Vitamins and trace elements in the prevention of minor malformations

Gromova O.A., Torshin I.Yu., Tetruashvili N.K.

1Ivanovo State Medical Academy, Ministry of Health of Russia, Ivanovo 153000, Sheremetiev pr. 8, Russia 2Moscow Institute of Physics and Technology, Dolgoprudny 141700, Institutsky pereulok, 9, Russia 3Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia, Moscow 117997, Ac. Oparina str. 4, Russia
Objective. To analyze the relationship between the provision of vitamins and trace elements during pregnancy and the so-called minor malformations
Material and methods. The review presents the results of a systematic analysis of foreign and Russian studies of the associations between trace element deficiencies and the pathogenesis, incidence, and severity of fetal congenital malformations (CMFs).
Results. Trace element deficiencies during pregnancy are associated with obvious CMFs (syndactyly and other limb defects, impaired dentition, hernias, etc.) and CMF that manifested itself in early childhood (congenital heart defects, defects of the ureter, gallbladder, etc.). An analysis has shown that folates fall far short of being not the only trace element that is needed to prevent malformations, including the so-called minor ones (defects of the limbs, teeth, etc.). For example, zinc that regulates the activity of more than 1200 zinc-dependent proteins, as well as vitamin A and vitamin PP have no less an important role to play in the prevention of defects of dentition, fingers, auricles, lungs, diaphragm, and gallbladder. Deficiencies of zinc, vitamins A, E, D, and C and any of the B vitamins (including folates, pyridoxine and cyanocobalamin) stimulate the development of both minor and major malformations.
Conclusion. The data from basic researches and evidence-based medicine indicate that it is necessary to mandatorily use vitamin-mineral complexes, including all the above trace elements, for the effective primary prevention of any fetal malformations.

Keywords

minor congenital malformations
trace elements
elevit pronatal

Supplementary Materials

  1. Table. Known and congenital malformations associated with Zn -dependent signaling pathways functioning disorders
  2. Fig. 1. Different e VPR, which leads n arushenie activity of zinc-dependent protein Shh
  3. Fig. 2. The spatial structure of ubiquitin ligase (for example Ub-ligase CBL-type E3 ubiquitin ligase), the lack of activity is associated with's facial dysmorphism and retardation (Noonan syndrome, OMIM 613563). Showed zinc atom in the domain part of the "zinc finger» (PDB file 4a4b)

References

1. Geissler C., Powers H., eds. Human nutrition. Elsevier, Churchill Livingstone, Netherlands; 2005.

2. Громова О.А., Торшин И.Ю. Витамин D – смена парадигмы. М.: ГЭОТАР-Медиа; 2017. [Gromova O.A., Torshin I.Yu. Vitamin D – a paradigm shift. Moscow: GEOTAR-Media; 2017. (in Russian)]

3. Коденцова В.М., Вржесинская О.А. Витамины в питании беременных. Гинекология. 2002; 4(1): 7-12. [Kodentsova V.M., Vrzhesinskaya O.A. Vitamins in the diet of pregnant women. Ginekologiya. 2002; 4 (1): 7-12. (in Russian)]

4. Цейцель Э.И. Первичная профилактика врожденных дефектов: поливитамины или фолиевая кислота? РМЖ. 2012; 20(21): 1122-32. [Tseitsel E.I. Primary prevention of birth defects: multivitamins or folic acid? Russian Medical Journal. 2012; 20 (21): 1122-32. (in Russian)]

5. Carmichael S.L., Yang W., Shaw G.M. Maternal dietary nutrient intake and risk of preterm delivery. Am. J. Perinatol. 2013; 30(7): 579-88.

6. Schuster O., Weimann H. J., Muller J., Menke A., Menke G. Pharmakokinetik und relative bioverfügbarkeit von eisen und folsäure bei gesunden versuchspersonen. Arzeneim.-Forsch. 1993; 43: 761-6.

7. Хорошилов И.Е., Успенский Ю.В. Новые подходы в лечебном питании беременных и кормящих женщин. Гинекология. 2008; 10(4): 67-77. [Khoroshilov I.E., Uspenskiy Yu.V. New approaches in the therapeutic nutrition of pregnant and lactating women. Ginekologiya. 2008; 10(4): 67-77. (in Russian)]

8. Лиманова О.А., Торшин И.Ю., Сардарян И.С., Калачева А.Г., Hababpashev A., Karpuchin D., 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., 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)]

9. Громова О.А., Торшин И.Ю., Галустян А.Н., Лиманова О.А., Волков А.Ю., Калачева А.Г., Гришина Т.Р., Громов А.Н., Рудаков К.В. Обеспеченность витамином D детей и подростков 7-14 лет и взаимосвязь дефицита витамина D с нарушениями здоровья детей. Анализ крупномасштабной выборки пациентов посредством интеллектуального анализа данных. Педиатрия. Журнал им. Г.Н. Сперанского. 2015; 2: 175-84. [Gromova O.A., Torshin I.Yu., Galustyan A.N., Limanova O.A., Volkov A.Yu., Kalacheva A.G., Grishina T.R., Gromov A.N., Rudakov K.V. Provision of vitamin D for children and adolescents 7-14 years and the relationship between vitamin D deficiency and children’s health disorders. Analysis of a large-scale sample of patients through data mining. Pediatriya. Zhurnal im. G.N. Speranskogo. 2015; 2: 175-84. (in Russian)]

10. Marceau G., Gallot D., Lemery D., Sapin V. Metabolism of retinol during mammalian placental and embryonic development. Vitam. Horm. 2007; 75: 97-115.

11. Pan J., Baker K.M. Retinoic acid and the heart. Vitam. Horm. 2007; 75: 257-83.

12. Zile M.H., Kostetskii I., Yuan S., Kostetskaia E., St Amand T.R., Chen Y., Jiang W. Retinoid signaling is required to complete the vertebrate cardiac left/right asymmetry pathway. Dev. Biol. 2000; 223(2): 323-38.

13. Xing X., Tao F. Advance of study on vitamin A deficiency and excess associatied with congenital heart disease. Wei Sheng Yan Jiu. 2008; 37(6): 754-6.

14. Halilagic A., Ribes V., Ghyselinck N.B.., Zile MH., Dolle P., Studer M. Retinoids control anterior and dorsal properties in the developing forebrain. Dev. Biol. 2007; 303(1): 362-75.

15. Askin D.F., Diehl-Jones W. Pathogenesis and prevention of chronic lung disease in the neonate. Crit. Care Nurs. Clin. North Am. 2009; 21(1): 11-25.

16. Brossaud J., Pallet V., Corcuff J.B. Vitamin A, endocrine tissues and hormones: interplay and interactions. Endocr. Connect. 2017; Jul 18. pii: EC-17-0101. doi: 10.1530/EC-17-0101.

17. Chen K., Zhang X., Wei X.P., Qu P., Liu Y.X., Li T.Y. Antioxidant vitamin status during pregnancy in relation to cognitive development in the first two years of life. Early Hum. Dev. 2009; 85(7): 421-7.

18. White J.C., Highland M., Kaiser M., Clagett-Dame M. Vitamin A deficiency results in the dose-dependent acquisition of anterior character and shortening of the caudal hindbrain of the rat embryo. Dev. Biol. 2000; 220(2): 263-84.

19. Tateya I., Tateya T., Surles R.L., Tanumihardjo S., Bless D.M. Prenatal vitamin A deficiency causes laryngeal malformation in rats. Ann. Otol. Rhinol. Laryngol. 2007; 116(10): 785-792.

20. Hill B., Holroyd R., Sullivan M. Clinical and pathological findings associated with congenital hypovitaminosis A in extensively grazed beef cattle. Aust. Vet. J. 2009; 87(3): 94-8.

21. El-Khashab E.K., Hamdy A.M., Maher K.M., Fouad M.A., Abbas G.Z. Effect of maternal vitamin A deficiency during pregnancy on neonatal kidney size. J. Perinat. Med. 2013; 41(2): 199-203.

22. Beurskens L.W., Tibboel D., Lindemans J., Duvekot J.J., Cohen-Overbeek T.E., Veenma D.C. et al. Retinol status of newborn infants is associated with congenital diaphragmatic hernia. Pediatrics. 2010; 126(4): 712-20.

23. Mitchell L.E., Murray J.C., O’Brien S., Christensen K. Retinoic acid receptor alpha gene variants, multivitamin use, and liver intake as risk factors for oral clefts: a population-based case-control study in Denmark, 1991-1994. Am. J. Epidemiol.2003;158(1):69-76.

24. Громова О.А., Торшин И.Ю. Витамины и минералы: между Сциллой и Харибдой. М.: МЦНМО; 2013. [Gromova O.A., Torshin I.Yu. Vitamins and minerals: between Scylla and Charybdis. Moscow: МЦНМО; 2013. (in Russian)]

25. Krapels I.P., van Rooij I.A., Ocke M.C., West C.E., van der Horst C.M., Steegers-Theunissen R.P. Maternal nutritional status and the risk for orofacial cleft offspring in humans. J. Nutr. 2004;134(11): 3106-13.

26. Karras S., Paschou S.A., Kandaraki E., Anagnostis P., Annweiler C., Tarlatzis B.C. et al. Hypovitaminosis D in pregnancy in the Mediterranean region: a systematic review. Eur. J. Clin. Nutr. 2016; 70(9): 979-86. doi: 10.1038/ejcn.2016.12.

27. Zhang M.X., Pan G.T., Guo J.F., Li B.Y., Qin L.Q., Zhang Z.L. Vitamin D deficiency increases the risk of gestational diabetes mellitus: a meta-analysis of observational studies. Nutrients. 2015; 7(10): 8366-75. doi: 10.3390/nu7105398.

28. Shorey-Kendrick L.E., McEvoy C.T., Ferguson B., Burchard J., Park B.S., Gao L. et al. Vitamin C prevents offspring DNA methylation changes associated with maternal smoking in pregnancy. Am. J. Respir. Crit. Care Med. 2017; Apr 19. doi: 10.1164/rccm.201610-2141OC.

29. Verma R.J., Sherlin D.M. Vitamin C ameliorates fluoride-induced embryotoxicity in pregnant rats. Hum. Exp. Toxicol. 2001; 20(12): 619-23.

30. Oliveira F.A., Galan D.T., Ribeiro A.M., Santos Cruz J. Thiamine deficiency during pregnancy leads to cerebellar neuronal death in rat offspring: role of voltage-dependent K+ channels. Brain Res. 2007; 1134(1): 79-86.

31. Emonts P., Seaksan S., Seidel L., Thoumsin H., Gaspard U., Albert A., Foidart J.M. Prediction of maternal predisposition to preeclampsia. Hypertens. Pregnancy. 2008; 27(3): 237-45.

32. Krapels I.P., van Rooij I.A., Ocke M.C., van Cleef B.A., Kuijpers-Jagtman A.M., Steegers-Theunissen R.P. Maternal dietary B vitamin intake, other than folate, and the association with orofacial cleft in the offspring. Eur. J. Nutr. 2004; 43(1): 7-14.

33. Yang W., Shaw G.M., Carmichael S.L., Rasmussen S.A., Waller D.K., Pober B.R., Anderka M. Nutrient intakes in women and congenital diaphragmatic hernia in their offspring. Birth Defects Res. A Clin. Mol. Teratol. 2008; 82(3): 131-8.

34. Shaw G.M., Carmichael S.L., Laurent C., Rasmussen S.A. Maternal nutrient intakes and risk of orofacial clefts. Epidemiology. 2006; 17(3): 285-91.

35. 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.

36. Robitaille J., Carmichael S.L., Shaw G.M., Olney R.S. 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.

37. Carmichael S.L., Rasmussen S.A., Lammer E.J., Ma C., Shaw G.M. Craniosynostosis and nutrient intake during pregnancy. Birth Defects Res. A Clin. Mol. Teratol. 2010; 88(12): 1032-9.

38. Shaw G.M., Carmichael S.L., Yang W., Lammer E.J. Periconceptional nutrient intakes and risks of conotruncal heart defects. Birth Defects Res. A Clin. Mol. Teratol. 2010; 88(3): 144-51.

39. Ronnenberg A.G., Venners S.A., Xu X., Chen C., Wang L., Guang W. et al. Preconception B-vitamin and homocysteine status, conception, and early pregnancy loss. Am. J. Epidemiol. 2007; 166(3): 304-12.

40. Thaver D., Saeed M.A., Bhutta Z.A. Pyridoxine (vitamin B6) supplementation in pregnancy. Cochrane Database Syst. Rev. 2006; (2): CD000179.

41. Robitaille J., Carmichael S.L.., Shaw GM., 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. doi: 10.1002/bdra.20587.

42. Werler M.M., Hayes C., Louik C., Shapiro S., Mitchell A.A. Multivitamin supplementation and risk of birth defects. Am. J. Epidemiol. 1999; 150(7): 675-82.

43. Vujkovic M., Ocke M.C., van der Spek P.J., Yazdanpanah N., Steegers E.A., Steegers-Theunissen R.P. Maternal Western dietary patterns and the risk of developing a cleft lip with or without a cleft palate. Obstet. Gynecol. 2007; 110(2, Pt 1): 378-84.

44. Neggers Y.H., Singh J. Zinc supplementation to protein-deficient diet in CO-exposed mice decreased fetal mortality and malformation. Biol. Trace Elem. Res. 2006; 114(1-3): 269-79.

45. Scholpp S., Wolf O., Brand M., Lumsden A. Hedgehog signalling from the zona limitans intrathalamica orchestrates patterning of the zebrafish diencephalon. Development. 2006; 133(5): 855-64.

46. Czeizel A.E., Puho E. Maternal use of nutritional supplements during first month os pregnanc Maternal use of nutritional supplements during the first month of pregnancy and decreased risk of Down’s syndrome: case-control study. Nutrition. 2005; 21(6): 698-704.

Received 16.06.2017

Accepted 23.06.2017

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

For citations: 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

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