Pregnancy and labor in overweight and obese women with and without supplementation of a complex containing myoinositol and D-chiroinositol in the ratio of 5:1, manganese and folic acid
Solovyeva A.V., Rudenko D.B., Ermolenko K.S., Spitsyna M.A., Doronina O.K., Mamchich D.S.
Objective: To determine the characteristics of the course of pregnancy in overweight and obese women with and without supplementation of Dikirogen complex containing myoinositol and D-chiroinositol in the ratio of 5:1, manganese and folic acid.
Materials and methods: This was a retrospective analysis of the patients’ records and obstetric histories of 70 pregnant women. The women were divided into two groups: group 1 (n=30) included overweight and obese patients who received the complex; group 2 (n=40) included overweight and obese women who did not receive the complex. The analysis of anthropometric data of pregnant women, patients’ histories, course of pregnancy and labor, neonatal condition was carried out.
Results: The incidence of gestational diabetes mellitus (GDM) was significantly lower in women who took a complex containing myoinositol and D-chiroinositol in the ratio of 5:1, manganese and folic acid: GDM was detected in 3.33% of women in the first trimester (in 15% in group 2), and in 10% in the second trimester (in 17.5% in group 2). Significant differences were noted in fasting serum glucose levels: 4.28 (0.3) mmol/l in the first trimester in group 1, 4.64 (0.4) mmol/l in group 2; 4.46 (0.4) mmol/l in the second trimester in group 1 and 4.69 (0.5) mmol/l in group 2; 4.52 (0.3) mmol/l in the third trimester in group 1 and 4.75 (0.3) mmol/l in group 2 (p<0.05).
The patients in group 2 (without supplementation) were more likely to have iron deficiency anemia: 20% in the first trimester, 57.5% in the second trimester, and 50% in the third trimester (compared to 10% in group 1 in the first trimester, 30% in the second trimester, and 10% in the third trimester). The women of group 2 more often had acute respiratory viral infections, which, apparently, were associated with impaired formation of immune cells due to iron deficiency. The patients of group 1 who received myoinositol and D-chiroinositol complex in the ratio of 5:1, manganese and folic acid had a total body weight gain of 10.1 (2.6) kg, compared to the group without supplementation who had weight gain of 14.09 (3.4) kg, i.e. it was lower by 2.85–3.07 kg (χ2=13.037, p<0.05). Perineal tears were more frequent in labor in the patients in group 2, which were most likely related to the weight of the children, as macrosomia was diagnosed in 30% of the newborns (the body weight of the newborns was lower in group 1, χ2=5.143, p=0.023). Another possible reason is the high frequency of iron deficiency anemia in the patients of group 2 and syndrome of tissue trophic disorders.
Conclusion: The prescription of the Dikirogen complex, containing myoinositol and D-chiroinositol in the ratio of 5:1, manganese and folic acid, is a method for preventing such pregnancy complications as GDM, iron deficiency anemia, acute respiratory infections, and abnormal weight gain. The women who took Dikirogen during pregnancy had a lower incidence of perineal tears in labor, and their babies were more likely to be born with normal weight.
Authors’ contributions: Solovyeva A.V., Doronina O.K. – developing the concept of the article; Solovyeva A.V., Rudenko D.B., Spitsyna M.A. – writing the text; Solovyeva A.V., Rudenko D.B., Spitsyna M.A., Ermolenko K.S., Doronina O.K., Mamchich D.S. – literature review; Solovyeva A.V. – editing, approval of the final version of the article.
Conflicts of interest: Authors declare lack of the possible conflicts of interests.
Funding: The study was conducted without sponsorship.
Patient Consent for Publication: The patients provided informed consent for the publication of their data.
Authors' Data Sharing Statement: The data supporting the findings of this study are available on request from the corresponding author after approval from the principal investigator.
For citation: Solovyeva A.V., Rudenko D.B., Ermolenko K.S., Spitsyna M.A., Doronina O.K., Mamchich D.S. Pregnancy and labor in overweight and obese women with and without supplementation of a complex containing myoinositol and D-chiroinositol in the ratio of 5:1, manganese and folic acid.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2024; (7): 121-129 (in Russian)
https://dx.doi.org/10.18565/aig.2024.129
Keywords
References
- Callahan E.A., ed. National Academies of Sciences, Engineering, and Medicine. Global trends in obesity. Current status and response to the global obesity pandemic: Proceedings of a workshop. Washington, DC: The National Academies Press. 2019. https://dx.doi.org/1010.17226/25273.
- World Health Organization. Obesity and overweight (Key facts), 2016. Available at: https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight
- Ng M., Fleming T., Robinson M., Thomson B., Graetz N., Margono C. et al. Global, regional, and national prevalence of overweight and obesity in children and adults during 1980-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2014; 384(9945): 766-81. https://dx.doi.org/10.1016/S0140-6736(14)60460-8.
- Gomersall S.R., Dobson A.J., Brown W.J. Weight gain, overweight, and obesity: determinants and health outcomes from the Australian Longitudinal Study on Women's Health. Curr. Obes. Rep. 2014; 3(1): 46-53. https://dx.doi.org/10.1007/s13679-013-0077-4.
- Соловьева А.В., Фаткуллин И.Ф., Ахметгалиев А.Р., Винокурова Е.А., Алейникова Е.Ю., Кузнецова О.А. Комплексная терапия аномальных маточных кровотечений у женщин с избыточной массой тела и ожирением с применением миоинозитола и D-хироинозитола в соотношении 5:1. Гинекология. 2021; 23(5): 402-6. [Solovyeva A.V., Fatkullin I.F., Akhmetgaliev A.R., Vinokurova E.A., Aleynikova E.Yu., Kuznetsova O.A. Comprehensive therapy with myoinositol and D-chiroinositol in a 5:1 ratio for abnormal uterine bleeding in overweight and obese women. Gynecology. 2021; 23(5): 402-6. (in Russian)]. https://dx.doi.org/0.26442/20795696.2021.5.201200.
- Радзинский В.Е., Соловьева А.В., Кулешов В.М., Каткова Н.Ю., Мингалева Н.В., Коротких И.Н., Обоскалова Т.А., Воронцова А.В. Возможность оздоровления женщин с избыточной массой тела и ожирением на этапе прегравидарной подготовки. Акушерство и гинекология. 2023; 1: 83-90. [Radzinsky V.E., Solovyeva A.V., Kuleshov V.M.,Katkova N.Yu., Mingaleva N.V., Korotkikh I.N., Oboskalova T.A., Vorontsova A.V. A possibility for health improvement in overweight and obese women at the stage of pregravid preparation. Obstetrics and Gynecology. 2023; (1): 83-90. (in Russian)]. https://dx.doi.org/10.18565/aig.2022.292.
- Fuchs F., Senat M.V., Rey E., Balayla J., Chaillet N., Bouyer J. et al. Impact of maternal obesity on the incidence of pregnancy complications in France and Canada. Sci. Rep. 2017; 7(1): 10859. https://dx.doi.org/10.1038/s41598-017-11432-5.
- Schummers L., Hutcheon J.A., Bodnar L.M., Lieberman E., Himes K.P. Risk of adverse pregnancy outcomes by prepregnancy body mass index: a population-based study to inform prepregnancy weight loss counseling. Obstet. Gynecol. 2015; 125(1): 133-43. https://dx.doi.org/10.1097/AOG.0000000000000591.
- Bahri Khomami M., Joham A.E., Boyle J.A., Piltonen T., Silagy M., Arora C. et al. Increased maternal pregnancy complications in polycystic ovary syndrome appear to be independent of obesity-A systematic review, meta-analysis, and meta-regression. Obes. Rev. 2019; 20(5): 659-74. https://dx.doi.org/10.1111/obr.12829.
- Black M.H., Sacks D.A., Xiang A.H., Lawrence J.M. The relative contribution of prepregnancy overweight and obesity, gestational weight gain, and IADPSG-defined gestational diabetes mellitus to fetal overgrowth. Diabetes Care. 2013; 36(1): 56-62. https://dx.doi.org/10.2337/dc12-0741.
- Cheney K., Farber R., Barratt A.L., McGeechan K., de Vries B., Ogle R. et al. Population attributable fractions of perinatal outcomes for nulliparous women associated with overweight and obesity, 1990-2014. Med J Aust. 2018; 208(3): 119-25. https://dx.doi.org/10.5694/mja17.00344.
- Rasmussen K.M., Catalano P.M., Yaktine A.L. New guidelines for weight gain during pregnancy: what obstetrician/gynecologists should know. Curr. Opin. Obstet. Gynecol. 2009; 21(6): 521-6. https://dx.doi.org/10.1097/GCO.0b013e328332d24e.
- Bennett C.J., Walker R.E., Blumfield M.L., Gwini S.M., Ma J., Wang F. et al. Interventions designed to reduce excessive gestational weight gain can reduce the incidence of gestational diabetes mellitus: A systematic review and meta-analysis of randomised controlled trials. Diabetes Res. Clin. Pract. 2018; 141: 69-79. https://dx.doi.org/10.1016/j.diabres.2018.04.010.
- Торшин И.Ю., Майорова Л.А., Уварова Е.В., Тапильская Н.И., Громова О.А. Хемореактомный анализ стереоизомеров инозитола: различные профили фармакологического действия миоинозитола и D-хироинозитола при нарушениях женской репродуктивной системы. Вопросы акушерства, гинекологии и перинатологии. 2020; 19(5): 57-69. [Torshin I.Yu., Mayorova L.A., Uvarova E.V., Tapilskaya N.I., Gromova O.A. Chemoreactomic analysis of inositol stereoisomers: different profiles of pharmacological activity of myo-inositol and D-chiro-inositol in females with reproductive system disorders. Gynecology, Obstetrics and Perinatology. 2020; 19(5): 57-69.(in Russian)]. https://dx.doi.org/10.20953/1726-1678-2020-5-57-69.
- Mumtaz A., Ainy, Batool M., Ali S.S., Yasmin S., Israr N. Role of myo-inositol supplementation in prevention of gestational diabetes mellitus in parturient women at risk. J. Soc. Obstet. Gynaecol. Pak. 2022; 12(4): 319-23.
- Mashayekh-Amiri S., Mohammad-Alizadeh-Charandabi S., Abdolalipour S., Mirghafourvand M. Myo-inositol supplementation for prevention of gestational diabetes mellitus in overweight and obese pregnant women: a systematic review and meta-analysis. Diabetol. Metab. Syndr. 2022; 14(1): 93. https://dx.doi.org/10.1186/s13098-022-00862-5.
- Farren M., Daly N., McKeating A., Kinsley B., Turner M.J., Daly S. The prevention of gestational diabetes mellitus with antenatal oral inositol supplementation: a randomized controlled trial. Diabetes Care. 2017; 40(6): 759-63. https://dx.doi.org/10.2337/dc16-2449.
- Tahir F., Majid Z. Inositol supplementation in the prevention of gestational diabetes mellitus. Cureus. 2019; 11(9): e5671. https://dx.doi.org/10.7759/cureus.5671.
- Nachum Z., Zafran N., Salim R., Hissin N., Hasanein J., Gam Ze Letova Y. et al. Glyburide versus metformin and their combination for the treatment of gestational diabetes mellitus: a randomized controlled study. Diabetes Care. 2017; 40(3): 332-7. https://dx.doi.org/10.2337/dc16-2307.
- D'Anna R., Scilipoti A., Giordano D., Caruso C., Cannata M.L., Interdonato M.L. et al. Myo-inositol supplementation and onset of gestational diabetes mellitus in pregnant women with a family history of type 2 diabetes: a prospective, randomized, placebo-controlled study. Diabetes Care. 2013; 36(4): 854-7. https://dx.doi.org/10.2337/dc12-1371.
- D'Anna R., Di Benedetto A., Scilipoti A., Santamaria A., Interdonato M.L., Petrella E. et al. Myo-inositol supplementation for prevention of gestational diabetes in obese pregnant women: a randomized controlled trial. Obstet. Gynecol. 2015; 126(2): 310-5. https://dx.doi.org/10.1097/AOG.0000000000000958.
- Епишкина-Минина А.А., Хамошина М.Б., Старцева Н.М., Дамирова С.Ф., Зюкина З.В., Аникеев А.С. Гестационный сахарный диабет и анемия: контраверсии патогенеза. Акушерство и гинекология: новости, мнения, обучение. 2020; 8(3) Приложение: 86-93. [Epishkina-Minina A.A.,Khamoshina M.B., Startseva N.M., Damirova S.F., Zyukina Z.V.,Anikeev A.S. Gestational diabetes mellitus and anaemia: the contraversions of pathogenesis. Obstetrics and Gynecology: News, Opinions, Training. 2020; 8(3). Supplement: 86-93. (in Russian)]. https://dx.doi.org/10.24411/2303-9698-2020-13914.
- Старцева Н.М., Свиридова М.И., Учамприна В.А., Аникеев А.С., Леффад М.Л. Гетерогенность анемического синдрома при ожирении и гестационном сахарном диабете. Женское здоровье и репродукция. 2021; 2(49): 39-52. [Startseva N.M., Sviridova M.I., Uchamprina V.A., Anikeev A.S.,Leffad L.M. Heterogeneity of anemic syndrome in obesity and gestational diabetes mellitus. Women's Health and Reproduction. 2021; 2(49): 39-52.(in Russian)].
- Зима А.П., Прохоренко Т.С., Саприна Т.В., Мусина Н.Н., Новицкий В.В., Байков А.Н. Патогенез анемического синдрома у беременных с гестационным сахарным диабетом. Бюллетень сибирской медицины. 2020; 19(2): 28-33. [Zima A.P., Prokhorenko T.S., Saprina T.V., Musina N.N., Novitsky V.V., Baykov A.N. Pathogenesis of anemia in pregnant women with gestational diabetes mellitus. Bulletin of Siberian Medicine. 2020; 19(2): 28-33. (in Russian)]. https://dx.doi.org/10.20538/1682-0363-2020-2-28-33.
- Белокриницкая Т.Е., Фролова Н.И., Шаповалов К.Г., Колмакова К.А., Анохова Л.И., Авраченкова А.В., Преймак С.В., Григорьев А.В., Филёва Т.Ю., Горбунова А.Н., Дунаев Д.А., Сербина К.С. COVID-19 у беременных и небеременных пациенток раннего репродуктивного возраста. Гинекология. 2021; 23(3): 255-9. [Belokrinitskaya T.E., Frolova N.I., Shapovalov K.G., Kolmakova K.A., Anohova L.I., Avrachenkova A.V., Prejmak S.V., Grigor’ev A.V., Filyova T.Yu., Gorbunova A.N., Dunaev D.A., Serbina K.S. COVID-19 in pregnant and non-pregnant women of early reproductive age. Gynecology. 2021; 23(3): 255-9. (in Russian)]. https://dx.doi.org/10.26442/20795696.2021.3.200882.
- Karachaliou M., Georgiou V., Roumeliotaki T., Chalkiadaki G., Daraki V., Koinaki S. et al. Association of trimester-specific gestational weight gain with fetal growth, offspring obesity, and cardiometabolic traits in early childhood. Am. J. Obstet. Gynecol. 2015; 212(4): 502.e1-14. https://dx.doi.org/10.1016/j.ajog.2014.12.038.
- Diesel J.C., Eckhardt C.L., Day N.L., Brooks M.M., Arslanian S.A.,Bodnar L.M. Is gestational weight gain associated with offspring obesity at 36 months? Pediatr. Obes. 2015; 10(4): 305-10. https://dx.doi.org/10.1111/ijpo.262.
- Freeman A.M., Rai M., Morando D.W. Anemia screening. StatPearls. Treasure Island (FL): StatPearls Publishing. 2022.
Received 30.05.2024
Accepted 15.07.2024
About the Authors
Alina V. Solovyova, Dr. Med. Sci., Associate Professor, Associate Professor at the Department of Obstetrics and Gynecology with a course of Perinatology, Medical Institute, Patrice Lumumba Peoples’ Friendship University of Russia, 117198, Russia, Moscow, Miklouho-Maklaya str., 8, +7(985)447-79-28, av_soloveva@mail.ru,https://orcid.org/0000-0001- 6711-1563
Daria B. Rudenko, obstetrician-gynecologist, Stavropol Regional Clinical Perinatal Center, 355041, Russia, Stavropol Territory, Stavropol, Lomonosov str., 44, Dariarudenko16@gmail.com, https://orcid.org/0009-0007-1264-2931
Kristina S. Ermolenko, PhD, Teaching Assistant at the Department of Obstetrics and Gynecology with a course in Perinatology, Medical Institute, Patrice Lumumba Peoples’ Friendship University of Russia, 117198, Russia, Moscow, Miklouho-Maklaya str., 8, k.s.ermolenko@yandex.ru, https://orcid.org/0000-0003-4408-1378
Maria A. Spitsyna, PhD student at the Department of Obstetrics and Gynecology with a course in Perinatology, Medical Institute, Patrice Lumumba Peoples’ Friendship University of Russia, 117198, Russia, Moscow, Miklouho-Maklaya str., 8, lotyreva31@gmail.com, https://orcid.org/0009-0005-3745-0042
Olga K. Doronina, Dr. Med. Sci., Professor at the Department of Obstetrics and Gynecology with a course of Perinatology, Medical Institute, Patrice Lumumba Peoples’ Friendship University of Russia, 117198, Russia, Moscow, Miklouho-Maklaya str., 8, doronina-ok@rudn.ru, https://orcid.org/0000-0002-4288- 353X
Daria S. Mamchich, resident at the Department of Obstetrics and Gynecology with a course in Perinatology, Medical Institute, Patrice Lumumba Peoples’ Friendship University of Russia, 117198, Russia, Moscow, Miklouho-Maklaya str., 8, dasha.mamchich@gmail.com, https://orcid.org/0000-0003-3331-4033
Corresponding author: Alina V. Solovyova, av_soloveva@mail.ru