The impact of war-related somatic traumas on women’s reproductive health and psychological status
DOI:
https://doi.org/10.18370/2309-4117.2025.77.8-13Keywords:
somatic trauma, war-related trauma, reproductive health, secondary amenorrhea, stress, polycystic ovary syndromeAbstract
Background. Somatic trauma can have a significant impact on women’s reproductive health due to impaired neuroendocrine regulation and the development of psycho-emotional stress. The war in Ukraine in recent years has led to an increase in injuries among the civilian population, including women of reproductive age, but the impact of somatic trauma in war on reproductive function remains poorly understood. Women with concomitant endocrine and gynecological pathologies, who may be more vulnerable to stress, require special attention.
Objective of the study: to evaluate the impact of different types of somatic traumas sustained during the war on the reproductive health and psycho-emotional state of women.
Materials and methods. The cross-sectional study included 64 women aged 18–45 years (mean age 31.4 ± 6.7 years) who sustained injuries as a result of hostilities in 2022–2024. Research sample was formed on the basis of the First Territorial Medical Association of Lviv. The inclusion criteria were documented injuries as a result of hostilities, the absence of cancer or severe somatic diseases before the injury. Data were collected through clinical interviews, medical records analysis, and HADS scores. Full feedback was provided by 56 women.
Results. The most common injuries among the women studied were gunshot / explosion injuries, traumatic brain injuries and limb injuries. Amenorrhea (57.1%) was the most common reproductive disorder, while the strongest associations were found between gunshot / explosive injuries and decreased libido and dyspareunia, and between traumatic brain injuries and decreased libido. Women with these injuries also had higher levels of anxiety and depression. The concomitant polycystic ovary syndrome had a negative impact on women’s psycho-emotional status, as patients with a history of this disease demonstrated significantly higher levels of anxiety.
Conclusions. Somatic traumas sustained in war significantly impair women’s reproductive health, with the nature and severity of gynecological complaints depending on the type of trauma sustained. Disorganization of the psycho-emotional state of women against the background of trauma leads to increased levels of anxiety and depression, especially among women with concomitant polycystic ovary syndrome, which should be taken into account in the multidisciplinary management of these patients.
References
- Długosz P. War trauma and strategies for coping with stress among Ukrainian refugees staying in Poland. J Migr Health. 2023 Jul 7;8:100196. DOI: 10.1016/j.jmh.2023.100196.
- Rickels E, Steudel W.I, Repschläger U, et al. The Long-Term Sequelae of Traumatic Brain Injury Over 10 Years of Follow-Up – A Matched Cohort Study Based on Routine Data of a Statutory Health Insurance Carrier. Dtsch Arztebl Int. 2023 Apr 21;120(16):271–6. DOI: 10.3238/arztebl.m2023.0046.
- Ripley DL, Harrison-Felix C, Sendroy-Terrill M, et al. The impact of female reproductive function on outcomes after traumatic brain injury. Arch Phys Med Rehabil. 2008 Jun;89(6):1090–6. DOI: 10.1016/j.apmr.2007.10.038.
- Courtois F, Alexander M, McLain ABJ. Women`s Sexual Health and Reproductive Function After SCI. Top Spinal Cord Inj Rehabil. 2017 Winter;23(1):20–30. DOI: 10.1310/sci2301-20.
- Maas AIR, Menon DK, Manley GT, et al. Traumatic brain injury: progress and challenges in prevention, clinical care, and research. Lancet Neurol. 2022;21(11):1004–60. DOI: 10.1016/S1474-4422(22)00309-X.
- Menon DK, Schwab K, Wright DW, et al. Position statement: definition of traumatic brain injury. Arch Phys Med Rehabil. 2010;91(11):1637–40. DOI: 10.1016/j.apmr.2010.05.017.
- Nair SS, Surendran Рђ, Prabhakar RB, et al. Comparison between FOUR score and GCS in assessing patients with traumatic head injury: a tertiary centre study. International Surgery Journal. 2017;4(2):656. DOI: 10.18203/2349-2902.isj20170209.
- Harhangi BS, Kompanje EJ, Leebeek FW, et al. Coagulation disorders after traumatic brain injury. Acta Neurochir (Wien). 2008;150(2):165–75. DOI: 10.1007/s00701-007-1475-8.
- Yi JH, Hazell AS. Excitotoxic mechanisms and the role of astrocytic glutamate transporters in traumatic brain injury. Neurochem Int. 2006;48(5):394–403. DOI: 10.1016/j.neuint.2005.12.001.
- Snook ML, Henry LC, Sanfilippo JS, et al. Association of Concussion With Abnormal Menstrual Patterns in Adolescent and Young Women. JAMA Pediatr. 2017;171(9):879–86. DOI: 10.1001/jamapediatrics.2017.1140.
- Lima R, Monteiro A, Salgado A.J, et al. Pathophysiology and Therapeutic Approaches for Spinal Cord Injury. Int J Mol Sci. 2022;23(22):13833. DOI: 10.3390/ijms232213833.
- Eckert MJ, Martin MJ. Trauma: Spinal Cord Injury. Surg Clin North Am. 2017;97(5):1031–45. DOI: 10.1016/j.suc.2017.06.008.
- McDaid D, Park AL, Gall A, et al. Understanding and modelling the economic impact of spinal cord injuries in the United Kingdom. Spinal Cord. 2019;57(9):778–88. DOI: 10.1038/s41393-019-0285-1.
- Robertson K, Ashworth F. Spinal cord injury and pregnancy. Obstet Med. 2022;15(2):99–103. DOI: 10.1177/1753495X211011918.
- Alizadeh A, Dyck SM, Karimi-Abdolrezaee S. Traumatic Spinal Cord Injury: An Overview of Pathophysiology, Models and Acute Injury Mechanisms. Front Neurol. 2019;10:282. DOI: 10.3389/fneur.2019.00282.
- Iezzoni LI, Chen Y, McLain A.B. Current pregnancy among women with spinal cord injury: findings from the US national spinal cord injury database. Spinal Cord. 2015;53(11):821–6. DOI: 10.1038/sc.2015.88.
- Morton C, Le JT, Shahbandar L, et al. Pregnancy outcomes of women with physical disabilities: a matched cohort study. PM R 2013;5(2): 90–8. DOI: 10.1016/j.pmrj.2012.10.011.
- McLain A.B, Zhang L, Troncale J, et al. Pregnancy, labor, and delivery outcomes of women with and without spinal cord injury. J Spinal Cord Med. 2023;46(3):405–13. DOI: 10.1080/10790268.2021.2018155.
- Salomon, J, Schnitzler, A, Ville, Y, et al. Prevention of urinary tract infection in six spinal cord-injured pregnant women who gave birth to seven children under a weekly oral cyclic antibiotic program.” Int J Infect Dis 2009;13(3): 399–402. DOI: 10.1016/j.ijid.2008.08.006.
- Rau CS, Wu SC, Kuo PJ, et al. Epidemiology of Bone Fracture in Female Trauma Patients Based on Risks of Osteoporosis Assessed using the Osteoporosis Self-Assessment Tool for Asians Score. Int J Environ Res Public Health. 2017;14(11):1380. DOI: 10.3390/ijerph14111380.
- Alton TB, Gee AO. Classifications in brief: young and burgess classification of pelvic ring injuries. Clin Orthop Relat Res 2014;472(8):2338–42. DOI: 10.1007/s11999-014-3693-8.
- Berger-Groch J, Thiesen DM, Grossterlinden LG, et al. The intra- and interobserver reliability of the Tile AO, the Young and Burgess, and FFP classifications in pelvic trauma. Arch Orthop Trauma Surg. 2019;139(5):645–50. DOI: 10.1007/s00402-019-03123-9.
- Beckmann NM, Chinapuvvula NR. Sacral fractures: classification and management. Emerg Radiol. 201724 (6):605–17. DOI: 10.1007/s10140-017-1533-3.
- Sadeghpour A, Aslani H, Torab R, et al. Genital and Sexual Function in Women With a History of Pelvic Fracture. [Internet]. Crescent Journal of Medical and Biological Science. 2019;6(1):109–14. Available from: https://www.researchgate.net/publication/364368336_Genital_and_Sexual_Function_in_Women_With_a_History_of_Pelvic_Fracture
- Rovere G, Smakaj A, Perna, A, et al. Correlation between traumatic pelvic ring injuries and sexual dysfunctions: a multicentric retrospective study. International Orthopaedics (SICOT). 2023;47:1407–14. DOI: 10.1007/s00264-023-05767-0.
- Vallier HA, Cureton BA, Schubeck D. Pelvic ring injury is associated with sexual dysfunction in women. J Orthop Trauma. 2012;26(5) 308–13. DOI: 10.1097/BOT.0b013e31821d700e.
- Goussous N, Sawyer MD, Wuersmer LA, et al. Comparison of sexual function and quality of life after pelvic trauma with and without Angioembolization. Burns Trauma. 2015;3:21. DOI: 10.1186/s41038-015-0022-8.
- Cannada LK, Barr J. Pelvic fractures in women of childbearing age. Clin Orthop Relat Res. 2010;468.7:1781–9. DOI: 10.1007/s11999-010-1289-5.
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