Obstetrics and GynecologyObstetrics and GynecologyАкушерство и гинекология0300-90922412-5679Bionika Media51657910.18565/aig.2022.208Exchange of ExperienceОбмен опытомResearch ArticleThe structural analysis of mental disorders in pregnant women with COVID-19 pneumoniaСтруктурный анализ нарушений психологического состояния беременных с пневмонией COVID-19https://orcid.org/0000-0001-9358-1825AlimovaKhilola P.АлимоваХилола Пулатовна
Uzbekistan

Dr. Med. Sci., Deputy Director

д.м.н., заместитель директора

Khilola.Alimova69@mail.ruhttps://orcid.org/0000-0002-7575-294XVoitovaGavkhar A.ВоитоваГавхар Алишеровна
Uzbekistan

M.D., obstetrician-gynecologist, perinatal psychologist, Tashkent City Center of Women's Reproductive Health; Senior Researcher, Republican Specialized Infectious Diseases Hospital Zangiota No. 1

к.м.н., врач акушер-гинеколог, врач-перинатальный психолог, Ташкентский городской центр репродуктивного здоровья женщин; с.н.с., ГУ «Республиканская специализированная инфекционная больница Зангиота №1»

gavharv@mail.ruRepublican Specialized Infectious Diseases Zangiota-1 HospitalГУ «Республиканская специализированная инфекционная больница Зангиота №1»Tashkent City Center of Women's Reproductive HealthТашкентский городской центр репродуктивного здоровья женщин2007202351001073006202330062023Copyright ©; 2023, Bionika MediaCopyright ©; 2023, ООО «Бионика Медиа»2023Bionika MediaООО «Бионика Медиа»https://journals.eco-vector.com/0300-9092/article/view/516579

Objective: To make a structural analysis of psychoemotional disorders in pregnant women with COVID-19 pneumonia. Hamilton Anxiety Rating Scale

Materials and methods: The prospective investigation enrolled 3080 pregnant women infected with SARS-CoV-2; of them 889 were in the first trimester; 1056 and 1135 were in the second and third trimesters, respectively. The vast majority (64.3%; 1980/3080) of cases were diagnosed with moderate COVID-19 pneumonia. Psychoemotional disorders were identified and its severities were assessed using. The Hamilton Anxiety Rating Scale-7 was used to identify psychoemotional disorders and to assess their severity; posttraumatic stress disorders (PTSDs) were detected using the IES-6 and depressive syndrome was identified using the PHQ-9.

Results: A considerable part (80.1%; 2467/3080) of pregnant women during COVID-19 infection was noted to have psychoemotional disorders; with 100% (n=1056) in the second trimester of pregnancy. Depressive syndrome was evident in the first trimester, while anxiety states and PTSDs were more characteristic for the second trimester. There was a higher incidence of mixed mental disorders with the higher pregnancy status. The most of pregnant women with psychoemotional disorders (51.5%; 1585/3080) was assigned to a cohort of patients with moderate COVID-19; in the same pattern of moderate COVID-19 pneumonia, there was a preponderance of cases of PTSDs (59.5%; 1178/1980).

PTSDs showed a practically equal incidence among pregnant women with severe and very severe COVID-19 (54.3 and 52.7%, respectively), as well as anxiety (28.6 and 28.4%, respectively) and depressive (17.1 and 18.9, respectively) states. The high incidence of mixed psychoemotional disorders was characteristic for pregnant women with severe and very severe COVID-19 pneumonia (46.7 and 52.7%, respectively, which indicates the aggravation of the clinical presentations of psychoemotonal disorders during COVID-19 pneumonia progression.

Conclusion: Psychoсихоemotional disorders during COVID-19 infection are characteristic for a considerable part of pregnant women. Moreover, their early detection using specialized questionnaire scales (HARS-7, IES-6, and PHQ-9) can be favorable to the timely inclusion of a psychological component of treatment policy and prevent poor perinatal and social consequences.

Цель: Провести структурный анализ нарушений психоэмоционального статуса беременных женщин с пневмонией COVID-19.

Материалы и методы: Проспективное исследование включало 3080 беременных женщин, инфицированных SARS-CoV-2; из них 889 находились в I триместре, 1056 – во II и 1135 – в III триместре беременности. В подавляющем большинстве (64,3%; 1980/3080) случаев диагностировано среднетяжелое течение пневмонии COVID-19. Выявление и оценка степени тяжести психоэмоциональных нарушений проводились по шкалам оценки тревожных расстройств ГТР-7, посттравматических стрессовых расстройств (ПТСР) IES-6 и депрессивного синдрома PHQ-9.

Результаты: У значительной части (80,1%; 2467/3080) беременных женщин на фоне инфицирования COVID-19 отмечаются психоэмоциональные нарушения, со 100% (n=1056) показателем во II триместре беременности. Депрессивный синдром был выражен в I триместре, а тревожные состояния и ПТСР были более характерны для II триместра беременности. Отмечено повышение встречаемости смешанных расстройств психики по мере повышения статуса беременности. Большая часть беременных женщин с психоэмоциональными расстройствами (51,5%; 1585/3080) были отнесены к когорте среднетяжелого течения COVID-19. В самой же структуре среднетяжелого течения пневмонии COVID-19 преобладали случаи ПТСР (59,5%; 1178/1980). Практически равную частоту встречаемости имели ПТСР среди беременных с COVID-19 тяжелой и крайне тяжелой степени (54,3 и 52,7% соответственно), так же, как и тревожные (28,6 и 28,4% соответственно) и депрессивные (17,1 и 18,9% соответственно) состояния. Высокая частота встречаемости смешанных психоэмоциональных расстройств была характерна для беременных женщин с пневмонией COVID-19 тяжелой и крайне тяжелой степени – 46,7 и 52,7% соответственно, что свидетельствует об усугублении клинической картины психоэмоциональных нарушений на фоне прогрессирования пневмонии COVID-19.

Заключение: Психоэмоциональные нарушения на фоне инфицирования COVID-19 характерны для значительной части беременных женщин. При этом их раннее выявление с использованием специализированных шкал-опросников (ГТР-7, IES-6 и PHQ-9) может способствовать своевременному подключению психологической составляющей терапевтической тактики и предупредить неблагоприятные перинатальные и социальные последствия.

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