Assessment of Mental Status and Behavioral Reactions of Women with Premature Births at Different Gestation Times

Preterm birth is one of the most complex and socially significant problems of obstetrics and gynecology today. The pathogenesis of non-pregnancy is not fully disclosed, which does not allow to fully justify an effective set of medical and preventive measures. The increase in the number of women with the threat of pregnancy interruption should be noted on the background of increasing the overall morbidity and mortality of the population, reducing the birth rate of children associated with adverse socio-environmental conditions. Therefore, the problem of preterm births has gone beyond being purely medical and carries medical and social and socio-economic orientation. The purpose of the study is to analyze the state of mental and behavioral reactions in women with abortion in different terms. Material and methods. 119 pregnant women who were admitted to the Kharkiv city perinatal center were screened. Group I involved 64 women between 19 and 28 with abortions in the early 23-27 weeks and the late 28-36 weeks of the term. The comparison group included 55 women aged from 19 to 32 with a physiological course of pregnancy, which ended in childbirth without complications at the time of 38-41 weeks. The criteria for including women into groups were: young reproductive age, single-pregnancy; absence of gestosis, acute and chronic gynecological and somatic diseases. Diagnosis of preterm birth was carried out in the presence of abdominal pain syndrome and structural changes in the cervix. The research was carried out in compliance with the principles of bioethics. Results and discussion. To realize the goal, the method of unfinished sentences was used that would characterize the behavior and mental state of patients, give a qualitative assessment of the levels of conflict with respect to the family, mother, father, husband, children, persons of the opposite sex, sexual life, comrades, acquaintances, subordinates, colleagues at work, higher individuals, as well as fears, dangers, etc. Anonymous questionnaire of patient groups was used during research, evaluation was carried out on the basis of commonly accepted psychological concepts and expressed on a three-point scale: 0 points – the ratio was indifferent, the conflict was not detected; 1 point – the ratio was moderately negative, the patient himself saw ways to overcome the conflict; 2 points – the ratio was clearly negative, due to the presence of unresolved conflicts, indicating the violation of adaptation and the necessary psychotherapeutic correction. Each person completed the questionnaire with 60 unfinished sentences, which were divided into 15 groups and represented a reflection of the analytical and synthetic activity of the cerebral cortex, a state of behavioral and mental disorders. Conclusions. The conflict levels analysis indicated the close relationship of socio-environmental and socio-economic factors with the mechanisms of formation and progress of premature births in women, which was confirmed by violation of behavioral reactions, mental status and analytical and synthetic activity of the higher parts of the central nervous system. This determines the feasibility of using psychoprophylactic approach in order to correct conflicts in patients at the earliest stages of pregnancy. The leading and prognostically significant socio-environmental factors that influence the development of preterm birth are indicators of the relationship among relatives. While other indicators of conflict act as refinement corrections and are the consequence of behavioral reactions and mental state, indicating the important role of analytical and synthetic activity of the cerebral cortex in the formation of mechanisms for the development of premature births.