Impact of forced migration due to armed conflict on the autonomic nervous system in pregnant women in Ukraine

Background. The autonomic nervous system (ANS) plays a key role in maintaining homeostasis of the body, especially during pregnancy. Dysfunctions of the ANS can have a significant impact on the course of pregnancy and the postpartum period, in parti­cular contributing to the development of depressive disorders. Aim: to assess the impact of forced migration due to armed conflict on the functional status of the ANS in pregnant women in Ukraine via comparative analysis of three cohorts. Materials and methods. A prospective cohort study was conducted in 2023–2024 in the Lviv region. A total of 1000 participants were divided into three groups: group 1 (n = 333): women displaced from high-intensity conflict areas; group 2 (n = 333): relocators from regions with minimal military activity; control group (n = 334): women with no relocation experience. The ANS assessment employed the adapted Wein autonomic symptom questionnaire and physiological measurements (heart rate, systolic and diastolic blood pressure, cardiac output, Kérdö index). Statistical analysis was conducted in the R environment using Student’s t-test, ANOVA, and Pearson correlation. Results. Group 1 demonstrated a significant (p < 0.05) dominance of sympathetic activity: average sympathetic score was 66.7 ± 5.2 (55.6 %), parasympathetic — 47.7 ± 5.0 (47.7 %). Group 2 also showed elevated sympathetic symptoms (70.3 ± 6.9; 61.6 %) compared to controls (41.7 % sympathetic; 65.6 % parasympathetic). The control group maintained stable homeostasis with predominant parasympathetic tone. Physiological parameters confirmed higher rates of tachycardia and hypertension in displaced participants. Conclusions. Forced migration induced by armed conflict significantly disrupts the ANS balance in pregnant women, increasing sympathetic activity and the risk of pregnancy complications. Targeted medical and psychological interventions are needed to enhance adaptive autonomic regulation in this vulnerable population.