Some indicators of biochemical and hormonal homeostasis in internally displaced women with threatened miscarriage, living in the Luhansk region
Background. The threatened miscarriage is the most common pregnancy complication that occurs in 15–20 % of cases of ongoing pregnancy. The aim of this work was to study the features of electrolyte status and level of vitamin 25(OH)D in pregnant women with threatened miscarriage in I and II trimesters, living in the Luhansk region and having the status of internally displaced persons (IDP), to improve treatment and preventive measures and prevent obstetric and perinatal complications in such women. Materials and methods. The study included 27 pregnant women who had IDP status and were hospitalized for threatened miscarriage to the hospitals, located in the Luhansk region (group I). The control group consisted of 30 pregnant women with no relevant past medical history and with physiological course of pregnancy with similar gestation period (group II). Clinical and obstetric examinations were carried out, the content of vitamin 25(OH)D and the concentration of trace elements such as Na+, K+, Cl+, Ca2+, P, Mg, Zn in the blood serum were determined. Results. It was found that in pregnant women of group I, the concentrations of magnesium (0.74 (0.73–0.78)) and vitamin 25(OH)D (26.85 (23.38–29.04)) were significantly lower compared with the control group (0.79 (0.75–0.83) and 28.21 (25.85–29.15), respectively). In group I, a statistically significant positive correlation was found between the concentrations of vitamin 25(OH)D and ionized calcium (r = 0.445, p = 0.02), between the content of phosphorus and the body mass index (r = 0.456, p = 0.017). Conclusions. Antenatal study of electrolyte and vitamin 25(OH)D content in the blood serum of pregnant women with symptoms of threatened miscarriage and IDP status will allow us to individualize the approach to the management of pregnancy and to develop timely, if necessary, corrective and rehabilitation measures that will contribute to a successful pregnancy outcome and influence the health of the mother and her offspring.
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IDCP Global Overview 2015: People Internally Displaced by Conflict and Violence (2015). URL: http://www.internal-displacement.org/sites/default/files/inline-files/20150506-global-overview-2015-en.pdf
Allansson M., Melander E., Themnér L. Organized violence, 1989–2016. J. Peace Res. 2017. 54(4). 574-87. doi: 10.1177/0022343317718773.
Forced displacement in 2018. Global trends. URL: https://www.unhcr.org/globaltrends2018/
Global Report on Internal Displacement 2019. Available from: http://www.internal-displacement.org/sites/default/files/publications/documents/2019-IDMC-GRID.pdf
Ahmed S.R., El-Sammani Mel-K., Al-Sheeha M.A., Aitallah A.S., Jabin Khan F., Ahmed S.R. Pregnancy outcome in women with threatened miscarriage: a year study. Mater. Sociomed. 2012. 24(1). 26-8. doi: 10.5455/msm.2012.24.26-28.
Weiss J.L., Malone F.D., Vidaver J. et al. Threatened abortion: A risk factor for poor pregnancy outcome, a population-based screening study. Am. J. Obstet. Gynecol. 2004 Mar. 190(3). 745-50.
Liu L., Johnson H.L., Cousens S. et al. Global, regional, and national causes of child mortality: An updated systematic analysis for 2010 with time trends since 2000. Lancet. 2012. 379. 2151-2161. doi: 10.1016/S0140-6736(12)60560-1.
Saraswat L., Bhattacharya S., Maheshwari A., Bhattacharya S. Maternal and perinatal outcome in women with threatened miscarriage in the first trimester: a systematic review. BJOG. 2010 Feb. 117(3). 245-57. doi: 10.1111/j.1471-0528.2009.02427.x.
Blencowe H., Cousens S., Chou D. et al. Born too Soon: the global epidemiology of 15 million preterm births. Reprod. Health. 2013. 10(1). S2. doi: 10.1186/1742-4755-10-S1-S2.
Van Zijl M.D., Koullali B., Mol B.W., Pajkrt E., Oudijk M.A. Prevention of preterm delivery: Current challenges and future prospects. Int. J. Womens Health. 2016. 8. 633-645. doi: 10.2147/IJWH.S89317.
Fuchs F., Senat M.V. Multiple gestations and preterm birth. Semin. Fetal Neonatal Med. 2016. 21. 113-120. doi: 10.1016/j.siny.2015.12.010.
Manuck T.A. Racial and ethnic differences in preterm birth: A complex, multifactorial problem. Semin. Perinatol. 2017. 41. 511-518. doi: 10.1053/j.semperi.2017.08.010.
Zhang G., Feenstra B., Bacelis J. et al. Genetic Associations with Gestational Duration and Spontaneous Preterm Birth. N. Engl. J. Med. 2017. 377. 1156-1167. doi: 10.1056/NEJMoa1612665.
Frey H.A., Klebanoff M.A. The epidemiology, etiology, and costs of preterm birth. Semin. Fetal Neonatal Med. 2016. 21. 68-73. doi: 10.1016/j.siny.2015.12.011.
Englund-Ögge L., Brantsæter A.L., Sengpiel V. et al. Maternal dietary patterns and preterm delivery: Results from large prospective cohort study. BMJ. 2014. 348. g1446. doi: 10.1136/bmj.g1446.
Chia A.R., Chen L.W., Lai J.S. et al. Maternal Dietary Patterns and Birth Outcomes: A Systematic Review and Meta-Analysis. Adv. Nutr. 2019. 10. 685-695. doi: 10.1093/advances/nmy123.
Ota E., Mori R., Middleton P. et al. Zinc supplementation for improving pregnancy and infant outcome. Cochrane Database Syst. Rev. 2015. 2. CD000230. doi: 10.1002/14651858.CD000230.pub5. 2015;2.
Wilson R.L., Grieger J.A., Bianco-Miotto T., Roberts C.T. Association between Maternal Zinc Status, Dietary Zinc Intake and Pregnancy Complications: A Systematic Review. Nutrients. 2016. 8. 641. doi: 10.3390/nu8100641.
Crosby D.D., Shepherd E.A., Crowther C., Makrides M. Magnesium supplementation in pregnancy. Cochrane Database Syst. Rev. 2014. 4. CD000937.
Dalton L.M., Ní Fhloinn D.M., Gaydadzhieva G.T., Mazurkiewicz O.M., Leeson H., Wright C.P. Magnesium in pregnancy. Nutr. Rev. 2016 Sep. 74(9). 549-57. doi: 10.1093/nutrit/nuw018. Epub 2016 Jul 21.
Villar J., Merialdi M., Gulmezoglu A.M. et al. Nutritional interventions during pregnancy for the prevention or treatment of maternal morbidity and preterm delivery: An overview of randomized controlled trials. J. Nutr., 2003. 133. 1606s-1625s. doi: 10.1093/jn/133.5.1606S.
Saraf R., Morton S.M., Camargo C.A. Jr, Grant C.C. Global summary of maternal and newborn vitamin D status — a systematic review. Matern. Child Nutr. 2016. 12(4). 647-668. https://doi.org/10.1111/mcn.12210.
Zhou S., Tao Y., Huang K., Zhu B. Vitamin D and risk of preterm birth: Up-to-date meta-analysis of randomized controlled trials and observational studies. J. Obstet. Gynaecol. Res. 2017. 43. 247-256. doi: 10.1111/jog.13239.
Qin L.L., Lu F.G., Yang S.H., Xu H.L., Luo B.A. Does Maternal Vitamin D Deficiency Increase the Risk of Preterm Birth: A Meta-Analysis of Observational Studies. Nutrients. 2016. 8. 301. doi: 10.3390/nu8050301.
Kiely M.E., Zhang J.Y., Kinsella M., Khashan A.S., Kenny L.C. Vitamin D status is associated with uteroplacental dysfunction indicated by pre-eclampsia and small-for-gestational-age birth in a large prospective pregnancy cohort in Ireland with low vitamin D status. The American Journal of Clinical Nutrition. 2016 Aug. 104(2). 354-361. https://doi.org/10.3945/ajcn.116.130419.
Urrutia R.P., Thorp J.M. Vitamin D in pregnancy: current concepts. Curr. Opin. Obstet. Gynecol. 2012. 24. 57-64. doi: 10.1097/GCO.0b013e3283505ab3.
Websky K., Hasan A.A., Reichetzeder C., Tsuprykov O., Hocher B. Impact of vitamin D on pregnancy-related disorders and on offspring outcome. J. Steroid Biochem. Mol. Biol. 2018 Jun. 180. 51-64. doi: 10.1016/j.jsbmb.2017.11.008.
Mehrotra V., Sandhu A., Nautiyal R. Association of vitamin D in pregnancy and after 15 days of delivery along with neonatal. Clinical Nutrition Experimental. 2019. 28. 102-110. https://doi.org/10.1016/j.yclnex.2019.10.001.
Kamudoni P., Poole C., Davies S.J. An estimate of the economic burden of vitamin D deficiency in pregnant women in the United Kingdom. Gynecol. Endocrinol. 2016. 32. 592-597. doi: 10,3109/09513590.2016.1160374.
Kamal S., Sharan A., Kumar U., Shahi S.K. Serum magnesium level in preterm labour. Indian J. Pathol. Microbiol. 2003 Apr. 46(2). 271-3. https://www.ncbi.nlm.nih.gov/pubmed/15022938.
Okunade K.S., Oluwole A.A., Adegbesan-Omilabu M.A. A Study on the Association between Low Maternal Serum Magnesium Level and Preterm Labour. Adv. Med. 2014. 2014. 704875. doi: 10.1155/2014/704875.
Kiely M., Hemmingway A., O’Callaghan K.M. Vitamin D in pregnancy: current perspectives and future directions. Ther. Adv. Musculoskelet. Dis. 2017 Jun. 9(6). 145-154. doi: 10.1177/1759720X17706453.
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