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4 . 2021

Micronutrient provision of women in the Russian Federation: impact on the favorable course of pregnancy, perinatal outcomes and demographic indicators

Abstract

This review article summarizes the current evidence on the role of micronutrient support in pregnancy. Proper supply of vitamins and minerals is one of the most important condition for the development of the fetus and a favorable course of pregnancy. In Russia, the prevalence of hypovitaminosis is extremely high, along with this, usually we are talking about poly-hypovitaminosis (deficiency of several vitamins at once). The use of folic acid and multivitamins has been proven to prevent neural tube closure defects and other fetal malformations, and therefore folic acid is recommended in many countries at a dose of 400-800 mcg per day. In 2019, a new Cochrane meta-analysis was published, according to which multivitamins have an advantage over iron and folic acid in the prevention of complications of pregnancy and perinatal outcomes, such as the birth of children with very low birth weight, intrauterine growth retardation, early preterm birth. The greatest evidence is provided by vitamin-mineral complexes containing folic acid, vitamin D and iron and corresponding to the UNIMMAP standard. Given the importance of the issue, the authors are conducting a socio-economic study, which will be published later. Preliminary results of calculations show that an increase in the number of those using vitamins before pregnancy from 10% to at least 50% could prevent 8.9 thousand cases of perinatal mortality, 1.3 thousand cases of disability and 6.8 thousand congenital pathologies.

Keywords:micronutrients, polyhypovitaminosis, pregnancy, perinatal outcomes, demographic indicators, folic acid, vitamin D, iron supplements

Funding. The authors declare no sponsorship.

Conflict of interest. Socio-economic research on the effects of multivitamins (collection, analysis of data, presentation of results) is supported by JSC "Bayer". Authors Sokolov K.A., Kartashov D.D., Suldenko V.V. are Bayer staff members and meet the ICMJE International Publication Criteria. All article authors express their independent opinion and do not receive any fees for participation in this publication from any multivitamin manufacturer organizations.

For citation: Baranov I.I., Dmitriev M.E., Popovich L.D., Tetruashvili N.K., Yarmolinskaya M.I., Zimokha A.Yu., Kartashov D.D., Svetlichnaya S.V., Sokolov K.A., Suldenko V.V. Micronutrient provision of women in the Russian Federation: impact on the favorable course of pregnancy, perinatal outcomes and demographic indicators. Akusherstvo i ginekologiya: novosti, mneniya, obuchenie [Obstetrics and Gynecology: News, Opinions, Training]. 2021; 9 (4): 44-51. DOI: https://doi.org/10.33029/2303-9698-2021-9-4-44-51 (in Russian)

REFERENCES

1. Federal State Statistics Service. Fertility, mortality and natural increase in 2021. (in Russian)

2. Resolution of the Council of Experts «An Individualized Approach to Micronutrient Supplementation during Pregnancy». Akusherstvo i ginekologiya [Obstetrics and Gynecology]. 2020; 11: 248-50. DOI: https://doi.org/10.18565/aig.2020.11.248-250 (in Russian)

3. Коденцова В.М., Вржесинская О.А. Витамины в питании беременных и кормящих женщин. Voprosy ginekologii, akusherstva i perinatologii [Problems of Gynaecology, Obstetrics and Perinatology]. 2013; 12: 38-50. (in Russian)

4. Institute of Medicine. Dietary Reference Intakes for Calcium, Phosphorus, Magnesium, Vitamin D, and Fluoride. 1997.

5. Committee on Medical Aspects of Food Policy. Dietary Reference Values for Food Energy and Nutrients in the United Kingdom. Report of the Panel on Dietary Reference Values of the Committee on Medical Aspects of Food Policy. London: HMSO, 1991.

6. Blumfield M.L., Hure A.J., Macdonald-Wicks L., Smith R., Collins C.E. A systematic review and meta-analysis of micronutrient intakes during pregnancy in developed countries. Nutr Rev. 2013; 71: 118-32. DOI: https://doi.org/10.1111/nure.12003

7. Kodentsova V.M., Vrzhesinskaya O.A., Kosheleva O.V., Beketova NA, Sharafetdinov K.Kh. Antioxidant vitamin status of obese patients in terms of the risk of comorbidities. Obes Metab. 2020; 17: 22-32. DOI: https://doi.org/10.14341/omet10144

8. Wieder-Huszla S., Jurczak A., Szkup M., Barczak K., Dot^gowska B., Schneider-Matyka D., et al. Relationships between vitamin D3 and metabolic syndrome. IJERPH. 2019; 16: 175. DOI: https://doi.org/10.3390/ijerph16020175

9. Onishchenko G.G., Suplotova L.A., Sharukho G.V. Prevention of micronutrient deficiency in the implementation of the Concept of a healthy diet. Zdorov'ye naseleniya i sreda obitaniya [Public Health and Habitat]. 2011. 4-7. (in Russian)

10. Petrushkina A.A., Pigarova E.A., Rozhinskaya L.Y. The prevalence of vitamin D deficiency in Russian Federation. Osteoporos Bone Dis 2019; 21: 15-20. DOI: https://doi.org/10.14341/osteo10038

11. Tao M., Shao H., Gu J., Zhen Z. Vitamin D status of pregnant women in Shanghai, China. J Matern Fetal Neonatal Med. 2012; 25: 237-9. DOI: https://doi.org/10.3109/14767058.2011.569613

12. Ren A., Zhang L., Li Z., Hao L., Tian Y., Li Z. Awareness and use of folic acid, and blood folate concentrations among pregnant women in northern China - an area with a high prevalence of neural tube defects. Reprod Toxicol. 2006; 22: 431-6. DOI: https://doi.org/10.1016/j.re-protox.2006.02.003

13. Bayer internal data. Marketing research report on the use and attitude of consumers to Elevit products in Russia. 2020. (in Russian)

14. Smithells R.W., Sheppard S., Schorah C.J., Seller M.J., Nevin N.C., Harris R., et al. Possible prevention of neural tube defects by periconceptional vitamin supplementation. Lancet. 1980; 1 (8164): 339-40.

15. MRC Vitamin Study Research Group; Wald N. Prevention of neural tube defects: results of the Medical Research Council Vitamin Study. Lancet. 1991; 338: 131-7.

16. Marangoni F., Cetin I., Verduci E., Canzone G., Giovannini M., Scollo P., et al. Maternal diet and nutrient requirements in pregnancy and breastfeeding. an Italian Consensus Document. Nutrients. 2016; 8: 629. DOI: https://doi.org/10.3390/nu8100629

17. US Preventive Services Task Force; Bibbins-Domingo K., Grossman D.C., Curry S.J., Davidson K.W., Epling J.W., et al. Folic acid supplementation for the prevention of neural tube defects: US Preventive Services Task Force Recommendation Statement. JAMA. 2017; 317: 183. DOI: https://doi.org/10.1001/jama.2016.19438

18. World Health Organisation. e-Library of Evidence for Nutrition Actions (eLENA). Fortification of wheat flour. 2017.

19. Greenberg J.A., Bell S.J., Guan Y., Yu Y. Folic Acid supplementation and pregnancy: more than just neural tube defect prevention. Rev Obstet Gynecol. 2011; 4 (2): 52-9.

20. Lamers Y., Prinz-Langenohl R., Bramswig S., Pietrzik K. Red blood cell folate increase more after supplementation with [6 S]-5-methyltetrahy-drofolate than with folic acid in women of childbearing age. Am J Clin Nutr. 2006; 84: 156-61. DOI: https://doi.org/10.1093/ajcn/84.1.156

21. Czeizel A.E., Dudas I., Metneki J. Pregnancy outcomes in a randomised controlled trial of periconceptional multivitamin supplementation. Final report. Arch Gynecol Obstet. 1994; 255 (3): 131-9.

22. Czeizel A.E. Primary prevention of neural-tube defects and some other major congenital abnormalities: recommendations for the appropriate use of folic acid during pregnancy. Paediatr Drugs. 2000; 2: 437-49. DOI: https://doi.org/10.2165/00128072-200002060-00003

23. Keats E.C., Haider B.A., Tam E., Bhutta Z.A. Multiple-micronutrient supplementation for women during pregnancy. Cochrane Database Syst Rev. 2019; 3: CD004905. DOI: https://doi.org/10.1002/14651858. CD004905.pub6

24. Czeizel A.E., Metneki J., Dudas I. The effect of preconceptional multivitamin supplementation on fertility. Int J Vitam Nutr Res. 1996; 66: 55-8.

25. Maconochie N., Doyle P., Prior S., Simmons R. Risk factors for first trimester miscarriage-results from a UK-population-based case-control study. BJOG. 2007; 114: 170-86. DOI: https://doi.org/10.111Vj.1471-0528.2006.01193.x

26. Monastra G., De Grazia S., De Luca L., Vittorio S., Unfer V. Vitamin D: a steroid hormone with progesterone-like activity. Eur Rev Med Pharmacol Sci. 2018; 22: 2502-12. DOI: https://doi.org/10.26355/eurrev_201804_14845

27. Bodnar L.M., Catov J.M., Simhan H.N., Holick M.F., Powers R.W., Roberts J.M. Maternal vitamin D deficiency increases the risk of preeclampsia. J Clin Endocrinol Metab. 2007; 92: 3517-22. DOI: https://doi.org/10.1210/jc.2007-0718

28. Amraei M., Mohamadpour S., Sayehmiri K., Mousavi S.F., Shirza-dpour E., Moayeri A. Effects of vitamin D deficiency on incidence risk of gestational diabetes mellitus: a systematic review and meta-analysis. Front Endocrinol. 2018; 9: 7. DOI: https://doi.org/10.3389/fendo.2018.00007

29. Special Programme of Research D and Research Training in Human Reproduction (World Health Organization), World Health Organization. WHO antenatal care recommendations for a positive pregnancy experience: nutritional interventions update: multiple micronutrient supplements during pregnancy. 2020.

30. Douglas Wilson R., Van Mieghem T., Langlois S., Church P. Guideline No. 410: prevention, screening, diagnosis, and pregnancy management for fetal neural tube defects. J Obstet Gynaecol Can. 2021; 43: 124-39.e8. DOI: https://doi.org/10.1016/jjogc.2020.11.003

31. Baranov I.I. Algorithm of vitamin support for pregnancy. Obstetrics and Gynecology. Diagnostic and treatment algorithms. 2020: 14-15. (in Russian)

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CHIEF EDITORS
CHIEF EDITOR
Sukhikh Gennadii Tikhonovich
Academician of the Russian Academy of Medical Sciences, V.I. Kulakov Obstetrics, Gynecology and Perinatology National Medical Research Center of Ministry of Healthсаre of the Russian Federation, Moscow
CHIEF EDITOR
Kurtser Mark Arkadievich
Academician of the Russian Academy of Sciences, MD, Professor, Head of the Obstetrics and Gynecology Subdepartment of the Pediatric Department, N.I. Pirogov Russian National Scientific Research Medical University, Ministry of Health of the Russian Federation
CHIEF EDITOR
Radzinsky Viktor Evseevich
Corresponding Member of the Russian Academy of Sciences, MD, Professor, Head of the Subdepartment of Obstetrics and Gynecology with a Course of Perinatology of the Medical Department in the Russian People?s Friendship University

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