Peculiarities of micronutrient metabolism in obese pregnant women (literature review)
DOI:
https://doi.org/10.14739/2310-1210.2021.3.203959Keywords:
pregnancy, obesity, deficiency, insufficiency, micronutrients, vitamin D, ferritin, iron, folic acid, magnesium, trace elements, pregnancy complicationsAbstract
Here we summarize uptodate data on the influence of the most significant micro, macroelements, and vitamins, such as magnesium, vitamin D, iron, and folic acid, on the course of pregnancy and childbirth in obese women. The paper considers both domestic and foreign recommendations for correcting nutritional deficiencies to prevent the development of complications from the pregravid stage to the end of lactation.
Nowadays, the deficiency of micro-, macroelements and vitamins is an extremely urgent problem, especially in a group of special risk, i.e. overweight and obese women, whose number is steadily growing simultaneously with an increase of the number of pregnant women of 35+ years of age. It is important to consider a woman's body mass index to prescribe the minimum effective dose of the necessary drugs. Timely preventive personalized correction of the micronutrient state can reduce the risks of such major obstetric syndromes as preeclampsia, premature birth, fetal growth retardation, miscarriage, and placental dysfunction.
References
World Health Organization. (2016). WHO recommendations on antenatal care for a positive pregnancy experience. https://www.who.int/publications/i/item/9789241549912
Medved', V. I., & Gritsai, I. N. (2013). Ozhirenie i beremennost' [Obesity and pregnancy]. Mystetstvo likuvannia, (4), 28-32. [in Russian].
Stevens, G. A., Finucane, M. M., De-Regil, L. M., Paciorek, C. J., Flaxman, S. R., Branca, F., Peña-Rosas, J. P., Bhutta, Z. A., Ezzati, M., & Nutrition Impact Model Study Group (Anaemia). (2013). Global, regional, and national trends in haemoglobin concentration and prevalence of total and severe anaemia in children and pregnant and non-pregnant women for 1995-2011: a systematic analysis of population-representative data. The Lancet. Global Health, 1(1), e16-e25. https://doi.org/10.1016/S2214-109X(13)70001-9
Zhuk, S. I., Pehnio, T. V., & Bykova, O. G. (2014). Zalizodefitsytna anemiia vahitnykh [Iron deficiency anemia is pregnant]. Zdorov'e zhenshchiny, (8), 40-42. [in Ukrainian].
Hrytsulia, M. A. (2020). Taktyka vedennia vahitnykh iz zalizodefitsytnoiu anemiieiu. Osnovni polozhennia rekomendatsii Brytanskoho tovarystva hematolohii [Tactics of managing pregnant women with iron deficiency anemia. The main provisions of the British Society of Hematology recommendations]. Zdorovia Ukrainy, (1. Akusherstvo, Hinekolohiia, Reproduktolohiia), 92-106. [in Ukrainian].
Shikh, E. V., & Bril', Yu. A. (2018). Zhelezodefitsit: katastrofa dlya neirogeneza [Iron deficiency: a disaster for neurogenesis]. StatusPraesens, (5), 82-89. [in Russian].
Daru, J., Colman, K., Stanworth, S. J., De La Salle, B., Wood, E. M., & Pasricha, S. R. (2017). Serum ferritin as an indicator of iron status: what do we need to know? The American Journal of Clinical Nutrition, 106(Suppl. 6), 1634S-1639S. https://doi.org/10.3945/ajcn.117.155960
Boychuk, A. V., Budnik, T. O., & Boyarchuck, O. R. (2016). Otsinka zabezpechennia vahitnykh zhinok vitaminom D i kaltsiiem za rezultatamy opytuvannia [Assesment of vitamin D and calcium dietary intakes by pregnant women: survey results]. Problemy osteolohii, 19(3-4), 17-20. [in Ukrainian].
Tatarchuk, T. F., Deyniuk, K. D., Zanko, O. V., Yusko, T. I., & Tarnopolska, V. O. (2018). Vitamin D-defitsytni stany v genezi porushen reproduktyvnoho zdorovia zhinky [Vitamin D-deficiency states in the genesis of woman reproductive health disorders]. Reproduktyvna endokrynolohiia, (3), 84-94. [in Ukrainian].
Povorozniuk, V. V., & Balatska, N. I. (2012). Defitsyt vitaminu D u naselennia Ukrainy ta faktory ryzyku yoho rozvytku [Vitamin D deficiency in the population of Ukraine and risk factors for its development]. Bil. Suhloby. Khrebet, (4), 7-13. http://www.mif-ua.com/archive/article/34626 [in Ukrainian].
Manasova, G. S., Andrievsky, A. G., Didenkul, N. V., Shpak, I. V., Turchyn, M. I., & Kuzmin, N. V. (2020). Role of the hormonal system “Vitamin D/Vitamin D receptors” in the formation of some pregnancy complications. Reproduktyvna endokrynolohiia, (1), 65-68. https://doi.org/10.18370/2309-4117.2020.51.65-68
De-Regil, L. M., Palacios, C., Lombardo, L. K., & Peña-Rosas, J. P. (2016). Vitamin D supplementation for women during pregnancy. Cochrane Database of Systematic Reviews, (1), Article CD008873. https://doi.org/10.1002/14651858.CD008873.pub3
Pigarova, E. A., Rozhinskaya L. Ya., Belaya, Zh. E., Dzeranova, L. K., Karonova, T. L., Ilyin, A. V., Melnichenko, G. A., & Dedov, I. I. (2016). Klinicheskie rekomendatsii Rossiiskoi assotsiatsii endokrinologov po diagnostike, lecheniyu i profilaktike defitsita vitamina D u vzroslykh [Russian Association of Endocrinologists recommendations for diagnosis, treatment and prevention of vitamin D deficiency in adults]. Problemy endokrinologii, 62(4), 60-84. https://doi.org/10.14341/probl201662460-84 [in Russian].
Boychuk, A. V., & Budnik, T. O. (2018). N Nadkhodzhennia vitaminu D ta kaltsiiu u vahitnykh zhinok [Suppressing vitamin d and calcium in pregnant women]. Zbirnyk naukovykh prats asotsiatsii akusheriv-hinekolohiv Ukrainy, (1), 26-30. https://doi.org/10.35278/2664-0767.1(41).2018.171307 [in Ukrainian].
Bulavenko, O. V., Tatarchuk, T. F., Konkov, D. G., & Furman, O. V. (2018). Suchasni stratehii klinichnoho menedzhmentu defitsytu vitaminu D u praktytsi akushera-hinekoloha [The modern strategies of clinical management of vitamin d deficiency in practices of the obstetrician gynecologist]. Reproduktyvna endokrynolohiia, (1), 38-44. https://doi.org/10.18370/2309-4117.2018.39.38-44 [in Ukrainian].
Tatarchuk, T. F., Bulavenko, O. V., Kapshuk, I. M., & Tarnopolskaya, V. O. (2015). Nedostatnist vitaminu D v henezi porushen reproduktyvnoho zdorovia [Vitamin D deficiency in the genesis of reproductive health disorders]. Ukrainskyi medychnyi chasopys, (5), 56-61. [in Ukrainian].
McDonnell, S. L., Baggerly, K. A., Baggerly, C. A., Aliano, J. L., French, C. B., Baggerly, L. L., Ebeling, M. D., Rittenberg, C. S., Goodier, C. G., Mateus Niño, J. F., Wineland, R. J., Newman, R. B., Hollis, B. W., & Wagner, C. L. (2017). Maternal 25(OH)D concentrations ≥40 ng/mL associated with 60% lower preterm birth risk among general obstetrical patients at an urban medical center. PLOS ONE, 12(7), Article e0180483. https://doi.org/10.1371/journal.pone.0180483
Andersen, L. B., Jørgensen, J. S., Jensen, T. K., Dalgård, C., Barington, T., Nielsen, J., Beck-Nielsen, S. S., Husby, S., Abrahamsen, B., Lamont, R. F., & Christesen, H. T. (2015). Vitamin D insufficiency is associated with increased risk of first-trimester miscarriage in the Odense Child Cohort. The American Journal of Clinical Nutrition, 102(3), 633-638. https://doi.org/10.3945/ajcn.114.103655
Korchinska, O. O., & Loya, N. O. (2018). Rol defitsytu vitaminu D u vynyknenni akusherskykh ta perynatalnykh uskladnen (Ohlyad literatury) [Role of vitamin D deficiency in the development obstetric and perinatal complications (Literature review)]. Zdorov'e zhenshchiny, (5), 93-96. [in Ukrainian].
Zhang, M. X., Pan, G. T., Guo, J. F., Li, B. Y., Qin, L. Q., & Zhang, Z. L. (2015). Vitamin D Deficiency Increases the Risk of Gestational Diabetes Mellitus: A Meta-Analysis of Observational Studies. Nutrients, 7(10), 8366-8375. https://doi.org/10.3390/nu7105398
Bodnar, L. M., Krohn, M. A., & Simhan, H. N. (2009). Maternal Vitamin D Deficiency Is Associated with Bacterial Vaginosis in the First Trimester of Pregnancy. The Journal of Nutrition, 139(6), 1157-1161. https://doi.org/10.3945/jn.108.103168
Chekman, I. S., Gorchakova, N. A., Berezhniy, V. V., Davydiuk, A. V., & Roman'ko, M. R. (2017). Farmakolohiya vitaminu D [Pharmacology of vitamin D]. Sovremennaya pediatriya, (2), 28-36. https://doi.org/10.15574/SP.2017.82.28 [in Ukrainian].
Absatarova, J. S., & Andreeva, E. N. (2014). Rol' vitamina D i melatonina v patogeneze sindroma polikistoznykh yaichnikov [The role of vitamin D and melatonin in the pathogenesis of polycystic ovary syndrome]. Ozhirenie i metabolizm, (1), 20-23. [іn Russian].
Maltseva, L. I., Vasilyeva, E. N., Denisova, T. G., & Gerasimova, L. I (2017). Obespechennost' vitaminom D i korrektsiya ego defitsita pri beremennosti [Provision with vitamin D and correction of its deficit during pregnancy]. Prakticheskaya meditsina, (5), 18-21. [іn Russian].
Holick, M. F., Binkley, N. C., Bischoff-Ferrari, H. A., Gordon, C. M., Hanley, D. A., Heaney, R. P., Murad, M. H., Weaver, C. M., & Endocrine Society (2011). Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline. The Journal of clinical endocrinology and metabolism, 96(7), 1911-1930. https://doi.org/10.1210/jc.2011-0385
Komisarenko, Y. I., Bobrik, M. I., Sidorova, I. V., & Burka O. A. (2014). Vitamin D: potentsial klinichnykh rishen u praktytsi likaria [Vitamin D: potential clinical decisions in doctor practice]. Reproductive endocrinology, (6), 105-108. [in Ukrainian].
Khyts, A. R. (2020). Menedzhment patsiientiv z ozhyrinniam: rekomendatsii Yevropeiskoho tovarystva endokrynolohii (European Society of Endocrinology – ESE) [Management of obese patients: recommendations of the European Society of Endocrinology (ESE)]. Ukrainskyi medychnyi chasopys, (1), 48-50. [in Ukrainian].
Shilin, D. E., & Spirichev, V. B. (2006). Mineral'nyi gomeostaz i kostnyi metabolizm v organizme beremennoi, ploda, rebenka [Mineral homeostasis and bone metabolism in the body of a pregnant woman, fetus, child] Osteoporoz i osteopatii, (2), 26-32. [in Russian].
Mazur, I. P., Tatarchuk, T. F., & Gabal, V. A. (2016). Mineral'nyi obmen pri beremennosti i ego adekvatnaya korrektsiya [Mineral metabolism at pregnancy and its adequate correction]. Reproductive endocrinology, (1), 36-39. [in Russian]. https://doi.org/10.18370/2309-4117.2016.27.36-40
Shurpyak, S. A., & Zhemela, N. I. (2014). Rol' balansa mikroelementov i vitaminov v obespechenii gestatsionnogo protsessa [The role of trace elements and vitamins balance in ensuring the gestational process]. Zdorov'e zhenshchiny, (5), 37-40. [in Russian].
Zhabchenko, I. A. (2019). Suchasnyi pohliad na rol folativ u profilaktytsi perynatalnykh problem (ohliad literatury) [Modern view of the role of folate in prophylaxis of perinatal problems (Literature review)]. Reproductive endocrinology, (2), 57-61. [in Ukrainian].
de Batlle, J., Ferrari, P., Chajes, V., Park, J. Y., Slimani, N., McKenzie, F., Overvad, K., Roswall, N., Tjønneland, A., Boutron-Ruault, M. C., Clavel-Chapelon, F., Fagherazzi, G., Katzke, V., Kaaks, R., Bergmann, M. M., Trichopoulou, A., Lagiou, P., Trichopoulos, D., Palli, D., Sieri, S., … Romieu, I. (2014). Dietary folate intake and breast cancer risk: European prospective investigation into cancer and nutrition. Journal of the National Cancer Institute, 107(1), 367. https://doi.org/10.1093/jnci/dju367
Zaichenko, H. V., Pedachenko, N. Yu., & Zhabchenko, I. A. (2019). Debaty pro folaty: pohliad farmakoloha ta akushera-hinekoloha [Debate on folate: the view of a pharmacologist and obstetrician-gynecologist]. Zdorovʼia Ukrainy, (2), 3-4. [in Ukrainian].
Michels, K. A., Wactawski-Wende, J., Mills, J. L., Schliep, K. C., Gaskins, A. J., Yeung, E. H., Kim, K., Plowden, T. C., Sjaarda, L. A., Chaljub, E. N., & Mumford, S. L. (2017). Folate, homocysteine and the ovarian cycle among healthy regularly menstruating women. Human reproduction, 32(8), 1743-1750. https://doi.org/10.1093/humrep/dex233
Radzinskii, V. E., Ryabinkina, T. S., & Raevskaya, O. A. (2017). Tekhnogennyi otbor [Technogenic selection]. Status Praesens. Ginekologiya, akusherstvo, besplodnyi brak, (5), 103-111. [in Russian].
Radzinskii, V. E., Bril', Yu. A., & Makletsova, S. A. (2017). Tol'ko samoe neobkhodimoe! [Only the essentials!]. Status Praesens. Ginekologiya, akusherstvo, besplodnyi brak, (6), 111-119. [in Russian].
Zaichenko, A. V. (2018). Folaty i omega-3-PNZhK v akusherstve: bol'she chem profilaktika defektov nervnoi trubki [Folate and omega-3-polyunsaturated fatty acids in obstetrics: more than prevention of neural tube defects]. Zdorovia Ukrainy. Hinekolohiia. Akusherstvo. Reproduktolohiia, (1), 1-4. [in Russian].
Ordiyants, І. M., & Bril', Yu. A. (2020). Potentsial mikronutrientnoi podderzhki beremennykh v profilaktike akusherskikh i perinatal'nykh riskov [The potential of micronutrient support for pregnant women in the prevention of obstetric and perinatal risks]. Status Praesens. Ginekologiya, akusherstvo, besplodnyi brak, (2/3), 42-51. [in Russian].
Ministry of Health of Ukraine. (2011, July 15). Pro orhanizatsiiu ambulatornoi akushersko-hinekolohichnoi dopomohy v Ukraini. Nakaz MOZ Ukrainy № 417 vid 16.07.2011 r. [About the organization of outpatient obstetric and gynecological care in Ukraine (No. 417)]. https://zakon.rada.gov.ua/rada/show/v0417282-11
Shurpyak, S. A. (2019). Vedenie zhenshchin s ozhireniem pri beremennosti. Green-top Guideline No. 72 (2018) [Management of obese women during pregnancy Green-top Guideline No. 72 (2018)]. Zdorov'e zhenshchiny, (2), 104-121.
Radzinskii, V. E., Pustotina, O. A., Verizhnikova, E. V., Dikke, G. B., Ilovaiskaya, I. A., Kurmacheva, N. A., Makletsova, S. A., Maksimova, Yu. V, & Simonovskaya, Kh. Yu. (2016). Pregravidarnaya podgotovka : klinicheskii protokol [Pre-pregnancy preparation: clinical protocol]. Moscow: Editorial Board of StatusPraesens. http://rpc03.ru/wp-content/uploads/2016/09/Pregravidarnaja-podgotovka.compressed.pdf [in Russian].
Moussa, H. N., Hosseini Nasab, S., Haidar, Z. A., Blackwell, S. C., & Sibai, B. M. (2016). Folic acid supplementation: what is new? Fetal, obstetric, long-term benefits and risks. Future science OA, 2(2), FSO116. https://doi.org/10.4155/fsoa-2015-0015
Babak, S. I., Krotiuk, T. F., & Halushko, O. A. (2017). Porushennia vodno-elektrolitnoho balansu ta yikh korektsiia [Violation of water-electrolyte balance and their correction]. Hostri na nevidkladni stany v praktytsi likaria, (5-6), 21-24. [in Ukrainian].
Tetruashvili, N. K., Gromova, O. A., & Serov, V. N. (2012). Ispol'zovanie tsitrata magniya pozvolyaet osushchestvlyat' profilaktiku prezhdevremennykh rodov u beremennykh s vysokim riskom nevynashivaniya [The use of magnesium citrate allows the prevention of premature birth in pregnant women at high risk of miscarriage]. Mat' i ditya, (17), 846. [in Russian].
Torshin, I. Iu., Gromova, O. A., Sukhikh, G. T., & Rudakov K. V. (2008). Molekulyarnye mekhanizmy regulyatsii magniem platsentarnykh belkov [Molecular mechanisms of magnesium regulation of placental proteins]. Rossiiskii vestnik akushera-ginekologa, 8(6), 9-16. [in Russian].
Gromova, O. A., Torshin, I. Iu., Tetruashvili, N. K., & Rudakov, K. V. (2009). Magnii i trombofiliya beremennykh: molekulyarnye mekhanizmy i dokazatel'naya meditsina [Magnesium and thrombophilia in pregnant women: molecular mechanisms and evidence-based medicine]. Rossiiskii vestnik akushera-ginekologa, 9(6), 75-80. [in Russian].
Dadak, K., Makatsariya, A. D., Blinov, D. V., & Zimovina, U. V. (2014). Klinicheskie i biokhimicheskie aspekty primeneniya preparatov magniya v akusherstve, ginekologii i perinatologii [Clinical and biochemical aspects of the use of magnesium in obstetrics, gynecology and perinatology]. Akusherstvo. Ginekologiya. Reproduktsiya, 8(2), 69-78. [in Russian].
Gromova, O. A., Fedotova, L. E., Grishina, T. R., Torshin, I. Y., Kalacheva, A. G., & Limanova, O. A. (2014). Rol' magniya v formirovanii metabolicheskogo sindroma, korrektsii izbytochnogo vesa i ozhireniya u detei i podrostkov [The role of magnesium in the formation of metabolic syndrome, correction of overweight and obesity in children and adolescents]. Pediatrics, 93(2), 123-133. [in Russian].
Shilov, A. M., Mel'nik, M. V., Osiya, A. O., Sviridova, A. Yu., & Gryaznov, D. A. (2008). Rol' defitsita magniya v patogeneze metabolicheskogo sindroma [The role of magnesium deficiency in the pathogenesis of metabolic syndrome]. Russkii meditsinskii zhurnal, 16(21), 1439-1444. [in Russian].
Kosheleva, N. G., & Nikologorskaya, E. V. (2010, December 1). Profilakticheskoe primenenie Magne-V6 u beremennyh zhenshchin s arterial'noj gipertoniej i ozhireniem, stradayushchih nevynashivaniem beremennosti [Prophylactic use of Magne-B6 in pregnant women with hypertension and obesity, suffering from miscarriage]. Medi.ru. Podrobno o lekarstvakh. [in Russian]. Retrieved from https://medi.ru/info/2179
Downloads
Published
How to Cite
Issue
Section
License
Authors who publish with this journal agree to the following terms:- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access)