Pathological pregnancy and psychological symptoms in women [Patološka trudnoća i psihički simptomi u žena]

Bjelanović, Vedran and Babić, Dragan and Orešković, Slavko and Tomić, Vajdana and Martinac, Marko and Juras, Josip (2012) Pathological pregnancy and psychological symptoms in women [Patološka trudnoća i psihički simptomi u žena]. Collegium Antropologicum, 36 (3). pp. 847-852. ISSN 0350-6134

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Abstract

Pregnancy is followed by many physiologic, organic and psychological changes and disorders, which can become more serious in pregnancy followed by complications, especially in women with pathological conditions during pregnancy. The purpose of this study was to find out and analyze the prevalence and intensity of psychological disorders in women with pathological conditions during pregnancy and compare it with conditions in pregnant women who had normal development of pregnancy. The research is approved by the Ethical committee of the Mostar University Hospital Center, and it was made in accordance with Helsinki declaration and good clinical practices. The research conducted section for pathology of pregnancy of Department for gynecology and obstetrics of the Mostar University Hospital Center. It included 82 pregnant women with disorders in pregnancy developement and control group consisted of pregnant women who had normal development of pregnancy. The research work was conducted from September 2007 to August 2008 in Mostar University Hospital Center. Pregnant women had Standard and laboratory tests, Ultrasound. CTG examinations were done for all pregnant women and additional tests for those women with complications during pregnancy. Pregnant women completed sociobiographical, obstetrical-clinical and psychological SCL 90-R questionnaire. Pregnant women with pathological pregnancy exibited significantly more psychological symptoms in comparison to pregnant women with normal pregnancy (p < 0.001 to p = 0.004). Frequency and intensity of psychical symptoms and disorders statisticly are more characteristic in pathological pregnancy (61%/40.6%). The statistical data indicate a significantly higher score of psychological disorders in those pregnant women with primary school education (p = 0.050), those who take more than 60% carbohydrates (p = 0.001), those with pathological CTG records (p < 0.001), those with pathological ultrasound results (p < 0.001 to 0.216) and those pregnant women with medium obesity and obesity (p = 0.046). Body mass index (BMI) during normal pregnancy development is lower (p = 0.002) but the levels of glucose, triglycerides, cholesterol, HDL and LDL in blood are higher Blood pressure in pregnant women with pathological pregnancy was statistically significantly higher (p < 0.001). Diagnostic criteria for the metabolic syndrome were found in 19 pregnant women with the pathological pregnancy. Statistically, in those women, a significantly higher appearance of psychological symptoms and disorders was observed in comparison to the pregnant women without metabolic syndrome (p < 0.001). The research has shown that 87.8% from all pregnant women included in this study have been hospitalized due to premature birth, hypertensive disorders, and diabetes in pregnancy, and also due to bleeding in the second and third trimester of pregnancy.

Abstract in Croatian

Trudnoća je praćena brojnim fiziološkim, organskim i psihičkim promjenama i poremećajima, koji se mogu i pogoršati u trudnoći praćenoj komplikacijama, posebice ako se radi o ženama s patologijom trudnoće. Cilj rada je bio utvrditi i analizirati izraženost, učestalost i jačinu psihičkih simptoma i poremećaja u žena s patologijom trudnoće i usporediti ih s trudnicama u kojih je tijek trudnoće uredan. Istraživanje je odobreno od strane Etičkog povjerenstva Kliničke bolnice Mostar, a provedeno je u skladu s Helsinškom deklaracijom i načelima dobre kliničke prakse. Presječna prospektivna studija provedena je na Odsjeku patologije trudnoće Odjela za ginekologiju i porodiljstvo Kliničke bolnice Mostar. Skupinu je činilo 82 trudnice s poremećenim tijekom trudnoće, a kontrolna skupina su 80 trudnica s normalnim tijekom trudnoće. Istraživanje je provedeno od 9. mjeseca 2007. do 8. mjeseca 2008. godine u KB Mostar. Trudnicama su rađene standardne i laboratorijske pretrage, UZV, CTG te dodatne pretrage u trudnoći s komplikacijama. Trudnice su ispunjavale sociobiografski, opstetričko-klinički i psihološki SCL 90-R upitnik. Trudnice s patologijom trudnoće pokazivale su statistički značajno više psihičkih simptoma u odnosu na trudnice s normalnom trudnoćom (p<0,001 do p=0,004). Učestalost i jačina psihičkih simptoma i poremećaja statistički je značajno veća u patološkoj trudnoći (61%/40,6%). Statističkom obradom podataka primijećena je statistički značajno veća izraženost psihičkih poremećaja u trudnica s osnovnom školom (p=0,050), trudnica koje uzimaju više od 60% ugljikohidrata (Hi-kvadrat test p=0,001), trudnica s patološkim CTG zapisima (p<0,001), trudnica s patološkim ultrazvučnim nalazom (p<0,001 do 0,216) i trudnica s umjerenom pretilošću i pretilošću (p=0,046). Body mass indeks prije trudnoće (BMI) u žena s normalnim tijekom trudnoće je niži (p=0,002), a veća razina GUK-a, triglicerida, kolesterola, HDL i LDL (p=0,017). Krvni tlak je statistički značajno viši u trudnica s patološkom trudnoćom (p<0,001). U 19 trudnica u patološkoj trudnoći nađeni su kriteriji za dijagnozu metaboličkog sindroma, te kod njih nađena statistički značajno viša pojavnost psihičkih simptoma i poremećaja u trudnoći u odnosu na trudnice bez dijagnoze metaboličkog sindroma (p<0,001). Istraživanjem je utvrđeno da je 87,8% trudnica hospitalizirano zbog prijetećeg prijevremenog poroda, hipertenzivnih poremećaja u trudnoći i dijabetesa u trudnoći, te krvarenja u drugom i trećem tromjesečju trudnoće.

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