Nesrin Ardahanlı, Rukiye Höbek Akarsu
Lokman Hekim Health Sciences - 2025;5(3):249-259
Hypertensive disorders of pregnancy constitute a significant global public health challenge, contributing substantially to maternal, fetal, and perinatal morbidity and mortality, particularly in low- and middle-income countries.[1-4] Among these disorders, gestational hypertension (GHT) is a prevalent clinical entity characterized by the new onset of systolic blood pressure >=140 mmHg and/or diastolic blood pressure >=90 mmHg, first detected after 20 weeks of gestation in the absence of proteinuria or end-organ dysfunction.[5] Although traditionally approached from a hemodynamic and obstetric perspective, emerging evidence highlights the importance of considering the psychological dimensions of GHT, particularly as they pertain to maternal mental health. Alexithymia, a multidimensional personality construct defined by impairments in identifying, describing, and expressing emotional experiences, has been increasingly implicated in the pathophysiology of various somatic and psychiatric disorders.[6,7] Individuals with alexithymic traits exhibit externally oriented thinking, a diminished capacity for fantasy, and difficulties in distinguishing between affective states and physiological sensations. These features collectively compromise emotional regulation and interpersonal functioning, rendering affected individuals more vulnerable to psychological distress in the context of chronic or acute medical conditions. Several studies in the general population have demonstrated a bidirectional association between hypertension and alexithymia.[8-10] Elevated blood pressure has been associated with increased alexithymic tendencies, while successful antihypertensive treatment appears to mitigate these symptoms. Conversely, alexithymia-related impairments in emotional regulation and autonomic homeostasis may contribute to the development or exacerbation of hypertensive states. Despite these findings, there is a notable paucity of research specifically examining the interplay between alexithymia and GHT, a condition uniquely characterized by both hemodynamic alterations and the psychoneuroendocrine complexities of pregnancy. Furthermore, pregnancy itself represents a physiological state accompanied by significant hormonal fluctuations, emotional lability, and psychosocial stress. Prior research suggests that alexithymia levels may be elevated even among normotensive pregnant women when compared to non-pregnant counterparts, further underscoring the vulnerability of this population to emotional dysregulation.[9,11] The additive burden of gestational hypertension in this context may potentiate these effects, amplifying the risk for adverse maternal mental health outcomes.The present study aims to quantitatively assess alexithymia levels in pregnant women diagnosed with GHT in comparison to normotensive pregnant controls, utilizing the validated 20-item Toronto Alexithymia Scale (TAS-20). By elucidating the emotional and psychological profiles of women with GHT, this investigation seeks to expand the current understanding of the psychosomatic dimension of gestational hypertension. The findings may inform the integration of psychological screening protocols into routine antenatal care, ultimately contributing to more comprehensive and individualized maternal health strategies.
