ASSESSMENT OF PSYCHO-EMOTIONAL STATE IN WOMEN WITH HYPEREMESIS GRAVIDARUM

Ostafiichuk S. O., Perkhulyn O. M., Kusa O. M., Makarchuk O. M.

CLINICAL AND EXPERIMENTAL MEDICINE

Scentific article

Hyperemesis gravidarum is a condition wich characterized by severe nausea and vomiting in the first half of pregnancy. Etiological factors are hormonal, metabolic, immunological, genetic and psycho-emotional changes during pregnancy. Objective. To assess the anxiety and depression status of women with hyperemesis gravidarum in relation to cortisol and dehydroepiandrosterone sulfate (DHEA-C). Materials and methods. This study involved 163 pregnant women: the main group – 109 patients with hyperemesis gravidarum, the control group – 54 pregnant women without vomiting. The level of anxiety was assessed on the scale of reactive and personal anxiety by Spielberg – Hanin, the state of depression by Beck Depression Scale, the cortisol and DHEA-C plasma blood levels were performed by enzyme-linked immunosorbent assay. Results. A high levels of both situational in 55.0% of women and personal anxiety in 60.6% (2.9 and 2.5 – fold higher compared control group (in both cases p<0.001)), the state of moderate / severe depression in the majority of pregnant (88.1%) compared 3.7% control group (p<0.001) were in hyperemesis gravidarum group. In the main group, the levels of cortisol 1.5 – fold (p<0.02) and DHEA-C 1.6 – fold (p<0.05) were higher compared to the control. A direct correlations were shown between cortisol concentration and situational and personal anxiety levels (r=0.68, p=0.000 and r=0.66, p=0.000), cortisol and depression level (r=0.32, p= 0.001), DHEA-C and situational and personal anxiety levels (r=0.62, p=0.000 and r=0.56, p=0.000), DHEA-C and depression level (r=0.22, p=0.002). There was a direct association between cortisol and DHEA-C levels (r=0.53, p=0.000) in the main group. Conclusions. The psycho-emotional state is characterized by a high level of situational and personal anxiety, a pronounced level of depression in direct association with elevated stress hormones levels in hyperemesis gravidarum women. The psycho-emotional state of patients should be noticed during the evaluation for physical health of women with hyperemesis gravidarum.

hyperemesis gravidarum, depression, anxiety, cortisol, dehydroepiandrosterone sulfate

1. Fejzo MS, Trovik J, Grooten IJ, Sridharan K, Roseboom TJ, Vikanes Å, et al. Nausea and vomiting of pregnancy and hyperemesis gravidarum. Nat Rev Dis Primers. 2019;5(1):62. DOI: 10.1038/s41572-019-0110-3.
2. Ostafiіchuk SO. Dynamika rivnya leptynu v syrovattsi krovi zhinok pid chas vahitnosti, uskladnenoyi nadmirnym blyuvannyam. Art of medicine. 2021;3(19):52-7. DOI: 10.21802/artm.2021.3.19.52 .[in Ukrainian].
3. London V, Grube S, Sherer DM, Abulafia O. Hyperemesis gravidarum: a review of recent literature. Pharmacology. 2017;100:161-71. DOI: 10.1159/000477853.
4. Yıldırım E, Demir E. The relationship of hyperemesis gravidarum with sleep disorders, anxiety and depression. J Obstet Gynaecol. 2019;39(6):793-8. DOI: 10.1080/01443615.2019.1572725.
5. Elmas B, Vatansever M, Civan Kahve A, Salman Özgü B, Asut G, Çakmak IB, et al. Psychological resilience and anxiety in hyperemesis gravidarum. Turk J Obstet Gynecol. 2021;18:115-23. DOI: 10.4274/tjod.galenos.2021. 05994.
6.  Aksoy H, Aksoy Ü, Karadağ Öİ, Hacimusalar Y, Açmaz G, Aykut G, et al. Depression levels in patients with hyperemesis gravidarum: a prospective case–control study. Springer Plus. 2015;4:34-40. DOI: 10.1186/s40064-015-0820-2.
7. Yakymchuk NV. Poshyrenistʹ riznykh typiv psykholohichnoyi dominanty ta osoblyvosti psykhoemotsiynoho stanu u zhinok z platsentarnoyu dysfunktsiyeyu. Psykhosomatychna medytsyna ta zahalʹna praktyka. 2019;4(2):e0402162. [in Ukrainian].
8. Khudaverdyan DN, Saroyan MYU, Khudaverdyan AD, Arutyunyan AA. Vliyaniye psikhoemotsional’nogo stressa na soderzhaniye adrenokortikotropnogo gormona i kortizola v krovi beremennykh krys i ikh potomstva. Meditsinskaya nauka Armenii NAN RA. 2014;3:39-46. [in Russian].
9. Nath A, Murthy GVS, Babu GR, Renzo GCD. Effect of prenatal exposure to maternal cortisol and psychological distress on infant development in Bengaluru, southern India: a prospective cohort study. BMC Psychiatry. 2017;17:255. DOI: 10.1186/s12888-017-1424-x.
10. Zhuk SI, Shchurevsʹka OD. Hestoz z tochky zoru perynatalʹnoyi psykholohiyi. Zdorovʹe zhenshchyny. 2017;5(121):35-7. [in Ukrainian].
11. Heitmann K, Nordeng H, Hownen GC, Solheimsnes A, Holst L. The burden of nause and vomiting during pregnancy severe impacts on quality of life, daily life functioning and willingness to become pregnant again- result from a cross-sectional study. BMC Pregnancy Childbirth. 2017;17:75.
12. Bozzo P, Einarson TR, Koren G, Einarson A. Nausea and vomiting of pregnancy and depression: cause or effect? Clin Invest Med. 2011;34:245.
13. Walsh K, McCormack CA, Webster R, Pinto A, Lee S, Feng T, et al. Maternal prenatal stress phenotypes associate with fetal neurodevelopment and birth outcomes. Proceedings of the National Academy of Sciences. 2019;116(48):23996-24005. DOI: 10.1073/pnas.1905890116.
14. Syusyuka VH, Komarova OV, Peycheva OV, Averchenko YEH, Kochetova IM. Rivenʹ hormoniv stres-limituyuchoyi systemy u vahitnykh iz psykhoemotsiynymy porushennyamy, zumovlenymy tryvozhnistyu. Aktualʹni pytannya pediatriyi, akusherstva ta hinekolohiyi. 2018;1:112- 7. [in Ukrainian].
15. Bronson SL, Bale TL. The placenta as a mediator of stress effects on neurodevelopmental reprogramming. Neuropsychopharmacology. 2016;41:207-8.
16. Kasap E, Aksu EE, Gur EB, Genc M, Eskicioğlu F, Gökduman A, et al. Investigation of the relationship between salivary cortisol, dehydroepiandrosterone sulfate, anxiety, and depression in patients with hyperemesis gravidarum J Matern Fetal Neonatal Med. 2016;29(22):3686-9. DOI: 10.3109/14767058.2016.1140741.
17. Topalahmetoğlu Y, Altay MM, Cırık DA, Tohma YA, Çolak E, Coskun B, et al. Depression and anxiety disorder in hyperemesis gravidarum: A prospective case-control study. Turk J Obstet Gynecol. 2017;14:214-9. DOI: 10.4274/tjod.78477.

«Bulletin of problems biology and medicine» Issue 1 (163), 2022 year, 151-156 pages, index UDK 618.3-06:159.9.072

10.29254/2077-4214-2022-1-163-151-156