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Post a Comment Optimization of prenatal care as a measure to reduce reproductive losses and obstetric complications
- Authors: Sadykova G.K.1, Olina A.A.1,2,3, Padrul M.M.1
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Affiliations:
- Ye.A. Vagner Perm State Medical University
- The Research Institute of Obstetrics, Gynecology and Reproductology named after D.O. Ott
- North-Western State Medical University named after I.I. Mechnikov
- Issue: Vol 42, No 6 (2025)
- Pages: 36-51
- Section: Original studies
- URL: https://journals.rcsi.science/PMJ/article/view/381416
- DOI: https://doi.org/10.17816/pmj42636-51
- ID: 381416
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Abstract
Objective. To enhance prenatal monitoring of pregnant women by including recommendations for correcting nutrient deficiencies and dosing physical activity.
Materials and methods. An individual pregnancy management program based on lifestyle modification and correction of nutrient deficiencies was developed and evaluated. The effectiveness of this program was assessed through a comparative analysis of two groups. Group I included 417 women who followed the program with recommendations for lifestyle modification and correction of nutrient deficiencies. Group II comprised 394 patients who received standard prenatal care according to the conventional protocol at Perm antenatal clinics. The individual pregnancy management program included recommendations for lifestyle modification, physical activity, and fluid intake, as well as a vitamin-mineral complex in combination with individually selected single-nutrient supplements of vitamins and micronutrients.
Results. The effectiveness of the proposed program was assessed based on the frequency of obstetric complications and pregnancy outcomes. Intergroup differences were identified in the frequency of miscarriage (χ2 = 4.540; p = 0.034), extremely preterm birth (χ2 = 4.754; p = 0.03), preeclampsia (χ2 = 4.001; p = 0.046), fetal growth restriction (χ2 = 4.501; p = 0.034), intrahepatic cholestasis (χ2 = 6.039; p = 0.014), as well as gestational diabetes mellitus (χ2 = 4.035; p = 0.045).
Conclusions. Thus, the obtained data indicate the need to assess individual level of vitamin and nutrient intake, as a basis for a personalized approach to pregnancy management. Consulting pregnant women on nutrition, supplements and physical activity does not contradict current clinical guidelines and falls within the competence of an obstetrician-gynecologist in terms of implementing and monitoring the effectiveness of measures to prevent and promote a healthy lifestyle and select therapeutic nutrition.
About the authors
G. K. Sadykova
Ye.A. Vagner Perm State Medical University
Author for correspondence.
Email: gulnara-sadykova@mail.ru
ORCID iD: 0000-0003-2842-3905
PhD (Medicine), Associate Professor of the Department of Obstetrics and Gynecology №1
Russian Federation, PermA. A. Olina
Ye.A. Vagner Perm State Medical University; The Research Institute of Obstetrics, Gynecology and Reproductology named after D.O. Ott; North-Western State Medical University named after I.I. Mechnikov
Email: gulnara-sadykova@mail.ru
ORCID iD: 0000-0001-9101-7569
Sc (Medicine), Professor of the Department of Obstetrics and Gynecology №1, Deputy Director for Development, Professor of the Department of Obstetrics and Gynecology named after S.N. Davydov
Russian Federation, Perm; Saint Petersburg; Saint PetersburgM. M. Padrul
Ye.A. Vagner Perm State Medical University
Email: gulnara-sadykova@mail.ru
ORCID iD: 0000-0002-6111-5093
DSc (Medicine), Professor, Head of the Department of Obstetrics and Gynecology №1
Russian Federation, PermReferences
- Рыбаковский О.Л. Баланс населения регионов России в 1992–2023 гг. и переписные поправки. Народонаселение 2024; 2 (27): 71–82. doi: 10.24412/1561-7785-2024-2-71-82 / Rybakovsky O.L. Population balance of the regions of Russia in 1992–2023 and census corrections. Narodonaseleniye 2024; 2 (27): 71–82. doi: 10.24412/1561-7785-2024-2-71-82
- Kinshella M.L.W., Omar S., Scherbinsky K. Effects of maternal nutritional supplements and dietary interventions on placental complications: An umbrella review. Meta-Analysis and Evidence Map. Nutrients 2021; 13 (2): 472–503. doi: 10.3390/nu13020472
- Sairoz Prabhu K., Poojari V.G., Shetty S., Rao M., Kamath A. Maternal serum zinc, copper, magnesium, and iron in spontaneous abortions. Indian J Clin Biochem. 2023; 38 (1): 128–131. doi: 10.1007/s12291-022-01043-x
- Баланова Ю.А., Капустина А.В., Шальнова С.А. и др. Поведенческие факторы риска в российской популяции: результаты обследования по модифицированной методологии STEPS. Российский журнал профилактической медицины 2020; 23 (5): 56. doi: 10.17116/profmed20202305156 / Balanova Y.A., Kapustina A.V., Shalnova S.A. et al. Behavioral risk factors in the Russian population: results of a survey using a modified methodology STEPS. Profilakticheskaya Meditsina 2020; 23 (5): 56. doi: 10.17116/profmed20202305156
- Zhou Y., Lyu Y., Zhao R. et al. Development and validation of nutrition literacy assessment instrument for Chinese pregnant women. Nutrients 2022; 14 (14): 2863–2878. doi: 10.3390/nu14142863
- Скворцова М.Ю., Денисова Т.В., Денисова Ю.В. Дискуссионные вопросы нутриентной поддержки беременности. Вопросы гинекологии, акушерства и перинатологии 2020; 19 (2): 85–95. doi: 10.20953/1726-1678-2020-2-85-95 / Skvortsova M.Yu., Denisova T.V., Denisova Yu.V. Controversial issues in nutritional support during pregnancy. Gynecology, Obstetrics and Perinatology 2020; 19 (2): 85–95. doi: 10.20953/1726-1678-2020-2-85-95
- Del Castillo-Matamoros S.E., Poveda N.E. Importance of nutrition in pregnant women. Rev Colomb Obstet Ginecol. 2021; 72 (4): 339–345. doi: 10.18597/rcog.3825
- Скальный А.В. Физическая активность и обмен микроэлементов. Микроэлементы в медицине 2020; 21 (2): 3–12. doi: 10.19112/2413-6174-2020-21-2-3-12 / Skalny A.A. Physical activity and trace element metabolism. Trace Elements in Medicine (Moscow) 2020; 21 (2): 3–12. doi: 10.19112/2413-6174-2020-21-2-3-12
- Physical activity and exercise during pregnancy and the postpartum period: ACOG committee opinion, number 804. Obstet Gynecol. 2020; 135 (4): e178–e188. doi: 10.1097/AOG.0000000000003772
- Tuncalp Ö., Rogers L.M., Lawrie T.A. et al. WHO recommendations on antenatal nutrition: an update on multiple micronutrient supplements. BMJ Global Health 2020; 5 (7): 3375–3379. doi: 10.1136/bmjgh-2020-003375
- Тутельян В.А, Никитюк Д.Б. Нутрициология и клиническая диетология: национальное руководство. М.: ГЭОТАР-Медиа 2020: 656. / Tutelyan V.A., Nikityuk D.B. Nutrition and clinical dietetics: national guidelines. Moscow: GEOTAR-Media 2020: 656.
- Herrmann S.D., Willis E.A., Ainsworth B.E. The 2024 compendium of physical activities and its expansion. J Sport Health Sci. 2024; 13: 1–2. doi: 10.1016/j.jshs.2023.09.008
- World health organization. Guidelines on physical activity and sedentary behaviour. Geneva: World Health Organization 2020. Licence: CC BY-NC-SA 3.0 IGO.
- El-Bacha T. Nutrient sensing by the placenta: IGF-I/mTOR responses to preconception maternal nutrition intervention and implications to offspring birth size and lifelong heath. The Journal of Nutrition 2021; 151 (3): 471–472. doi: 10.1093/jn/nxaa436
- Green E.S., Arck P.C. Pathogenesis of preterm birth: bidirectional inflammation in mother and fetus. Semin Immunopathol. 2020; 42 (4): 413–429. doi: 10.1007/s00281-020-00807-y
- Chen L., Liu Y., Zhang Y., Zhang Y., Wang W., Han H., Yang C., Dong X. Superoxide dismutase ameliorates oxidative stress and regulates liver transcriptomics to provide therapeutic benefits in hepatic inflammation. PeerJ. 2023; 11: e15829. doi: 10.7717/peerj.15829
- Grzeszczak K., Kapczuk P., Kupnicka P., Simińska D.K., Lebdowicz-Knul J., Kwiatkowski S.K., Łanocha-Arendarczyk N., Chlubek D., Kosik-Bogacka D.I. The trace element concentrations and oxidative stress parameters in afterbirths from women with multiple pregnancies. Biomolecules 2023; 13 (5): 797. doi: 10.3390/biom13050797
- Kurlak L.O., Scaife P.J., Briggs L.V., Broughton Pipkin F., Gardner D.S., Mistry H.D. Alterations in antioxidant micronutrient concentrations in placental tissue, maternal blood and urine and the fetal circulation in pre-eclampsia. Int J Mol Sci. 2023; 24 (4): 3579. doi: 10.3390/ijms24043579
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