Effect of aerobic exercise combined with systematic nursing on psychological status and pregnancy outcomes in patients with gestational hypertension.

Am J Transl Res 2025;17(1):612-621 www.ajtr.org /ISSN:1943-8141/AJTR0158745 Original Article Effect of aerobic exercise combined with systematic nursing on psychological status and pregnancy outcomes in patients with gestational hypertension Xiaohong Wang1, Rui Xi2, Wenting Fu3, Nana Zhang4, Mei Wang2 Department of Obstetrical I, Gansu Province Maternal and Child Health Hospital, No. 143 Qilihe North Street, Qilihe District, Lanzhou 730000, Gansu, China; 2Department of Obstetrical, The First Affiliated Hospital of Xi’an Medical University, No. 48 Fenghao West Road, Lianhu District, Xi’an 710000, Shaanxi, China; 3Department of Anesthesia Operating Room I, Gansu Province Maternal and Child Health Hospital, No. 143 Qilihe North Street, Qilihe District, Lanzhou 730000, Gansu, China; 4Department of Obstetrical II, Gansu Province Maternal and Child Health Hospital, No. 143 Qilihe North Street, Qilihe District, Lanzhou 730000, Gansu, China 1 Received June 25, 2024; Accepted January 2, 2025; Epub January 15, 2025; Published January 30, 2025 Abstract: Objective: To assess the effectiveness of aerobic exercise combined with systematic nursing care on the psychological well-being and pregnancy outcomes of patients with gestational hypertension. Methods: A study was conducted on 200 patients with gestational hypertension treated from May 2023 to May 2024. Patients were assigned to an observation group (n=110), which received aerobic exercise and systematic nursing care, or a control group (n=90), which received standard care. Both groups were monitored until delivery. Pre- and post-intervention comparisons included scores for negative emotions, blood pressure, pregnancy outcomes, neonatal weight, Apgar scores, delivery methods, and patient satisfaction with nursing care. The systolic-to-diastolic peak (S/D) ratio in umbilical blood flow and heat shock protein 70 (HSP70) levels were analyzed, with ROC analysis used to evaluate their predictive value for adverse pregnancy outcomes. Logistic regression was employed to identify independent risk factors for low Apgar scores in neonates. Results: Following the intervention, the observation group showed significantly better blood pressure control and greater reductions in negative emotions compared to the control group (both P<0.05). The incidence of adverse pregnancy outcomes was significantly lower, and the rate of vaginal delivery was higher in the observation group (both P<0.05). Patients with adverse outcomes had significantly elevated S/D ratios and serum HSP70 levels (both P<0.05). The area under the ROC curve (AUC) for predicting pregnancy outcomes was 0.733 for the S/D ratio, 0.817 for HSP70, and 0.916 when combined, indicating strong predictive value. Neonates in the observation group had higher birth weights and Apgar scores (both P<0.05). Patient satisfaction with nursing care was also significantly higher in the observation group (P<0.05). Conclusion: Combining aerobic exercise with systematic nursing care is effective in improving psychological health, pregnancy outcomes, quality of life, and patient satisfaction in patients with gestational hypertension. Keywords: Aerobic exercise, systematic nursing care, gestational hypertension, psychological status, pregnancy outcomes Introduction Gestational hypertension is a common obstetric condition associated with factors such as malnutrition, placental ischemia, and genetic predisposition. Clinically, it manifests as elevated blood pressure, generalized edema, and proteinuria, with severe cases potentially progressing to coma, convulsions, and cardiopulmonary dysfunction, posing significant risks to both mother and fetus [1]. The prevalence of hypertension during pregnancy ranges from 5% to 12%, encompassing conditions such as gestational hypertension, preeclampsia-eclampsia, chronic hypertension with superimposed preeclampsia, and pregnancy complicated by chronic hypertension [2]. Hypertension during pregnancy can adversely affect the mother’s brain, kidneys, liver, cardiohttps://doi.org/10.62347/WWPA8609 Exploration of nursing plan for patients with gestational hypertension vascular, endocrine, and metabolic systems. It can also result in decreased placental perfusion due to inadequate remodeling of the uterine spiral arteries, leading to insufficient blood and oxygen supply to the placenta and impaired placental function. This can cause fetal growth restriction, intrauterine distress, therapeutic preterm birth, and even maternal and fetal mortality [3]. Additionally, many patients lack awareness and understanding of gestational hypertension, leading to anxiety and depression, which may further elevate blood pressure, cause heart rate instability, and worsen the condition [4]. Research indicates that alongside effective pharmacological treatment, appropriate interventions such as aerobic exercise and lifestyle modifications can improve the physical and mental well-being of patients with gestational hypertension. These measures help build confidence and determination to manage the condition, thus reducing the incidence of adverse pregnancy outcomes like postpartum hemorrhage, neonatal asphyxia, and eclampsia [5]. However, traditional nursing care often falls short in addressing the anxiety, unease, and depression experienced by pregnant women. The professionalism and attitude of nursing staff are crucial for achieving optimal outcomes [6]. Systematic nursing intervention, a modern patient-centered approach, provides comprehensive care tailored to patients’ needs and has been increasingly applied to conditions such as asthma, essential hypertension, and cardiovascular diseases [7]. It encompasses not only treatment and symptom management but also psychological support, health education, and overall well-being, leading to more organized and efficient nursing practices. This approach improves patient outcomes and quality of life [8]. Previous studies have shown that applying systematic nursing to pregnant women enhances pregnancy outcomes [9], but its impact on gestational hypertension specifically has not been analyzed. In addition to nursing, the patient’s ability to self-manage is also critical. Moderate aerobic exercise can improve circulation and metabolism, while relaxation training can enhance quality of life and alleviate anxiety and depression symptoms [10]. Prior research [11] has demonstrated that even basic exercise inter- 613 ventions can effectively reduce the risk of gestational hypertension. Currently, no studies have evaluated the combined effect of systematic nursing and aerobic exercise on improving psychological status and pregnancy outcomes in patients with gestational hypertension. This study aims to investigate the impact of aerobic exercise combined with systematic nursing care on these outcomes, as reported below. Materials and methods Clinical data A study was conducted on 200 patients with gestational hypertension admitted to Gansu Province Mater (...truncated)