The impact of war-related stress on the autonomic nervous system of pregnant women: risk assessment and correction strategies

Authors

  • M.Y. Malachynska Danylo Halytskyi National Medical University; Municipal Non-Profit Enterprise of the Lviv Regional Council “Lviv Regional Clinical Perinatal Center”, Lvi, Ukraine https://orcid.org/0009-0004-9812-9802
  • N.S. Veresniuk Danylo Halytskyi National Medical University; Municipal Non-Profit Enterprise of the Lviv Regional Council “Lviv Regional Clinical Perinatal Center”, Lviv, Ukraine https://orcid.org/0000-0001-5233-7105

DOI:

https://doi.org/10.18370/2309-4117.2025.77.14-18

Keywords:

autonomic nervous system, pregnant women, war-related stress, sympathetic hyperactivity, parasympathetic dysfunction, perinatal complications, forced displacement, sychological support

Abstract

Background. The autonomic nervous system (ANS) plays a crucial role in maintaining homeostasis during pregnancy, regulating maternal and fetal physiological processes. War-related stress and forced displacement significantly increase stress levels in pregnant women, potentially leading to ANS dysfunction and negatively impacting pregnancy outcomes.

Objective of the study: to assess the impact of war-related stress on ANS function in pregnant women who experienced forced relocation and compare their autonomic parameters with those of women who did not change residence. The study included 1000 pregnant women divided into three groups: the first - women who relocated from active combat zones, the second - women who moved from other regions of Ukraine, the third - a control group of Lviv residents.

Results. Women in the first group exhibited the most pronounced ANS dysfunction, with symptoms of sympathetic hyperactivity (elevated blood pressure, tachycardia, dry skin) and parasympathetic dysfunction (obesity, hypotension, bradycardia). The second group also demonstrated ANS disturbances, although less extent, whereas the control group had the lowest incidence of autonomic disorders.

The state of the ANS was determined using an adapted questionnaire by A.M. Wayne. The following studies were performed to assess vegetative parameters: measurement of systolic and diastolic blood pressure, heart rate, Kerdo vegetative index, and minute blood volume.

Conclusions. Obtained data underscore the need to develop and implement comprehensive medical and psychological support programs for pregnant women affected by forced displacement. The study suggests correction strategies, including psychological counseling, relaxation techniques, and physical activity, to mitigate the adverse effects of stress on ANS function and reduce the risk of perinatal complications.

Author Biographies

M.Y. Malachynska, Danylo Halytskyi National Medical University; Municipal Non-Profit Enterprise of the Lviv Regional Council “Lviv Regional Clinical Perinatal Center”, Lvi

PhD, associate professor, Department of Obstetrics and Gynecology;
director

N.S. Veresniuk, Danylo Halytskyi National Medical University; Municipal Non-Profit Enterprise of the Lviv Regional Council “Lviv Regional Clinical Perinatal Center”, Lviv

MD, associate professor, Department of Obstetrics, Gynecology and Perinatology;
deputy director for the quality of medical activities

References

  1. Anbalagan S, Falkowitz DM, Mendez MD. Neonatal Abstinence Syndrome. StatPearls Publishing LLC; 2025.
  2. Bleker LS, van Dammen L, Leeflang MMG, et al. Hypothalamic-pituitary-adrenal axis and autonomic nervous system reactivity in children prenatally exposed to maternal depression: A systematic review of prospective studies. Neurosci Biobehav Rev. 2020;117:243–52. DOI: 10.1016/j.neubiorev.2018.05.033: 10.1016/j. neubiorev.2018.05.033.
  3. Brislane Á, Davenport MH, Steinback CD. The sympathetic nervous system in healthy and hypertensive pregnancies: physiology or pathology? Exp Physiol. 2023;108(10):1238–44. DOI: 10.1113/ep089665: 10.1113/ep089665.
  4. Brooks VL, Fu Q, Shi Z, Heesch CM. Adaptations in autonomic nervous system regulation in normal and hypertensive pregnancy. Handb Clin Neurol. 2020;171:57–84.10.1016/b978-0-444-64239-4.00003-5. DOI: 10.1016/b978-0-444-64239-4.00003-5.
  5. Connett GJ. Asthma, classical conditioning, and the autonomic nervous system – a hypothesis for why children wheeze. Arch Dis Child. 2024;109(6):462–7.10.1136/archdischild-2023-325441 DOI: 10.1136/archdischild-2023-325441.
  6. Do TP, Remmers A, Schytz HW, et al. Red and orange flags for secondary headaches in clinical practice: SNNOOP10 list. Neurology. 2019;92(3):134–44. DOI: 10.1212/wnl.0000000000006697.
  7. Fedorowski A. Postural orthostatic tachycardia syndrome: clinical presentation, aetiology and management. J Intern Med. 2019;285(4):352–66. DOI: 10.1111/joim.12852.
  8. Felici M, Sgorbini M, Baragli P, et al. Autonomic nervous system balance in parturient mares: Spontaneous vs induced delivery. PLoS One. 2023;18(3):e0283116. DOI: 10.1371/journal.pone.0283116.
  9. Fritsche L, Hartkopf J, Hummel J, et al. Maternal Weight Gain during Pregnancy and the Developing Autonomic Nervous System-Possible Impact of GDM. Nutrients. 2022;14(24). DOI: 10.3390/nu14245220: 10.3390/nu14245220.
  10. Godley F 3rd, Meitzen J, Nahman-Averbuch H, et al. How Sex Hormones Affect Migraine: An Interdisciplinary Preclinical Research Panel Review. J Pers Med. 2024;14(2). DOI: 10.3390/jpm14020184: 10.3390/jpm14020184.
  11. Hayase M, Shimada M. Effects of maternity yoga on the autonomic nervous system during pregnancy. J Obstet Gynaecol Res. 2018;44(10):1887–95. DOI: 10.1111/jog.13729: 10.1111/jog.13729.
  12. Johnson AK, Xue B. Central nervous system neuroplasticity and the sensitization of hypertension. Nat Rev Nephrol. 2018;14(12):750–66. DOI: 10.1038/s41581-018-0068-5.
  13. Jovanović M, Stevanović B, Pajović V, et al. Vasopressin and cardiovascular autonomic adjustment in chronic hypertensive pregnancy. Hypertens Res. 2024;47(9):2393–404. DOI: 10.1038/s41440-024-01769-6.
  14. Jurczyk M, Dyląg KA, Skowron K, Gil K. Prenatal alcohol exposure and autonomic nervous system dysfunction: A review article. Folia Med Cracov. 2019;59(3):15–21. DOI: 10.24425/fmc.2019.131132.
  15. Krzeczkowski JE, Hall M, Saint-Amour D, et al. Prenatal fluoride exposure, offspring visual acuity and autonomic nervous system function in 6-month-old infants. Environ Int. 2024;183:108336. DOI: 10.1016/j.envint.2023.108336.
  16. Mercado L, Escalona-Vargas D, Blossom S, et al. The effect of maternal pregestational diabetes on fetal autonomic nervous system. Physiol Rep. 2023;11(9):e15680. DOI: 10.14814/phy2.15680.
  17. Mulkey SB, Kota S, Swisher CB, et al. Autonomic nervous system depression at term in neurologically normal premature infants. Early Hum Dev. 2018;123:11-6. DOI: 10.1016/j.earlhumdev.2018.07.003.
  18. Recher M, Garabedian C, Aubry E, et al. Opioid effect on the autonomic nervous system in a fetal sheep model. Arch Gynecol Obstet. 2021;304(1):73–80. DOI: 10.1007/s00404-020-05917-4.
  19. Schlatterer SD, du Plessis AJ. Exposures influencing the developing central autonomic nervous system. Birth Defects Res. 021;113(11):845–63. DOI: 10.1002/bdr2.1847: 10.1002/bdr2.1847.
  20. Shufelt CL, Pacheco C, Tweet MS, Miller VM. Sex-Specific Physiology and Cardiovascular Disease. Adv Exp Med Biol. 2018;1065:433–54. DOI: 10.1007/978-3-319-77932-4_27.
  21. Sharifi-Heris Z, Yang Z, Rahmani AM, Fortier MA, Sharifiheris H, Bender M. Phenotyping the autonomic nervous system in pregnancy using remote sensors: potential for complication prediction. Front Physiol. 2023;14:1293946. DOI: 10.3389/fphys.2023.1293946.
  22. Singh Solorzano C, Grano C. Predicting postpartum depressive symptoms by evaluating self-report autonomic nervous system reactivity during pregnancy. J Psychosom Res. 2023;174:111484. DOI: 10.1016/j.jpsychores.2023.111484.
  23. Song JJ, Ma Z, Wang J, et al. Gender Differences in Hypertension. J Cardiovasc Transl Res. 2020;13(1):47–54. DOI: 10.1007/s12265-019-09888-z.
  24. Spradley FT. Sympathetic nervous system control of vascular function and blood pressure during pregnancy and preeclampsia. J Hypertens. 2019;37(3):476–87. DOI: 10.1097/hjh.0000000000001901.
  25. Van den Bergh BRH, van den Heuvel MI, Lahti M, et al. Prenatal developmental origins of behavior and mental health: The influence of maternal stress in pregnancy. Neurosci Biobehav Rev. 2020;117:26–64. DOI: 10.1016/j.neubiorev.2017.07.003.

Downloads

Published

2025-05-30

How to Cite

Malachynska, M., & Veresniuk, N. (2025). The impact of war-related stress on the autonomic nervous system of pregnant women: risk assessment and correction strategies. REPRODUCTIVE ENDOCRINOLOGY, (77), 14–18. https://doi.org/10.18370/2309-4117.2025.77.14-18

Issue

No. 77 (2025)

Section

Pregnancy and childbirth

License

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Authors who publish with this journal agree to the following terms:

    1. Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.

    1. Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.