Micronutrient status of pregnant women with fetal congenital malformations

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Abstract

BACKGROUND: Congenital malformations of the central nervous system have extremely severe consequences, which makes it important to study their development and diagnosis during embryogenesis. Therefore, particularly relevant are studies in the field of prevention of fetal сongenital malformations.

AIM: The aim of this study was to assess the micronutrient status (vitamin D, serum and erythrocyte folic acid, vitamin B12) and homocysteine levels in women with induced abortion in the second trimester of pregnancy based on fetal indications (fetal сongenital malformations).

MATERIALS AND METHODS: This prospective cohort study enrolled 53 women with induced abortion for medical reasons from the fetus in the second trimester of gestation. All pregnant women were divided into two groups. Group 1 included 28 individuals without an established chromosomal abnormality in the fetus: with fetal сongenital malformations and no neural tube defects (n = 16) or with fetal сongenital malformations and neural tube defects (n = 12). Group 2 consisted of 25 pregnant women with established chromosomal abnormalities in the fetus.

RESULTS: In pregnant women with fetal сongenital malformations and neural tube defects, blood serum vitamin B12 level correlated with erythrocyte folic acid level and was lower compared with women with fetal сongenital malformations and no neural tube defects (p < 0.05). No significant differences were found for other parameters. In pregnant women with fetal сongenital malformations, homocysteine level did not differ from that in women with normal fetal development at this stage of pregnancy. Meanwhile, folic acid and vitamin B12 levels in women with fetal сongenital malformations were lower compared with pregnant women without this pathology (p < 0.001).

CONCLUSIONS: The features of micronutrient status found in patients with fetal сongenital malformations, in particular with neural tube defects, and the relationships between its individual parameters indicate complex etiologies of these pathologies. The data obtained indicate the expediency of assessing one-carbon metabolic parameters in the mother not only during pregnancy, but also at the stage of preconception preparation, as well as the need for additional research related to adequate control of vitamin intake and assessment of methionine cycle gene polymorphism.

About the authors

Yulia P. Milyutina

The Research Institute of Obstetrics, Gynecology, and Reproductology named after D.O. Ott

Email: milyutina1010@mail.ru
ORCID iD: 0000-0003-1951-8312
SPIN-code: 6449-5635

Cand. Sci. (Biol.)

Russian Federation, Saint Petersburg

Margarita O. Shengelia

The Research Institute of Obstetrics, Gynecology and Reproductology named after D.O. Ott

Email: bakleicheva@gmail.com
ORCID iD: 0000-0002-0103-8583

MD

Russian Federation, Saint Petersburg

Olesya N. Bespalova

The Research Institute of Obstetrics, Gynecology and Reproductology named after D.O. Ott

Email: shiggerra@mail.ru
ORCID iD: 0000-0002-6542-5953
SPIN-code: 4732-8089

MD, Dr. Sci. (Med.)

Russian Federation, Saint Petersburg

Olga V. Pachuliya

The Research Institute of Obstetrics, Gynecology, and Reproductology named after D.O. Ott

Email: for.olga.kosyakova@gmail.com
ORCID iD: 0000-0003-4116-0222
SPIN-code: 1204-3160

MD, Cand. Sci. (Med.)

Russian Federation, Saint Petersburg

Aleksandra A. Blazhenko

The Research Institute of Obstetrics, Gynecology and Reproductology named after D.O. Ott

Email: alexandrablazhenko@gmail.com
ORCID iD: 0000-0002-8079-0991
SPIN-code: 8762-3604

MD, Cand. Sci. (Med.)

Russian Federation, Saint Petersburg

Kirill А. Denisov

The Research Institute of Obstetrics, Gynecology and Reproductology named after D.O. Ott

Email: denisov4work@gmail.com
Russian Federation, Saint-Petersburg

Anastasia P. Sazonova

The Research Institute of Obstetrics, Gynecology and Reproductology named after D.O. Ott

Email: nastenka.sazonova.97@mail.ru
Russian Federation, Saint-Petersburg

Andrey V. Korenevsky

The Research Institute of Obstetrics, Gynecology and Reproductology named after D.O. Ott

Author for correspondence.
Email: a.korenevsky@yandex.ru
ORCID iD: 0000-0002-0365-8532
SPIN-code: 7942-6016

Dr. Sci. (Biol.)

Russian Federation, Saint-Petersburg

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2. Fig. 1. Nutrient status parameters and homocysteine levels in groups of pregnant women with fetal congenital malformations with or without a chromosomal abnormality: a, serum folic acid; b, erythrocyte folic acid; c, serum homocysteine; d, serum vitamin B12; e, serum vitamin D. CA, chromosomal abnormalities

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3. Fig. 2. Correlations between nutrient status parameters in groups of pregnant women with fetal congenital malformations: a, correlation relationships (red lines indicate significant associations); b, correlation relationships between folic acid and vitamin B12 levels in the group of women without neural tube defects; c, correlation relationships between folic acid and vitamin B12 levels in the group of women with neural tube defects. FAser, serum folic acid; FAer, erythrocyte folic acid; HC, serum homocysteine; B12, serum vitamin B12; D, serum vitamin D; NTD, neural tube defect; rs, Spearman’s rank correlation value; * p < 0.05

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4. Fig. 3. Nutrient status parameters and homocysteine levels in groups of pregnant women with fetal congenital malformations with or without neural tube defects: a, serum folic acid; b, erythrocyte folic acid; c, serum homocysteine; d, serum vitamin B12; e, serum vitamin D. NTD, neural tube defect; * p < 0,05

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5. Fig. 4. Nutrient status parameters and homocysteine levels in groups of pregnant women with fetal congenital malformations or with normal fetal development: a, serum homocysteine (n = 434 with normal development, n = 53 with congenital malformations); b, serum folic acid (n = 71 with normal development, n = 53 with congenital malformations; c, serum vitamin B12 (n = 71 with normal development, n = 53 with congenital malformations). MFCM, multiple fetal congenital malformations; * p < 0.001

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