Investigating Indicators of Anxiety, Psychoemotional Tension and Stress in Pregnant Women During Martial Law

Abstract

Introduction. Pregnancy is a vulnerable period marked by psychoemotional changes, ushering in a new stage with profound shifts in a woman's mental well-being. Elevated stress levels during pregnancy correlate with various adverse psychological and physiological outcomes for both the mother and child. In the current context, the ongoing war serves as an additional stressor for Ukrainian women. Pregnant women exposed to conflict face an increased risk of maternal mortality and a higher likelihood of delivering infants with health complications. Recognizing potential factors contributing to psychoemotional changes in pregnant women is a critical undertaking that should be initiated early in pregnancy.
 The purpose of this study is to assess indicators of anxiety, psychoemotional tension and stress in pregnant women during martial law
 Materials and methods. Psychometric testing of 50 pregnant women was performed by using three anxiety/stress scales: the Spielberger-Hanin Scale, the Psychological Stress Measure (PSM-25), and the Impact of Event Scale (IES-R). The participants were categorized into three groups: group 1 comprised pregnant women residing in areas directly impacted by the full-scale invasion, facing active hostilities or constant rocket fire without changing their residence (17 women, one experiencing occupation for < 1 month); group 2 included internally displaced women (13 individuals, two in settlements occupied for < 1 month); and group 3 encompassed 20 women residing in areas where active hostilities were not taking place.
 Results. According to the Spielberger-Hanin scale, the highest rate of reactive (46.2%, n=6) and personal anxiety (38.5%, n=5) was observed in the group of internally displaced women. The results of the IES-R were as follows, according to the invasion subscale: the highest level was observed in the group of women who were in settlements where there were no active hostilities (45%, n=9), avoidance was found in women who did not change their place of residence, where there was or continues to be active hostilities (58.8%, n=10), excitement – in internally displaced persons (46.2%, n=6). According to the PSM-25, no woman had a high level of stress, it was increased in women of the first group (23.5%, n=4). In the first studied group, complications were dominated by polyhydramnios (29.4%, n=5), fetal growth retardation syndrome (11.8%, n=2), umbilical cord localization pathology (5.9%, n=1), premature detachment a normally located placenta (11.8%, n=2) and one woman had surgery during pregnancy (5.9%, n=1). In the second group, there was a threat of abortion (30.8%, n=4). , preeclampsia in the first half of pregnancy (7.7%, n=1) and placenta localization pathology (7.7%, n=1). In the third group, there was a threat of premature birth (35%, n=7), preeclampsia (20% , n=4), oligohydramnios (25%, n=5), placental pathology (20%, n=4) and premature rupture of membranes (25%, n=5). Regarding the termination of pregnancies (table 4), the majority of pregnancies in all studied groups ended in term delivery, the highest percentage of premature deliveries (35%, n=7) was observed in the third group. In the group where there were women from the zone of active hostilities (group 1), one case of neonatal death was recorded, which was associated with significant fetal malformations.
 Conclusions. Stress is an adaptive process that induces changes in the body. This study revealed that each group experienced stress. It is noteworthy that stress during pregnancy is not solely attributed to war; factors such as the pregnancy itself, its parity, and the presence of somatic diseases also contribute. Consequently, there is a need to formulate measures for the psychoprophylaxis of women and to conduct further observations, assessing larger research cohorts.