Influence of environmental factors on disorders of compensatory-adaptive changes in pregnant women during the period of full-scale war in Ukraine

Background. The process of pregnancy by physiological type depends on many factors, among which the leading ones are the premorbid background against which pregnancy occurred, and the influence of epigenetic negative environmental factors of the woman’s place of residence. Objective of the study: to study the influence of environmental factors on compensatory-adaptive changes in the body of pregnant women during the period of full-scale war. Materials and methods. 60 pregnant women were observed. Anamnestic data were studied, anxiety and psycho-emotional state were assessed. Levels of cortisol, progesterone, magnesium, iron, vitamin D, ferritin, hemoglobin, and glucose were determined. The algorithm of therapeutic tactics of the examined women was personalized depending on the assessment of the general condition, mental health, anamnestic data, laboratory test results, etc. Results. The somatic anamnesis of the study participants indicates a high frequency of hypothyroidism. In the vast majority of women, the highest level of anxiety was in the first trimester. From the second trimester, the condition of pregnant women stabilized against the background of the recommended personalized therapy. Pregnancy, childbirth, postpartum periods took place against the background of significant psychoemotional stress, tension, and increased somato-vegetative function. The severity of these processes depends largely on the individual characteristics of the mental and physical state of the woman. Higher levels of anxiety led to higher levels of cortisol and lower levels of progesterone, magnesium, vitamin D, hemoglobin, and ferritin. The level of glucose tended to increase by trimester of gestation. Conclusions. Adverse environmental factors during pregnancy lead to disruption of compensatory and adaptive mechanisms and development of gestational complications. The pregnancy process reasonably requires a personalized algorithm for managing the each woman separately with the determination of the levels of cortisol, progesterone, vitamin D, magnesium, hemoglobin, iron, ferritin and correction of vitamin, macro-, microelement metabolism, progesterone content, as well as stabilization of psycho-emotional status, rational balanced nutrition, drinking regimen, prevention of hypodynamia.