New trends in nutritional support for pregnancy
Objective. To analyze the role of specialized vitamin and mineral supplements (VMSs) in supporting pregnancy women on the basis of published meta-analyses and clinical trials.Gromova O.A., Torshin I.Yu., Tetruashvili N.K., Limanova O.A.
Material and methods. Relevant publications over the last decade were selected in the Science Citation Database PubMed and additionally in Google Scholar.
Results. There is a positive trend in giving up less digestible and, in some cases, more toxic inorganic forms of micronutrients for more highly bioavailable ones. The equally important features are the use of biologically active forms of micronutrients and the increasing intake of omega-3 polyunsaturated fatty acids in the composition of VMSs for pregnant women.
Conclusion. The use of highly bioavailable VMSs by pregnant women allows primary prevention of fetal malformations. The presence of omega-3 polyunsaturated fatty acids in VMSs reduces the risk of visual dysfunctions and perinatal encephalopathy in the fetus.
Keywords
nutritional support of pregnancy
prevention of birth defects
lipofur
methylphosphoric acid
docosahexaenoic acid
pregnoton mom
Supplementary Materials
References
1. Цейцель Э. Первичная профилактика врожденных дефектов: поливитамины или фолиевая кислота? Гинекология. 2012; 14(5): 38-46. [Tseitsel E. Primary prevention of birth defects: multivitamins or folic acid? Ginekologiya. 2012; 14(5): 38-46. (in Russian)]
2. Махова А.А., Максимов М.Л. Коррекция витаминного статуса у беременных. РМЖ. 2014; 22(14): 1014-8. [Makhova A.A., Maksimov M.L. Correction of vitamin status in pregnant women. Russian Medical Journal. 2014; 22 (14): 1014-8. (in Russian)]
3. Торшин И.Ю., Гусев Е.И., Громова О.А., Калачева А.Г., Рудаков К.В. Мировой опыт изучения эффектов омега-3 полиненасыщенных жирных кислот: влияние на когнитивный потенциал и некоторые психические расстройства. Журнал неврологии и психиатрии им. С.С.Корсакова. 2011; 111(11): 79-86. [Torshin I.Yu., Gusev E.I., Gromova O.A., Kalacheva A.G., Rudakov K.V. World experience of studying the effects of omega-3 polyunsaturated fatty acids: the effect on cognitive potential and some mental disorders. S.S. Korsakov Journal of Neurology and Psychiatry. 2011; 111(11): 79-86. (in Russian)]
4. Громова О.А., Торшин И.Ю., Лиманова О.А. Омега-3 полиненасыщенные жирные кислоты и активные фолаты: перспективы комплексного применения для нутрициальной поддержки беременности и профилактики пороков развития (литературный обзор). Гинекология. 2013; 15(2): 71-7. [Gromova O.A., Torshin I.Yu., Limanova O.A. Omega-3 polyunsaturated fatty acids and active folates: perspectives of complex use for nutritional support of pregnancy and prevention of developmental defects (literary review). Ginekologiya. 2013; 15 (2): 71-7. (in Russian)]
5. Feng Y., Wang S., Chen R., Tong X., Wu Z., Mo X. Maternal folic acid supplementation and the risk of congenital heart defects in offspring: a meta-analysis of epidemiological observational studies. Sci. Rep. 2015; 5: 8506.
6. Громова О.А., Лиманова О.А., Керимкулова Н.В., Торшин И.Ю., Рудаков К.В. Дозирование фолиевой кислоты до, во время и после беременности: все точки над „i”. Акушерство и гинекология. 2014; 6: 88-95. [Gromova O.A., Limanova O.A., Kerimkulova N.V., Torshin I.Yu., Rudakova K.V. Folic acid dosage before, during, and after pregnancy: to dot the i’s and cross the t’s. Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2014; 6: 88-95. (in Russian)]
7. Pietrzik K., Bailey L., Shane B. Folic acid and L-5-methyltetrahydrofolate comparison of clinical pharmacokinetics and pharmacodynamics. Clin. Pharmacokinet. 2010; 49(8): 535-48.
8. Prinz-Langenohl R., Brämswig S., Tobolski O., Smulders Y.M., Smith D.E., Finglas P.M., Pietrzik K. [6S]-5-methyltetrahydrofolate increases plasma folate more effectively than folic acid in women with the homozygous or wild-type 677C-->T polymorphism of methylenetetrahydrofolate reductase. Br. J. Pharmacol. 2009; 158(8): 2014-21.
9. Лиманова О.А., Торшин И.Ю., Сардарян И.С., Калачева А.Г., Hababpashev A., Karpuchin D., Kudrin A., Юдина Н.В., Егорова Е.Ю., Белинская А.Ю., Гришина Т.Р., Громов А.Н., Федотова Л.Э., Рудаков К.В., Громова О.А. Обеспеченность микронутриентами и женское здоровье: интеллектуальный анализ клинико-эпидемиологических данных. Вопросы гинекологии, акушерства и перинатологии. 2014; 13(2): 5-15. [Limanova O.A., Torshin I.Yu., Sardaryan I.S., Kalacheva A.G., Hababpashev A., Karpuchin D., Kudrin A., Yudina N.V., Egorova E.Yu., Belinskaya A.Yu., Grishina T.R., Gromov A.N., Fedotova L.E., Rudakov K.V., Gromova O.A. Micronutrient supply and women’s health: intellectual analysis of clinical and epidemiological data. Voprosyi ginekologii, akusherstva i perinatologii. 2014; 13(2): 5-15. (in Russian)]
10. Громова О.А., Торшин И.Ю. Витамины и минералы: между Сциллой и Харибдой: о мисконцепциях и других чудовищах. М.: МЦНМО; 2013. 764с. [Gromova O.A., Torshin I.Yu. Vitamins and minerals: between Scylla and Charybdis: about misconceptions and other monsters. Мoscow: МЦНМО; 2013. 764p. (in Russian)]
11. Serhan C.N., Chiang N., Dalli J. The resolution code of acute inflammation: Novel pro-resolving lipid mediators in resolution. Semin. Immunol. 2015; 27(3): 200-15.
12. Makrides M., Best K. Docosahexaenoic acid and preterm birth. Ann. Nutr. Metab. 2016; 69(1): 29-34.
13. Makrides M., Duley L., Olsen Sjurdur F. Marine oil, and other prostaglandin precursor, supplementation for pregnancy uncomplicated by preeclampsia or intrauterine growth restriction. Cochrane Database Syst. Rev. 2006; (3): CD003402.
14. Harris M.A., Reece M.S., McGregor J.A., Wilson J.W., Burke S.M., Wheeler M. et al. The effect of Omega-3 docosahexaenoic acid supplementation on gestational length: randomized trial of supplementation compared to nutrition education for increasing n-3 intake from foods. Biomed. Res. Int. 2015; 2015: 123078.
15. Carvajal J.A. Docosahexaenoic acid supplementation early in pregnancy may prevent deep placentation disorders. Biomed. Res. Int. 2014; 2014: 526895.
16. Pietrantoni E., Del Chierico F., Rigon G., Vernocchi P., Salvatori G., Manco M. et al. Docosahexaenoic acid supplementation during pregnancy: a potential tool to prevent membrane rupture and preterm labor. Int. J. Mol. Sci. 2014; 15(5): 8024-36.
17. Kar S., Wong M., Rogozinska E., Thangaratinam S. Effects of omega-3 fatty acids in prevention of early preterm delivery: A systematic review and meta-analysis of randomized studies. Eur. J. Obstet. Gynecol. Reprod. Biol. 2016; 198: 40-6.
18. Ismail A.M., Ramadan M.F., Ali M.K., Abbas A.M., El Saman A.M., Makarem M.H. A randomized controlled study of the efficacy of 4 weeks of supplementation with ω-3 poly-unsaturated fatty acids in cases of unexplained oligohydramnios. J. Perinatol. 2016; 36(11): 944-7.
19. Pinto T.J., Vilela A.A., Farias D.R., Lepsch J., Cunha G.M., Vaz J.S. et al. Serum n-3 polyunsaturated fatty acids are inversely associated with longitudinal changes in depressive symptoms during pregnancy. Epidemiol. Psychiatr. Sci. 2017; 26(2): 157-68.
20. Gunaratne A.W., Makrides M., Collins C.T. Maternal prenatal and/or postnatal n-3 long chain polyunsaturated fatty acids (LCPUFA) supplementation for preventing allergies in early childhood. Cochrane Database Syst. Rev. 2015; (7): CD010085.
21. Scaglione F., Panzavolta G. Folate, folic acid and 5-methyltetrahydrofolate are not the same thing. Xenobiotica. 2014; 44(5): 480-8.
22. Ребров В.Г., Громова О.А. Витамины, макро- и микроэлементы. М.: ГЭОТАР-Медиа; 2008. 867с. [Rebrov V.G., Gromova O.A. Vitamins, macro and microelements. Moscow: GEOTAR-Media; 2008. 867p. (in Russian)]
23. Robitaille J., Carmichael S.L., Shaw G.M., Olney R.S.; National Birth Defects Prevention Study. Maternal nutrient intake and risks for transverse and longitudinal limb deficiencies: data from the National Birth Defects Prevention Study, 1997-2003. Birth Defects Res. A Clin. Mol. Teratol. 2009;85(9): 773-9.
24. Neugebauer J., Zanré Y., Wacker J. Riboflavin supplementation and preeclampsia. Int. J. Gynaecol. Obstet. 2006; 93(2): 136-7.
25. Smedts H.P., Rakhshandehroo M., Verkleij-Hagoort A.C., de Vries J.H., Ottenkamp J., Steegers E.A., Steegers-Theunissen R.P. Maternal intake of fat, riboflavin and nicotinamide and the risk of having offspring with congenital heart defects. Eur. J. Nutr. 2008; 47(7): 357-65.
26. Бекетова Н.А., Коденцова В.М., Абрамова Т.В., Сокольников А.А., Гмошинская М.В., Кошелева О.В., Переверзева О.Г., Вржесинская О.А., Карагулян О.Р. Витаминный статус беременных женщин, проживающих в московском регионе: влияние приема витаминно-минеральных комплексов. Фарматека. 2017; 3: 41-5. [Beketova N.A., Kodentsova V.M., Abramova T.V., Sokolnikov A.A., Gmoshinskaya M.V., Kosheleva O.V., Pereverzeva O.G., Vrshesinskaya O.A., Karagulian O.R. Vitamin status of pregnant women living in the Moscow region: the influence of vitamin and mineral complexes. Farmateka. 2017; 3: 41-5. (in Russian)]
27. Salam R.A., Zuberi N.F., Bhutta Z.A. Pyridoxine (vitamin B6) supplementation during pregnancy or labour for maternal and neonatal outcomes. Cochrane Database Syst. Rev. 2015; (6): CD000179.
28. Mock D.M. Biotin: from nutrition to therapeutics. J. Nutr. 2017; 147(8): 1487-92.
29. Finkelstein J.L., Layden A.J., Stover P.J. Vitamin B-12 and perinatal health. Adv. Nutr. 2015; 6(5): 552-63.
30. Grainger R.B., O’dell B.L., Hogan A.G. Congenital malformations as related to deficiencies of riboflavin and vitamin B12, source of protein, calcium to phosphorus ratio and skeletal phosphorus metabolism. J. Nutr. 1954; 54(1): 33-48.
31. Deshmukh U., Katre P., Yajnik C.S. Influence of maternal vitamin B12 and folate on growth and insulin resistance in the offspring. Nestle Nutr. Inst. Workshop Ser. 2013; 74: 145-54; discussion 154-6.
32. Громова О.А., Торшин И.Ю., Тетруашвили Н.К. Витамины и микроэлементы в профилактике малых пороков развития. Акушерство и гинекология. 2017; 8: 10-20. [Gromova O.A., Torshin I.Yu., Tetruashvili N.K. Vitamins and trace elements in the prevention of minor malformations. Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2017; (8): 10-20. (in Russian) http://dx.doi.org/10.18565/aig.2017.8.10-20]
33. Ota E., Mori R., Middleton P., Tobe-Gai R., Mahomed K., Miyazaki C., Bhutta Z.A. Zinc supplementation for improving pregnancy and infant outcome. Cochrane Database Syst. Rev. 2015; (2): CD000230.
34. Peña-Rosas J.P., De-Regil L.M., Dowswell T., Viteri F.E. Daily oral iron supplementation during pregnancy. Cochrane Database Syst. Rev. 2012; (12): CD004736.
35. Протопопова Т.А. Железодефицитная анемия и беременность. РМЖ. 2012; 20(17): 862-6. [Protopopova T.A. Iron deficiency anemia and pregnancy. Russian Medical Journal. 2012; 20 (17): 862-6. (in Russian)]
36. Blanco-Rojo R., Pérez-Granados A.M., Toxqui L., González-Vizcayno C., Delgado M.A., Vaquero M.P. Efficacy of a microencapsulated iron pyrophosphate-fortified fruit juice: a randomised, double-blind, placebo-controlled study in Spanish iron-deficient women. Br. J. Nutr. 2011; 105(11): 1652-9.
37. Pisani A., Riccio E., Sabbatini M., Andreucci M., Del Rio A., Visciano B. Effect of oral liposomal iron versus intravenous iron for treatment of iron deficiency anaemia in CKD patients: a randomized trial. Nephrol. Dial. Transplant. 2015; 30(4): 645-52.
38. Rogan W.J., Paulson J.A., Baum C., Brock-Utne A.C., Brumberg H.L., Campbell C.C. et al.; Council on Environmental Health. Iodine deficiency, pollutant chemicals, and the thyroid: new information on an old problem. Pediatrics. 2014; 133(6): 1163-6.
39. Reynolds A.N., Skeaff S.A. Maternal adherence with recommendations for folic acid and iodine supplements: A cross-sectional survey. Aust. N. Z. J. Obstet. Gynaecol. 2017; Oct 9.
40. Rumbold A., Ota E., Hori H., Miyazaki C., Crowther C.A. Vitamin E supplementation in pregnancy. Cochrane Database Syst. Rev. 2015; (9): CD004069.
41. De-Regil L.M., Palacios C., Lombardo L.K., Peña-Rosas J.P. Vitamin D supplementation for women during pregnancy. Cochrane Database Syst. Rev. 2016; (1): CD008873.
42. Rumbold A., Ota E., Nagata C., Shahrook S., Crowther C.A. Vitamin C supplementation in pregnancy. Cochrane Database Syst. Rev. 2015; (9): CD004072.
43. Head K.A. Natural approaches to prevention and treatment of infections of the lower urinary tract. Altern. Med. Rev. 2008; 13(3): 227-44.
44. Rayman M.P., Searle E., Kelly L., Johnsen S., Bodman-Smith K., Bath S.C. et al. Effect of selenium on markers of risk of pre-eclampsia in UK pregnant women: a randomised, controlled pilot trial. Br. J. Nutr. 2014;112(1): 99-111.
45. Mokhber N., Namjoo M., Tara F., Boskabadi H., Rayman M.P., Ghayour-Mobarhan M. et al. Effect of supplementation with selenium on postpartum depression: a randomized double-blind placebo-controlled trial. J. Matern. Fetal Neonatal Med. 2011; 24(1): 104-8.
Received 08.12.2017
Accepted 22.12.2017
About the Authors
Gromova Olga Alekseevna, MD, professor of Ivanovo State Medical Academy.153000, Russia, Ivanovo, Sheremetiev pr. 8. Tel.: +74932301766. E-mail: unesco.gromova@gmail.com
Torshin Ivan Yurievich, candidate of physic-mathematical sciences, associate professor, Moscow Institute of Physics and Technology.
141700, Russia, Moscow Region, Dolgoprudny, Institutsky pereulok, 9. Tel.: +74991352489, +74932416525
Tetruashvili Nana Kartlosovna, Doctor of Medicine, Head of the Department of Pregnancy Loss Prevention and Therapy, Research Center for Obstetrics,
Gynecology and Perinatology, Ministry of Health of Russia. 117997, Russia, Moscow, Ac. Oparina str. 4. Tel.: +74954381183. E-mail: tetrauly@mail.ru
Limanova Olga Adolfovna, PhD, associate professor, Department of Pharmacology and Clinical Pharmacology, Ivanovo State Medical Academy,
Ministry of Health of Russia. 153000, Russia, Ivanovo, Sheremetiev pr. 8
For citations: Gromova O.A., Torshin I.Yu., Tetruashvili N.K., Limanova O.A.
New trends in nutritional support for pregnancy. Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2018; (1): 21-8. (in Russian)
https://dx.doi.org/10.18565/aig.2018.1.21-28
Similar Articles
