - according to the results of a prospective study, the effect of complex therapy on the level of melatonin metabolites and placental hormones and their relationship with perinatal outcomes in pregnant women with sleep disorders was determined. Materials and methods. A randomized controlled trial was conducted in a group of 165 women with diagnosed sleep disorders. Study participants were tested using the Pittsburgh Sleep Quality Index (PSQI) questionnaire and, if sleep disturbances were detected, were randomized according to a table of random numbers into the main group (n=55) and the comparison group (n=60). The control group consisted of 50 pregnant women without sleep disorders. Subsequently, in all groups, melatonin levels were determined based on the level of its metabolite in urine - 6-sulfatoxymelatonin (6-SOM), as well as progesterone and placental lactogen. In the main group, in addition to sleep hygiene psychoeducation, complex therapy was prescribed, which included the use of a vitamin-mineral complex and micronized progesterone, and in the comparison group, only sleep hygiene psychoeducation was prescribed as generally recommended measures. In the groups of pregnant women with sleep disorders, the effect of the proposed complex on the level of 6-SOM in urine, placental lactogen, progesterone and their relationship with perinatal consequences (threat of premature birth, gestational diabetes, hypertensive disorders and preeclampsia, delivery by caesarean section, low fetal weight at birth, postpartum bleeding) compared to the control group. Results. As a result of the study, a significant increase in the levels of 6-SOM and placental hormones was established in the main group relative to the comparison group, and approaching the indicators of the control group of pregnant women without sleep disorders. An improvement in the quality of sleep and perinatal outcomes was also found in the main group compared to the comparison group, which we associated with the use of complex therapy with the appointment of a vitamin-mineral complex, micronized progesterone and training in sleep hygiene. Conclusions. The proposed complex therapy in the main group reliably increases the levels of 6-SOM and placental hormones in pregnant women with sleep disorders, which in turn improves the quality of sleep and perinatal outcomes. The study was carried out in accordance with the principles of the Declaration of Helsinki. The study protocol was approved by the Local Ethics Committee of these institutions. The informed consent of the children's parents was obtained for the research. No conflict of interests was declared by the authors.