BACKGROUND: The specific features of adaptive regulatory processes in pregnant women with prolonged residence in a war zone are of particular scientific interest due to the high stress vulnerability of this population. Morphofunctional asymmetries of the female body (lateral phenotype) are an important constitutional trait influencing stress resilience, in the formation of which the nervous and humoral regulatory systems play a leading role. AIM: The work aimed to study the features of the hormonal status in pregnant women with varying stress levels caused by prolonged residence in a war zone, depending on the type of lateral constitution. METHODS: Design: a prospective, selective, comparative study involving a non-random, stratified, continuous sample of respondents aged 18–28 years, with a first singleton pregnancy of uncomplicated course, no signs of obstetric condition according to clinical, hormonal, biochemical, ultrasound, and Doppler examinations, and who had lived in the corresponding region for at least three years prior to pregnancy. The study assessed the lateral phenotype, stress level, adaptive potential of the circulatory system, situational and trait anxiety, hormonal profile, hemogram and coagulation parameters. RESULTS: Assessment of the lateral phenotype in pregnant women revealed a predominance of low stress levels in those with a right lateral phenotype, and high stress levels in those with an ambidextrous phenotype. A decrease in 6-sulfatoxymelatonin levels (by an average of 35.1%) and sex hormones (by 12.6%) was found in pregnant women from the Donetsk and Luhansk People’s Republics compared to residents of the Rostov Region. Depending on the lateral phenotype, the highest levels of stress-response hormones were observed in women with an ambidextrous phenotype. Multifactorial decision tree analysis established that in pregnant women from the Donetsk and Luhansk People’s Republics, the leading factors in mechanisms of stress resilience formation were the adaptive potential of the cardiovascular system, melatonin levels, sex and stress-liberating hormones, body mass index, and age. At the same time, in residents of the Rostov Region, the hierarchy of influencing factors was represented by stress-response hormones, situational anxiety level, and hematologic parameters. CONCLUSION: In the ambidextrous type of lateral constitution, higher production of stress-response hormones combined with reduced melatonin production is significantly associated with the development of high stress levels, regardless of region of residence, indicating the highest stress vulnerability of this lateral constitution type compared to polar right and left lateral phenotypes. The higher prevalence of high stress levels (1.8-fold) in pregnant women with an ambidextrous phenotype from the Donetsk and Luhansk People’s Republics, compared with residents of the Rostov Region, indicates a more pronounced decrease in stress resilience in women who had lived in a war zone prior to relocation.
Botasheva et al. (Sun,) studied this question.