On the prospects of using vitamins and minerals in the prevention of early pregnancy losses

DOI

https://dx.doi.org/10.18565/aig.2021.4.12-22

Gromova O.A., Torshin I.Yu., Tetruashvili N.K., Baranov I.I., Gorodnova E.A., Kodentsova V.M., Kogan I.Yu., Tapilskaya N.I., Yarmolinskaya M.I., Bashmakova N.V., Mozgovaya E.V., Grishina T.R., Lapochkina N.P., Galustyan A.N.
1) Institute of Pharmacoinformatics, Federal Research Center “Informatics and Management”, Russian Academy of Sciences, Moscow, Russia; 2) Center of Big Data Storage and Analysis, M.V. Lomonosov Moscow State University, Moscow, Russia; 3) Academician V.I. Kulakov Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia, Moscow, Russia; 4) Federal Research Center for Nutrition, Biotechnology, and Food Safety, Moscow, Russia; 5) D.O. Ott Research Institute of Obstetrics, Gynecology, and Reproductology, Saint Petersburg, Russia; 6) I.I. Mechnikov North-Western State Medical University, Saint Petersburg, Russia; 7) Ural Research Institute of Maternal and Infant Care, Ministry of Health of Russia, Yekaterinburg, Russia; 8) Ivanovo State Medical Academy, Ministry of Health of Russia, Ivanovo, Russia; 9) Saint Petersburg State Pediatric Medical University, Ministry of Health of Russia, Saint Petersburg, Russia

The pathophysiology of sporadic miscarriage in early pregnancy is complex and includes chromosomal defects, thrombotic disorders, and elevated chronic systemic inflammation levels in particular. The associations between hypovitaminoses, dysmicroelementoses, and the pathophysiology of thrombophilia and chronic inflammation point to the promise for replenishing vitamin and mineral deficiencies to lower the risk of early pregnancy losses (EPL). The paper presents the results of fundamental and clinical studies of the relationship between reproductive losses and the provision of patients with vitamins B9, D, E, B12, folate, iron, selenium, zinc, magnesium, and omega-3 polyunsaturated fatty acids (PUFAs). In order to prevent EPL, vitamin E mono-preparations are not recommended for administration especially in large doses during pregnancy. In women with unexplained EPL, vitamin D3 deficiency (at serum 25(OH)D3 concentration less than 30 ng/ml) should be compensated, since the low vitamin D status reduces the effects of progesterone, increases the risk of thrombogenesis and inflammation, and is associated with a decrease in regulatory T-lymphocytes. In order to prevent spontaneous abortion, it is optimal to take multicomponent vitamin and mineral complexes. Vitamin D deficiency is most effectively compensated with a combination of vitamins A, C, B1, B2, B5, B6, B9, and omega-3 PUFAs.
Conclusion. Vitamin and micronutrient deficiencies in women with EPL are an urgent problem in obstetrics. Compensation of micronutrient deficiencies is a pathophysiological approach to reducing the risk of EPL.

early pregnancy loss

risk groups

evidence-based medicine

micronutrients

Full text (in Russian)

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Rumbold A., Middleton P., Pan N., Crowther C.A. Vitamin supplementation for preventing miscarriage. Cochrane Database Syst. Rev. 2011; (1): CD004073. https://dx.doi.org/10.1002/14651858.CD004073.pub3.
Ou H., Yu Q. Efficacy of aspirin, prednisone, and multivitamin triple therapy in treating unexplained recurrent spontaneous abortion: A cohort study. Int. J. Gynaecol. Obstet. 2020; 148(1): 21-6. https://dx.doi.org/10.1002/ijgo.12972.
Ou H., Yu Q. Effects of combination therapy with aspirin, prednisone, and Elevit in patients with unexplained recurrent early pregnancy loss. Zhonghua Yi Xue Za Zhi. 2017; 97(41): 3250-4. https://dx.doi.org/10.3760/cma.j.issn.0376-2491.2017.41.011.
Hamidian S., Talebi A.R., Fesahat F., Bayat M., Mirjalili A.M., Ashrafzadeh H.R. et al. The effect of vitamin C on the gene expression profile of sperm protamines in the male partners of couples with recurrent pregnancy loss: A randomized clinical trial. Clin. Exp. Reprod. Med. 2020; 47(1): 68-76. https://dx.doi.org/10.5653/cerm.2019.03188.

Received 13.04.2021

Accepted 19.04.2021

Olga A. Gromova, Dr. Med. Sci., Professor, Science Нead of the Institute of Pharmacoinformatics, leading researcher of the Department of Intellectual Systems,
Federal Research Center “Computer Science and Control” of Russian Academy of Sciences. Tel.: +7(499)783-33-27. E-mail: unesco.gromova@gmail.com.
ORCID: 0000-0002-7663-710X. 119333, Russia, Moscow, Vavilova str., 42.
Ivan Yu. Torshin, PhD in Applied Mathematics, Institute of Pharmacoinformatics, leading researcher of the Department of Intellectual Systems, Federal Research Center “Computer Science and Control” of Russian Academy of Sciences. Tel.: +7(499)783-33-27. E-mail: tiy135@ccas.ru. ORCID: 0000-0002-2659-7998.
119333, Russia, Moscow, Vavilova str., 42.
Nana K. Tetruashvili, Dr. Med. Sci., Head of the 2nd Obstetrics Department of Pathology of Pregnancy, V.I. Kulakov NMRC for OG&P of Minzdrav of Russia.
Tel.: +7(495)438-11-83. E-mail: tetrauly@mail.ru. 117997, Russia, Moscow, Ac. Oparina str., 4.
Vera M. Kodentsova, Dr. Bio. Sci., Professor, Senior Researcher, Laboratory of Vitamins and Microelements, FITS “Nutrition and Biotechnology”.
Tel.: +7(495)698-53-46. 109240, Russia, Moscow, Ustyinsky str., 2/14.
Natalia I. Tapilskaya, Dr. Med. Sci., Professor, Leading Researcher of the Department of Assisted Reproductive Technologies, D.O. Ott Research Institute of Obstetrics, Gynecology and Reproductology RAS. ORCID: 0000-0001-5309-0087. Tel.: +7(921)933-61-26. E-mail: tapnatalia@yandex.ru.
199034, Russia, St. Petersburg, Mendeleevskaya line, 3.
Elena V. Mozgovaya, Dr. Med. Sci., Associate Professor, Head of the Obstetric Department with Perinatology, D.O. Ott Research Institute of Obstetrics, Gynecology and Reproductology RAS; Professor, Department of Obstetrics, Gynecology and Reproductive Medicine, Faculty of Medicine, St. Petersburg State University.
Tel.: +7(911)929-99-47. E-mail: elmozg@mail.ru. 199034, Russia, St. Petersburg, Mendeleevskaya line, 3.
Maria I. Yarmolinskaya, professor of RAS, Dr. Med. Sci., professor, Head of the Department of Gynecology and Endocrinology, Head of Center “Diagnostics and treatment of endometriosis”, D.O. Ott Research Institute of Obstetrics, Gynecology and Reproductology RAS; professor at the Department of Obstetrics and Gynecology,
I.I. Mechnikov North-Western State Medical University, Ministry of Health of Russia. E-mail: m.yarmolinskaya@gmail.com. ORCID: 000-0002-6551-4147.
199034, Russia, St. Petersburg, Mendeleevskaya line, 3.
Nadezhda V. Bashmakova, Dr. Med. Sci., Professor, Honored Doctor of the Russian Federation, Chief Scientific Researcher, Ural Research Institute for Maternal and
Child Care, Ministry of Health of Russia; Chief obstetrician-gynecologist of the Ural Federal District.
Тел.: +7(343)371-87-68. E-mail: dr@niiomm.ru 620028 Russia, Еkaterinburg, Repin str., 1.
Tatiana R. Grishina, Dr. Med. Sci., Нead of the Department of Pharmacology, Ivanovo State Medical Academy, Ministry of Health of Russia.
Tel: +7(493)230-17-66. E-mail: farma37@bk.ru. ORCID: 0000-0002-1665-1188. 1530128, Russia, Ivanovo, Sheremetevskiy ave., 8.
Nina P. Lapochkina, Dr. Med. Sci., Associate Professor, Head of the Department of Oncology, Obstetrics and Gynecology, Ivanovo State Medical Academy,
Ministry of Health of Russia. Tel: +7(493)230-17-66. E-mail: lapochkina_n@mail.ru. 1530128, Russia, Ivanovo, Sheremetevskiy ave., 8.
Anna N. Galustyan, Candidate of Medical Sciences, Associate Professor, Head of the Department of Pharmacology with the course of clinical pharmacology and pharmacoeconomics, St. Petersburg State Pediatric University, Ministry of Health of Russia. Tel: +7(812)416-54-04; +7(812)542-80-14. E-mail: klinika.spb@gmail.com.
ORCID: 0000-0001-9679-632X. 194100, Russia, St. Petersburg, Litovskaya str., 2.

For citation: Gromova O.A., Torshin I.Yu., Tetruashvili N.K., Baranov I.I., Gorodnova E.A., Kodentsova V.M., Kogan I.Yu., Tapilskaya N.I., Yarmolinskaya M.I.,
Bashmakova N.V., Mozgovaya E.V., Grishina T.R., Lapochkina N.P., Galustyan A.N. On the prospects of using vitamins and minerals in the prevention of early pregnancy losses.
Akusherstvo i Ginekologiya/ Obstetrics and gynecology. 2021; 4: 12-22 (in Russian)
https://dx.doi.org/10.18565/aig.2021.4.12-22

On the prospects of using vitamins and minerals in the prevention of early pregnancy losses

Gromova O.A., Torshin I.Yu., Tetruashvili N.K., Baranov I.I., Gorodnova E.A., Kodentsova V.M., Kogan I.Yu., Tapilskaya N.I., Yarmolinskaya M.I., Bashmakova N.V., Mozgovaya E.V., Grishina T.R., Lapochkina N.P., Galustyan A.N.

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