Роль профілактики дефіциту вітаміну D у поліпшенні акушерських, перинатальних та віддалених результатів

Abstract

Much attention is paid to deficiencies prevention during pregnancy, since they negatively affect not only metabolic processes, including fetoplacental complex, but also the condition of the fetus, the newborn, and physical and mental development of the child in the future. Summarizing the recommendations for the use of vitamin D during pregnancy, it should be noted that the typical prophylactic dose is 400 IU/day starting from the first trimester. However, we should consider the use of corrective doses in the second and third trimesters when the fetal skeleton is growing and developing. A high dose of vitamin D (2000 IU/day) is recommended for women at high risk of developing hypertensive complications of pregnancy (a history of preeclampsia, in particular, arising before 28 weeks, arterial hypertension, chronic kidney disease), as well as pregnant women with comorbidity (systemic red lupus, rheumatoid arthritis, multiple sclerosis, cardiovascular disease, inflammatory bowel disease, oncological pathology). For women at risk of vitamin D deficiency, the recommended dose is less than 1000 IU/day. In case of confirmed vitamin D deficiency (<25-30 nmol/L), a correction dose of 2000-4000 IU/day is prescribed for 11 weeks to provide a cumulative dose of about 150,000 or 300,000 units in the second or third trimesters. Today, a sufficient number of vitamin D preparations are presented on the pharmaceutical market of Ukraine, among which one should pay attention to "Olidetrim" (Polpharma, Poland) in the form of oil solution in capsules ensuring its absorption and assimilation. Depending on the dosage, each capsule of the preparation contains 2000 IU or 4000 IU of vitamin D3 (cholecalciferol). In addition to the fat-soluble form, vitamin D preparation Aquadetrim® (Polpharma, Poland) is registered and successfully used in Ukraine. This is a unique form of vitamin D3 based on nanomycellae, which provides better absorption of vitamin D in the intestine. Key words: vitamin D, deficiency, pregnancy, fetus, prevention.