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妊娠期焦虑症与高血压疾病:流行病学、发病机制及管理策略

Anxiety and hypertensive disorders of pregnancy: Epidemiology, mechanisms, and management strategies.

作者信息

Liu Chun-Hua, Zhang Hai-Yan, Wang Fang, Mu Sha-Sha, Wen Feng-Yun

机构信息

Department of Obstetrics, Jiaozhou Central Hospital of Qingdao, Qingdao 266300, Shandong Province, China.

出版信息

World J Psychiatry. 2025 Jun 19;15(6):105944. doi: 10.5498/wjp.v15.i6.105944.

Abstract

This article comprehensively explores the relationship between anxiety and hypertensive disorders of pregnancy (HDP), covering epidemiology, potential mechanisms, and management strategies. HDP is the second leading cause of maternal and perinatal morbidity and mortality, encompassing subtypes such as gestational hypertension, preeclampsia, and eclampsia. Research indicates that anxiety is closely associated with the occurrence of HDP, potentially influencing blood pressure regulation and vascular function through neuroendocrine, inflammatory, genetic, and gut microbiota effects. Epidemiological data show that anxiety is prevalent during pregnancy and is linked to an increased risk of HDP. Biological mechanism studies reveal that anxiety can increase the risk of HDP by activating the hypothalamic-pituitary-adrenal axis, promoting inflammation, and affecting gut microbiota. In terms of treatment and management, psychological interventions (such as relaxation training, yoga, and mindfulness meditation) and pharmacological treatments (such as labetalol and nifedipine) play important roles in alleviating anxiety and improving the prognosis of HDP. Additionally, multidisciplinary collaboration and long-term postpartum follow-up are crucial for reducing the long-term risk of cardiovascular diseases. Despite significant progress in research on anxiety and HDP, many issues still require further exploration, including in-depth mechanism studies, optimization of clinical interventions, improvement of multidisciplinary collaboration models, long-term follow-up studies, and the impact of cultural and social factors.

摘要

本文全面探讨了焦虑与妊娠期高血压疾病(HDP)之间的关系,涵盖流行病学、潜在机制和管理策略。HDP是孕产妇和围产期发病及死亡的第二大主要原因,包括妊娠期高血压、子痫前期和子痫等亚型。研究表明,焦虑与HDP的发生密切相关,可能通过神经内分泌、炎症、遗传和肠道微生物群等影响来调节血压和血管功能。流行病学数据显示,焦虑在孕期普遍存在,且与HDP风险增加有关。生物学机制研究表明,焦虑可通过激活下丘脑-垂体-肾上腺轴、促进炎症反应和影响肠道微生物群而增加HDP风险。在治疗和管理方面,心理干预(如放松训练、瑜伽和正念冥想)和药物治疗(如拉贝洛尔和硝苯地平)在缓解焦虑和改善HDP预后方面发挥着重要作用。此外,多学科协作和产后长期随访对于降低心血管疾病的长期风险至关重要。尽管在焦虑与HDP的研究方面取得了重大进展,但仍有许多问题需要进一步探索,包括深入的机制研究、临床干预的优化、多学科协作模式的改进、长期随访研究以及文化和社会因素的影响。

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本文引用的文献

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Impact of Stress and Anxiety on Cardiovascular Health in Pregnancy: A Scoping Review.
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Stress-reducing interventions in pregnancy for the prevention of preterm birth: a systematic review and meta-analysis.
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