Ukrainian Journal Health of Woman. 2026. 3(184): 71-79. doi: 10.15574/HW.2026.3(184).7179
Chernov А. V., Serbeniuk А. V.
Shupyk National Healthcare University of Ukraine, Kyiv

For citation: Chernov АV, Serbeniuk АV. (2026). Vegetative adaptation and psychoemotional state of pregnant women with preeclampsia giving birth for the first time. Ukrainian Journal Health of Woman. 3(184): 71–79. doi: 10.15574/HW.2026.3(184).7179
Article received: Mar 16, 2026. Accepted for publication: Jun 01, 2026.

The autonomic nervous system (ANS) plays an important role in creating optimal conditions for the progression of pregnancy and the normal course of labor. It supports the physiological and biochemical parameters, the rhythm of the cardiovascular, respiratory and other systems of the female body during gestation.
Aim – to study the features of autonomic adaptation and psychoemotional state of pregnant women with preeclampsia (PE) who are giving birth for the first time, to optimize the prognosis and early diagnosis of it.
Materials and methods. The psychoemotional state of 201 pregnant women who are giving birth for the first time was analyzed. The main group (OG) – 101 pregnant women with PE, the control group (CG) – 40 pregnant women without PE. The state of the ANS and sleep quality were assessed using the Epworth       questionnaire; the level of reactive and personal anxiety was assessed using the method of C.D. Spielberger and Y.L. Khanin; the level of depression was diagnosed using the E. Beck depression scale.
Results. Mild sleep disturbances (18-22 points) prevailed in the OG, which amounted to 27 (26.7%) versus 8 (20.0%) in the CG, significant disturbances – 43 (42.6%) versus 1 (2.5%), respectively. A score of more than 9 points was received by 42 (41.6%) OG patients versus 10 (25.0%) pregnant CG, which is 1.7 times higher. This score is associated with the presence of obstructive sleep apnea syndrome, which is considered characteristic of arterial hypertension: in 30 (29.7%) OG patients versus 2 (5.0%) cases in the CG.
Conclusions. Nulliparous pregnant women with PE exhibit significant impairments in autonomic adaptation, changes in personality traits, psycho-emotional state, and sleep, as well as increased levels of anxiety and depressive conditions.
The study was conducted in accordance with the principles of the Declaration of Helsinki. Informed consent was obtained from all participants.
The author declares no conflict of interest.
Keywords: pregnancy, preeclampsia, autonomic adaptation, psycho-emotional state, reactive and trait anxiety, sleep disorders, depressive conditions.

REFERENСЕS

1. ACOG. (2020, Jun). Gestational Hypertension and Preeclampsia: ACOG Practice Bulletin, Number 222. Obstet Gynecol. 135(6): e237-e260. https://doi.org/10.1097/AOG.0000000000003891; PMid:32443079 PMCid:PMC8907436

2. Armaly Z, Jadaon JE, Jabbour A, Abassi ZA. (2018, Jul 25). Preeclampsia: Novel Mechanisms and Potential Therapeutic Approaches. Front Physiol. 9: 973. https://doi.org/10.3389/fphys.2018.00973; PMid:30090069 PMCid:PMC6068263

3. Bester M, Joshi R, Mischi M, van Laar J, Vullings R. (2023, May 10). On the distinct differences in autonomic regulation between pregnant and non-pregnant women – a heart rate variability analysis. Physiol Meas. 44(5). https://doi.org/10.1088/1361-6579/acce1e; PMid:37072002

4. Bogdan C, Apostol A, Ivan VM, Sandu OE, Petre I, Petre I et al. (2024, Aug 20). Autonomic Dysfunction and Cardiac Performance in Pregnant Women with Hypertensive Disorders: A Comparative Study Using Heart Rate Variability and Global Longitudinal Strain. Life (Basel). 14(8): 1039. https://doi.org/10.3390/life14081039; PMid:39202781 PMCid:PMC11355154

5. Cong X, Wang J, Yang L, Cui L, Hua Y, Gong P. (2025, May 21). Pregnancy stress in women at high risk of preeclampsia with their anxiety, depression, self-management capacity: a cross-sectional study. Front Psychol. 16: 1537858. https://doi.org/10.3389/fpsyg.2025.1537858; PMid:40470023 PMCid:PMC12133748

6. Floria M, Floria DE, Trifan AV, Tănase DM. (2025, Jan 28). Interdisciplinarity in Cardiovascular Diseases-A Necessity Alongside the Heart Team. Life (Basel). 15(2): 193. https://doi.org/10.3390/life15020193; PMid:40003602 PMCid:PMC11855978

7. Gherbesi E, Gianstefani S, Angeli F, Ryabenko K, Bergamaschi L, Armillotta M et al. (2024, Jan). Myocardial strain of the left ventricle by speckle tracking echocardiography: From physics to clinical practice. Echocardiography. 41(1): e15753. https://doi.org/10.1111/echo.15753; PMid:38284665

8. Goddard J, Wee MYK, Vinayakarao L. (2020, Dec). Update on hypertensive disorders in pregnancy. BJA Educ. 20(12): 411-416. Epub 2020 Oct 12. https://doi.org/10.1016/j.bjae.2020.07.007; PMid:33614162 PMCid:PMC7813671

9. Johns MW. (1991, Dec). A new method for measuring daytime sleepiness: the Epworth sleepiness scale. Sleep. 14(6): 540-545. https://doi.org/10.1093/sleep/14.6.540; PMid:1798888

10. Keramat A, Malary M, Moosazadeh M, Bagherian N, Rajabi-Shakib MR. (2021, Jan 26). Factors influencing stress, anxiety, and depression among Iranian pregnant women: the role of sexual distress and genital self-image. BMC Pregnancy Childbirth. 21(1): 87. https://doi.org/10.1186/s12884-021-03575-1; PMid:33499805 PMCid:PMC7836496

11. Kuo CD, Chen GY, Yang MJ, Lo HM, Tsai YS. (2000, Mar). Biphasic changes in autonomic nervous activity during pregnancy. Br J Anaesth. 84(3): 323-329. https://doi.org/10.1093/oxfordjournals.bja.a013433; PMid:10793590

12. Mintser OP ta in. (2018). Informatyka ta okhorona zdorovia. Pidruchnyk. Za red. O.P. Mintsera. Kyiv: Knyha plius: 352.

13. Moors S, Staaks KJJ, Westerhuis MEMH, Dekker LRC, Verdurmen KMJ et al. (2020, Apr). Heart rate variability in hypertensive pregnancy disorders: A systematic review. Pregnancy Hypertens. 20: 56-68. Epub 2020 Mar 5. https://doi.org/10.1016/j.preghy.2020.03.003; PMid:32179490

14. Petre I, Iurciuc S, Buleu F, Petre I, Moleriu RD, Popa D, Turi V, Bordianu A, Tasdemir R, Craciun LM, Marc L, Barna FM, Iurciuc M. The Impact of Medical Physical Training and a Structured Personalized Exercise Training Program on Hemodynamic Parameters and Arterial Stiffness in Pregnant Women. Biomedicines. 2024 Apr 30;12(5):986. PMCID: PMC11118944. https://doi.org/10.3390/biomedicines12050986; PMid:38790947

15. Popescu MR, Bouariu A, Ciobanu AM, Gică N, Panaitescu AM. (2022, Feb 15). Pregnancy Complications Lead to Subclinical Maternal Heart Dysfunction-The Importance and Benefits of Follow-Up Using Speckle Tracking Echocardiography. Medicina (Kaunas). 58(2): 296. https://doi.org/10.3390/medicina58020296; PMid:35208619 PMCid:PMC8877943

16. Savory NA, Hannigan B, John RM, Sanders J, Garay SM. (2021, Dec). Prevalence and predictors of poor mental health among pregnant women in Wales using a cross-sectional survey. Midwifery. 103: 103103. Epub 2021 Jul 22. https://doi.org/10.1016/j.midw.2021.103103; PMid:34392103

17. Sharifi-Heris Z, Rahmani AM, Axelin A, Rasouli M, Bender M. (2023, Jun 5). Heart Rate Variability and Pregnancy Complications: Systematic Review. Interact J Med Res. 12: e44430. https://doi.org/10.2196/44430; PMid:37276013 PMCid:PMC10280337

18. Sharifi-Heris Z, Yang Z, Rahmani AM, Fortier MA, Sharifiheris H, Bender M. (2023, Nov 21). Phenotyping the autonomic nervous system in pregnancy using remote sensors: potential for complication prediction. Front Physiol. 14: 1293946. https://doi.org/10.3389/fphys.2023.1293946; PMid:38074317 PMCid:PMC10702512

19. Sonaglioni A, Pusca I, Casieri F, Dell'Anna R, Luigi Nicolosi G et al. (2024, Aug). Echocardiographic assessment of left atrial mechanics in women with hypertensive disorders of pregnancy: A systematic review and meta-analysis. Eur J Obstet Gynecol Reprod Biol. 299: 62-70. Epub 2024 Jun 1. https://doi.org/10.1016/j.ejogrb.2024.05.044; PMid:38838388

20. Spielberger CD, Gorsuch RL, Lushene RE. (1970). Manual for the State-Trait Anxiety Inventory. Consulting Psychologists Press.

21. Spradley FT. (2019, Mar). Sympathetic nervous system control of vascular function and blood pressure during pregnancy and preeclampsia. J Hypertens. 37(3): 476-487. https://doi.org/10.1097/HJH.0000000000001901; PMid:30160658 PMCid:PMC6355368

22. Turi V, Iurciuc S, Crețu OM, Tit DM, Bungau S, Apostol A et al. (2021, Jan 1). Arterial function in hypertensive pregnant women. Is arterial stiffness a marker for the outcomes in pregnancy? Life Sci. 264: 118723. Epub 2020 Nov 5. https://doi.org/10.1016/j.lfs.2020.118723; PMid:33160988

23. Van Wingerden AS, Katsidoniotaki M, Haghighi N, Almonte C, Woolcock Martinez H, Valdes E et al. (2024, Dec). Postpartum Blood Pressure Variability and Heart Rate Variability in Preeclampsia. Hypertension. 81(12): 2510-2519. Epub 2024 Oct 15. https://doi.org/10.1161/HYPERTENSIONAHA.124.23321; PMid:39403810 PMCid:PMC11578794

24. Wang XJ, Chen LL, Hong MH, Kong LY, Xiang W, Fu L et al. (2025, Jun 6). Dynamic change in maternal cardiac function during pregnancy. Front Cardiovasc Med. 12: 1577213. https://doi.org/10.3389/fcvm.2025.1577213; PMid:40547503 PMCid:PMC12179202

25. Widatalla N, Keenan E, Palaniswami M, Khandoker A. (2025, Sep 17). Investigating the role of maternal heart rate variability in the onset of labor. Front Med (Lausanne). 12: 1659620. https://doi.org/10.3389/fmed.2025.1659620; PMid:41041459 PMCid:PMC12484162

26. Wilson MG, Bone JN, Mistry HD, Slade LJ, Singer J et al. (2024, Mar 5). Blood Pressure and Heart Rate Variability and the Impact on Pregnancy Outcomes: A Systematic Review. J Am Heart Assoc. 13(5): e032636. Epub 2024 Feb 27. https://doi.org/10.1161/JAHA.123.032636; PMid:38410988 PMCid:PMC10944029