The impact of pregnant women’s anxiety levels on the course of labor

In Ukraine, the demographic crisis exacerbates the importance of the issue of reproductive health.The objective: to study the features of uterine labor activity depending on the level of anxiety of the pregnant woman for improvement the management of pregnancy and childbirth.Materials and methods. During the preparatory stage of the study, we recorded and analyzed electromyohysterograms in 69 women in labor with its physiological course. The normal electromyography indicators with physiological contractile activity of the uterus in labor were determined. At the main stage of the study, we conducted a prospective clinical examination of 124 pregnant women who were interviewed by Spielberger State-Trait Anxiety Inventory and were subsequently divided into 3 groups depending on the level of reactive anxiety: I group – 38 women in labor with a low reactive anxiety level; II group – 35 women in labor with a moderate reactive anxiety level; III group – 51 women in labor with a high reactive anxiety level. Uterine electromyography was performed using a digital USB-oscilloscope «Hantek-6022BE». The level of anxiety in pregnant women was determined by questionnaire (Spielberger State-Trait Anxiety Inventory).Results. Normal labor activity was typical for 57.9% of pregnant women in the I group, 82.9% – in the II group and 60.8% of pregnant women in the III group (p<0.05). The frequency of weak labor activity was significantly different in pregnant women in the I and III groups – 36.8% and 23.5%, respectively, compared with the II group – 14.3% of cases (p < 0.05). Among pregnant women in the III group the hyperactive type of labor activity was detected in 9.8%, which is significantly higher than in the I and II groups (2.6% and 2.9%, respectively, p < 0.05). In pregnant women of the I and III groups the cases of discoordinated labor activity were detected, which was registered in 5.2% of pregnant women in the I group and in 5.9% in the III group, in pregnant women of the II group the discoordinated labor activity was not registered.Conclusions. The study revealed clear changes in uterine contractile activity depending on the level of reactive anxiety, in particular, the indicator of weakness of labor activity at a low reactive anxiety level was almost 2.6 times higher than the indicator in other groups, and hyperactive labor activity at a high anxiety was 3.4 times higher than the indicators of other groups.