Objectives: to evaluate the effectiveness of multidose supplementation of vitamin D on the dynamics of serum levels of markers of lipid metabolism in pregnant women with obesity. Materials and methods. The study included 75 pregnant women with the І degree of obesity and low vitamin D status, who were divided into subgroups depending on the vitamin D dose of and the baseline 25(OH)D level in blood serum: I subgroup – 24 women with 25(OH)D less than 22.0 ng/ml who received Decristol 4000 IU/day; II subgroup – 26 pregnant women with 25(OH)D = 22.1–28.0 ng/ml who received Decristol 2000 IU/day; III subgroup – 25 patients with 25(OH)D over 28.1 ng/ml, who received 1000 IU of vitamin D per day. Pregnant women of all these subgroups also took acetylsalicylic acid at a dose of 100 mg/day. The control group included 26 practically healthy women who received 600 IU of vitamin D per day. Serum adipokinins levels were studied at 11–13, 22–24 and 31–33 weeks of gestation.Results. Significant differences were found in the increase of leptin (p < 0.0001) and resistin (p < 0.0001) and the decrease of adiponectin (p = 0.006) in pregnant women with impaired vitamin D metabolism against the background of moderate obesity in the І trimester compared to the control group. A more positive effect was found for Decristol 4000 IU (patients with vitamin D deficiency), against the treatment of Decristol 2000 IU (patients with vitamin D deficiency). At 31–33 weeks of gestation, there was a statistically significant decrease in serum level of resistin (p = 0.006) and a similar increase in adiponectin (p = 0.025) in patients receiving vitamin D 4000 IU, compared with the same indicators in clinical subgroups. Resistin and adiponectin may be markers of perinatal pathology in obese pregnant women in the first trimester of gestation, in terms of specificity (91.5 and 78.7%, respectively), sensitivity (100.0 and 91.3%, respectively); positive probability (11.75 and 4.29%, respectively), negative prognostic value (100.0 and 94.9%, respectively) and test accuracy (94.3 and 82.9%, respectively).Conclusions. The use of markers of lipid metabolism as diagnostic criteria during pregnancy in women with the І degree of obesity and low vitamin D status has predictor and prognostic value for the risk of perinatal pathology and helps to assess the effectiveness of comprehensive prophylactic therapy.
Annotation. Obesity during pregnancy is associated with an increased risk of serious adverse perinatal outcomes. The aim of our clinical prospective study was to evaluate the clinical effectiveness of preventive therapy in pregnant women with obesity and vitamin D deficiency. Pregnant patients with obesity were divided into clinical subgroups, depending on the dose of vitamin D preparation at the beginning of preventive therapy in accordance with the initial serum level of 25(OH)D. The first subgroup of the clinical group of the prospective study - 24 women who had a level of 25(OH)D in blood serum less than 22.0 ng/ml, in addition to low dose (100 mg per day) of acetylsalicylic acid (ASA) received vitamin D (4000 IU per day), the II-nd clinical subgroup consisted of 26 pregnant women who received ASA (100 mg per day) and vitamin D (2000 IU per day) with an initial serum concentration of 25(OH)D 22.1-28.0 ng/ml and III-d subgroup – 25 patients who received the low dose ASA and vitamin D (1000 IU per day), who had a serum 25(OH)D content of more than 28.1 ng/ml. Practically healthy pregnant women from the control group received 600 IU of vitamin D per day. The prescription of the drugs began at 10-12 weeks of pregnancy, and ended at 36 weeks of gestation. Variational and statistical processing of the research results was performed using the "STATISTICA 10" Enterprise Portable program. According to analysis of the clinical effectiveness of complex preventive therapy we found that a more positive effect was achieved with additional supplementation of vitamin D to pregnant women in a dose of 4000 IU (100 μg) per day with prior – the established level of 25(OH)D <20 nmol/l (12 ng/ml), against the appointment of 2000 IU of vitamin D (50 μg) to patients with a level of 25(OH)D of 20-30 nmol/l (8-12 ng/ml). The clinical effectiveness of the aforementioned preventive strategy was primarily a significant reduction in perinatal pathology cases (by 2 times), de novo hypertensive disorders (by 3.7 times), placental dysfunction (by 5.5 times) and fetal growth restriction (by 4.6 times), fetal distress (3.1 times), uterine subinvolution (3.7 times), postpartum septic complications (7.3 times), early neonatal adaptation disorders (2.5 times), newborn asphyxia (3, 2 times), as well as a significant decrease in cases of anomalies of labor activity (р=0.04), bacterial vaginosis (р=0.03). During and after using the proposed prophylactic therapy, there were no cases of side effects of the drugs, both on the part of the mother, and on the part of the fetus and newborn child.
Preeclampsia (PE) is a main cause of morbidity and mortality for both mother and fetus. The frequency of PE is from 2 % to 8 %. The complications which are related to PE lead to more than 50,000 maternal deaths and more than 500,000 fetal deaths worldwide each year. In Ukraine, PE was diagnosed in 11,075 women in 2020 (39.32 per 1,000 births), of which severe PE was diagnosed in 1,573 women (5.58 per 1,000 births).The advances in obstetrics and neonatology have significantly mitigated many adverse pregnancy outcomes associated with PE. The optimal prevention of PE is essential to prevent the morbidity and mortality associated with this pathology. The number of researches about new management for the prevention or treatment of PE and new drugs that can affect the pathophysiology of the disease increases. The main value of potential candidates for the prevention of PE is the preclinical impact on oxidative stress, antiangiogenic factors, as well as thrombogenic potential and proinflammatory pathways of pathology development. A systematic data search was carried out in MEDLINE, ISI Web of Science, PubMed, Scopus, Google Scholar and Proquest databases for 2014–2022. In this review, the results of preclinical and clinical studies about the rational prevention of the development of PE in pregnant women at risk with the involvement of the most promising drugs were analyzed. Preclinical studies have suggested new molecular targeting strategies, such as monoclonal antibodies directed against tumor necrosis factor alpha, placental growth factor, and short interfering ribonucleic acid technology to inhibit soluble fms-like tyrosine kinase-1 or angiotensinogen gene expression. Other treatment approaches that have progressed to phase III trials (either completed or ongoing) include proton pump inhibitors, metformin, nitric oxide donors and precursors, recombinant antithrombin III, digoxin immune antigen, and melatonin. There are cases suggesting that deletion of circulating soluble fms-like tyrosine kinase-1 can help to stabilize PE and prolong pregnancy.
Annotation. Maternal obesity is associated with perinatal complications and increases the risk for the infant to develop cardiovascular disease later in life. The aim of present study was to assess the maternal serum 25(ОН)D levels and main clinical data in pregnancies with obese I in the presence or absence of comorbid diseases and to compare the results with healthy controls. In accordance with the purpose of our clinical study, in the first stage, we conducted a prospective analysis of the social, somatic, gynecological, and obstetric history of women with obesity and decreased serum levels of vitamin D. The main group consisted of 75 pregnant patients with grade I obesity (BMI = 30 - 34.99 kg/m2), serum 25 (OH) D content <32 ng/ml, however > 16 ng/ml and gestational endotheliopathy. The control group included 26 practically healthy pregnant women with a physiological course of gestation with a normative indicator of serum vitamin D. 85.3% of women with obese I had serum insufficiency (66.7%) and vitamin D deficiency (18.6%). Variational and statistical processing of the survey results was performed using the program “STATISTICA 10” Enterprise Portable with the definition of the main variational indicators. Moderate obesity and vitamin D insufficiency/deficiency were statistically likely to be associated with material security problems (p=0.031); unbalanced diet (p=0.03); hypodynamia (p=0.001); stressful working conditions (p=0.0045) and smoking (p=0.0045). Women with obesity and low vitamin D status had an increased risk of cardiovascular disease (p=0.029) and gastrointestinal disease (p=0.006). It was noteworthy that women with vitamin D imbalance and obese I had a significantly shorter duration of both the menstrual cycle (p=0.02) and duration of menstrual periods and blood loss during period (p=0.004 and p=0.02). For patients with obesity and decreased serum levels of 25 (OH) D, there was an increase in the number of cases of aggravated gynecological history (p=0.0001), in particular, cases of PCOS (p=0.03); frequency of miscarriage (p=0.042) and antenatal complications, in general (p=0.0012). Further research will assess the clinical effectiveness of personalized dose supplementation of vitamin D (depending on status) in obese pregnant women to prevent the development of perinatal pathology.
Widespread use of antibiotics in clinical practice leads to the development of antibiotic resistance and encourages the search for new ways of modulation of their therapeutic effect. One of the potentially successful modulators may be Hydrogen sulfide, but the mechanisms of its action require careful studies, including toxicological. The aim of the study was to study the effect of Hydrogen sulfide levels on the embryotoxicity and fetotoxicity of oral and intravaginal Clindamycin phosphate administration. The experimental study was performed on 60 pregnant female rats, which were divided into 6 experimental groups: group 1 – control group; group 2 – high level of serum Hydrogen sulfide; group 3 – Clindamycin phosphate intravaginally; group 4 – Clindamycin phosphate intravaginally with high level of serum Hydrogen sulfide; group 5 – Clindamycin phosphate orally; group 6 – Clindamycin phosphate orally with high level of serum Hydrogen sulfide. We studied the dynamics of weight gain in pregnant rats, the number of corpora lutea, the number of implantation sites in the uterus, the number of live and dead fetuses, preimplantation and postimplantation mortality, as well as the dynamics of body weight gain and mental development of offspring. Artificially increasing the serum level of Hydrogen sulfide in pregnant rats led to an increase in maternal weight gain, an increase in the weight and cranio-caudal size of embryos, as well as a decrease in the number of resorbed fetuses and postimplantation mortality. The insignificant toxic effect of high doses of oral Clindamycin phosphate was leveled in the group with elevated indices of serum Hydrogen sulfide. Rats born to females with elevated levels of serum Hydrogen sulfide showed faster rates of weight gain and normal mental development according to the “open field” test.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.