Немедикаментозна профілактика ускладнень вагітності у жінок з артеріальною гіпертензією в умовах воєнних дій в Україні

Aim. To assess anxiety levels in pregnant women with hypertensive disorders (HDs) and the effectiveness of the developed complex non-drug relaxation measures in conditions of military operations in Ukraine. Materials and methods. 170 pregnant women were examined during the period 2022–2024. At stage I, specialized psychometric testing was conducted using the Spielberger–Hanin scale and the Traumatic Event Impact Assessment Scale (IES-R) in two groups: 1 – pregnant women with HDs (n = 60); 2 – pregnant women without HDs (n = 60). At stage II, the relationship between pregnancy complications and the anxiety level in women with HDs was assessed. At stage III, the effectiveness of the developed complex non-drug treatment and prevention measures was assessed in both groups of pregnant women: 2D (n = 30) – in addition to drug therapy, non-drug methods were used, 2E (n = 20) – received standard drug therapy. Statistica 10 for Windows and Microsoft Excel 2016 programs were used for statistical processing of the results. Results. Moderate and high levels of both trait and state anxiety have been documented in most examined individuals of both groups (95.0 % and 91.7 %) according to the Spielberger–Hanin scale. High levels of trait and state anxiety prevailed in patients with HDs, 56.7 % and 43.3 %, respectively, with a statistical advantage of trait anxiety, p < 0.05, which were additional stress factors. Assessment of the traumatic event impact (IES-R) on the intrusion subscale has revealed a predominance of high anxiety levels in both groups (40.0 %); the avoidance subscale: 56.7 % in group 1 vs. 51.7 % in group 2; the physiological arousal subscale: 35.0 % in group 1 vs. 15.0 % in group 2, p < 0.05. The findings have suggested that the psychological state of pregnant women in Ukraine was significantly affected by the socio-psychological background associated with military operations. After the implementation of the complex measures, the preeclampsia incidence was significantly decreased (13.3 %), the percentage of vaginal births was increased, and their duration was reduced. Normalization of sleep and lactation initiation have been observed. The percentage of women with persistent arterial hypertension in the postpartum period was lower in group 2D (46.7 %) as compared to group 2E (60.0 %). Conclusions. A significant incidence of high anxiety levels in pregnant women in Ukraine has been revealed, that we believe to be associated with military operations in the area. Patients with hypertensive disorders are more prone to high anxiety levels, so these disorders can be considered additional stress factors. The proposed complex relaxation measures have demonstrated improved pregnancy outcomes, normalization of sleep and blood pressure after childbirth, and lactation initiation in pregnant women with arterial hypertension.