Anxiety Syndrome in Pregnant Women With Obesity and Gestational Diabetes Mellitus

Abstract

Introduction. Over the past three years, the population of Ukraine has faced chronic stress due to ongoing military actions within its borders. In current conditions, psychoemotional disorders in patients with somatic pathology are often underestimated, with physiological states being confused with pathological anxiety. This oversight can lead to ineffective treatment, worsening patient conditions, and negative prognoses. As a result, the diagnosis and treatment of anxiety syndrome, particularly in pregnant women with both obstetric and extragenital pathology under chronic stress, is a pressing issue in modern obstetrics. The purpose of this study was to assess the presence of anxiety syndrome in pregnant women of the Kharkiv region with obesity and gestational diabetes mellitus during martial law. Materials and methods. To achieve the objective of this study, 85 women aged 24 to 39 years were examined at 30–42 weeks of pregnancy. The main group consisted of 63 pregnant women with obesity and gestational diabetes mellitus, further divided into three clinical subgroups: the first group included 24 women with gestational diabetes mellitus, the second group comprised 16 women with pre-pregnancy obesity, and the third group consisted of 23 women with both gestational diabetes mellitus and obesity. The control group included 22 women without somatic or obstetric pathology. The GAD-7 questionnaire was used to assess the overall level of anxiety. Results and discussion. All participants answered the questionnaire with scores of 2–3 points, indicating significant anxiety levels, as total scores reached 14 points or higher. Notably, the average anxiety scores in the groups with gestational diabetes mellitus, obesity, and gestational diabetes mellitus with obesity were similar—16.5±2.3, 17.9±1.8, and 17.6±2.5, respectively— and were significantly higher than those of the control group, which averaged 4.4±2.6 (p < 0.05). Thus, all women in the main group (63 pregnant women) exhibited clear signs of anxiety, including irritability (95.2%), restlessness (79.4%), inability to relax (74.6%), and anticipation of dreadful events (66.0%). These symptoms were more pronounced in women with obesity compared to those with gestational diabetes mellitus without obesity. Conclusion. Under martial law conditions, pregnant women with comorbidity of gestational diabetes mellitus and obesity exhibit a significantly higher level of anxiety compared to women with a physiological pregnancy, although the latter also experience anxiety disorders, but to a lesser degree. Assessing anxiety disorders in pregnant women with gestational diabetes mellitus and obesity using the GAD-7 scale enables timely detection of these issues, even remotely. This facilitates appropriate referrals to specialists such as psychologists, psychotherapists, or psychiatrists, and allows for the early initiation of necessary therapy.