Dynamics of psychoemotional indicators of internally displaced women with threatened miscarriage against the background of comprehensive treatment

Main Article Content

I.Yu. Romanenko

Abstract

Background. According to the definition, internally displaced person is someone who is forced to flee his or her home but who remains within his or her country’s borders. Pregnancy is a state of increased vulnerability for the development of anxiety and depression, which are the most common mental disorders during pregnancy and after childbirth. About 54 % of women experience anxiety throughout the antenatal period, depressive disorders are manifested in 34 % of patients. According to some authors, sleep disturbances, which are reported by 11.5 to 85 % of pregnant wo­men, can affect the severity of antenatal and postnatal depressive and anxiety symptoms, as well as obstetric outcomes. The purpose of this research was to evaluate the effectiveness of comprehensive treatment in pregnant women with threatened miscarriage, who are living in the Luhansk region and having the status of an internally displaced person, to improve treatment and prophylactic measures and prevent obstetric and perinatal complications. Materials and methods. The study included 22 internally displaced women in first and second trimesters of pregnancy, who were admitted for threatened miscarriage to the hospitals located in the Luhansk region. Patients were randomly divided into subgroups (1a and 1b). Women of subgroup 1b were additionally treated with L-arginine, magnesium lactate dihydrate and pyridoxine hydrochloride for two weeks, as well as a vitamin-mineral complex. Clinical obstetric and psychometric examination was carried out before and after the treatment. Spielberger’s State-Trait Anxiety Inventory was used to assess the level of anxiety, Beck Depression Inventory — to eva­luate the level of depression, the questionnaire by A.M. Wein — to assess the autonomic disorders, the sleep quality questionnaire of the сenter for somnology — to evaluate the quality of sleep. The concentrations of progesterone and magnesium were determined. Results. After treatment, a statistically significant decrease in state anxiety, depressive manifestations and autonomic disorders was observed. The sleep parameters in patients of both groups significantly changed towards improvement. The indicator of trait anxie­ty in group 1a did not change significantly after the treatment. The concentration of progesterone increased in both groups, and magnesium level increased only in group 1b. Conclusions. Treatment with L-arginine, magnesium lactate dihydrate, pyridoxine hydrochloride, and a vitamin-mineral complex has been shown to be highly effective in reducing the severity and frequency of psychoemotional disorders in internally displaced women with threa­tened miscarriage, achie­ving emotional balance, relieving anxiety, fears asso­ciated with pregnancy and childbirth. A decrease in the indicators of state anxiety, depressive disorders, autonomic manifestations, and an improvement in sleep quality indicators can serve as criteria for the effectiveness of the treatment.

Article Details

How to Cite
Romanenko, I. “Dynamics of Psychoemotional Indicators of Internally Displaced Women With Threatened Miscarriage Against the Background of Comprehensive Treatment”. INTERNATIONAL JOURNAL OF ENDOCRINOLOGY (Ukraine), vol. 16, no. 8, Apr. 2021, pp. 686-91, doi:10.22141/2224-0721.16.8.2020.222890.
Section
Original Researches

References

IDCP. Global Overview 2015: People Internally Displaced by Conflict and Violence. Available from: https://www.internal-displacement.org/publications/global-overview-2015-people-internally-displaced-by-conflict-and-violence. Accessed: May 2015.

LeMaster JW, Broadbridge CL, Lumley MA, et al. Acculturation and post-migration psychological symptoms among Iraqi refugees: A path analysis. Am J Orthopsychiatry. 2018;88(1):38-47. doi: 10.1037/ort0000240.

Biaggi A, Conroy S, Pawlby S, Pariante CM. Identifying the women at risk of antenatal anxiety and depression: A systematic review. J Affect Disord. 2016 Feb;191:62-77. doi: 10.1016/j.jad.2015.11.014.

Rallis S, Skouteris H, McCabe M, Milgrom J. A prospective examination of depression, anxiety and stress throughout pregnancy. Women Birth. 2014 Dec;27(4):e36-42. doi: 10.1016/j.wombi.2014.08.002.

Rwakarema M, Premji SS, Nyanza EC, Riziki P, Palacios-Derflingher L. Antenatal depression is associated with pregnancy-related anxiety, partner relations, and wealth in women in Northern Tanzania: a cross-sectional study. BMC Womens Health. 2015 Sep 2;15:68. doi: 10.1186/s12905-015-0225-y.

Faisal-Cury A, Rossi Menezes P. Prevalence of anxiety and depression during pregnancy in a private setting sample. Arch Womens Ment Health. 2007 Feb;10(1):25-32. doi: 10.1007/s00737-006-0164-6.

Alder J, Fink N, Bitzer J, Hösli I, Holzgreve W. Depression and anxiety during pregnancy: a risk factor for obstetric, fetal and neonatal outcome? A critical review of the literature. J Matern Fetal Neonatal Med. 2007 Mar;20(3):189-209. doi: 10.1080/14767050701209560.

Vesga-López O, Blanco C, Keyes K, Olfson M, Grant BF, Hasin DS. Psychiatric disorders in pregnant and postpartum women in the United States. Arch Gen Psychiatry. 2008 Jul;65(7):805-15. doi: 10.1001/archpsyc.65.7.805.

Lee AM, Lam SK, Sze Mun Lau SM, Chong CS, Chui HW, Fong DY. Prevalence, course, and risk factors for antenatal anxiety and depression. Obstet Gynecol. 2007 Nov;110(5):1102-12. doi: 10.1097/01.AOG.0000287065.59491.70.

Dennis CL, Falah-Hassani K, Shiri R. Prevalence of antenatal and postnatal anxiety: systematic review and meta-analysis. Br J Psychiatry. 2017 May;210(5):315-323. doi: 10.1192/bjp.bp.116.187179.

National Institute for Health and Care Excellence (NICE). Antenatal and postnatal mental health: clinical management and service guidance: Guideline CG192. 2014. Available from: https://www.nice.org.uk/guidance/cg192.

The American College of Obstetricians and Gynecologists Committee Opinion no. 630. Screening for perinatal depression. Obstet Gynecol. 2015 May;125(5):1268-1271. doi: 10.1097/01.AOG.0000465192.34779.dc.

ACOG Committee Opinion No. 757 Summary: Screening for Perinatal Depression. Obstet Gynecol. 2018 Nov;132(5):1314-1316. doi: 10.1097/AOG.0000000000002928.

Ladyman C, Signal TL. Sleep Health in Pregnancy: A Scoping Review. Sleep Med Clin. 2018 Sep;13(3):307-333. doi: 10.1016/j.jsmc.2018.04.004.

Facco FL, Kramer J, Ho KH, Zee PC, Grobman WA. Sleep disturbances in pregnancy. Obstet Gynecol. 2010 Jan;115(1):77-83. doi: 10.1097/AOG.0b013e3181c4f8ec.

Nodine PM, Matthews EE. Common sleep disorders: management strategies and pregnancy outcomes. J Midwifery Womens Health. 2013 Jul-Aug;58(4):368-77. doi: 10.1111/jmwh.12004.

Sharma SK, Nehra A, Sinha S, et al. Sleep disorders in pregnancy and their association with pregnancy outcomes: a prospective observational study. Sleep Breath. 2016 Mar;20(1):87-93. doi: 10.1007/s11325-015-1188-9.

Chang JJ, Pien GW, Duntley SP, Macones GA. Sleep deprivation during pregnancy and maternal and fetal outcomes: is there a relationship? Sleep Med Rev. 2010 Apr;14(2):107-14. doi: 10.1016/j.smrv.2009.05.001.

Hashmi AM, Bhatia SK, Bhatia SK, Khawaja IS. Insomnia during pregnancy: Diagnosis and Rational Interventions. Pak J Med Sci. 2016 Jul-Aug;32(4):1030-7. doi: 10.12669/pjms.324.10421.

Kay-Stacey Margaret, Hrayr P. Attarian. Managing Sleep Disorders during Pregnancy. Gender and the Genome. 2017;1(1):34-45. doi: 10.1089/gg.2016.0006.

Reid KJ, Facco FL, Grobman WA, et al. Sleep During Pregnancy: The nuMoM2b Pregnancy and Sleep Duration and Continuity Study. Sleep. 2017 May 1;40(5):zsx045. doi: 10.1093/sleep/zsx045.

Hanin YuL. Anxiety Research in Sports. Vopr psihologii. 1978;6:72-5. (in Russian).

Beck AT, Ward CH, Mendelson M, Mock J, Erbaugh J. An inventory for measuring depression. Arch Gen Psychiatry. 1961 Jun;4:561-71. doi: 10.1001/archpsyc.1961.01710120031004.

Vein AM, editor. Autonomic disorders: Clinic, diagnostics, treatment. Moskva: OOO Meditsinskoe informatsionnoe agentstvo; 2003. 752 р. (in Russian)

Vein AM, Eligulashvili TS, Poluektov MG. Sleep apnea syndrome and other respiratory disorders associated with sleep: clinic, diagnosis, treatment. Moskva: Eidos Media; 2002. 310 р. (in Russian).

Pankiv VI, Payenok OS, Kostiv MO. Modern views on the algorithm of management of pregnant women and women in labor with diffuse toxic goiter. Mìžnarodnij endokrinologìčnij žurnal. 2016;(78):77-86. DOI: 10.22141/2224-0721.6.78.2016.81864.

Nikseresht S, Etebary S, Karimian M, Nabavizadeh F, Zarrindast MR, Sadeghipour HR. Acute administration of Zn, Mg, and thiamine improves postpartum depression conditions in mice. Arch Iran Med. 2012 May;15(5):306-11.

Botturi A, Ciappolino V, Delvecchio G, Boscutti A, Viscardi B, Brambilla P. The Role and the Effect of Magnesium in Mental Disorders: A Systematic Review. Nutrients. 2020 Jun 3;12(6):1661. doi: 10.3390/nu12061661.