Abstract
Introduction. The hormonal system “vitamin D/vitamin D receptors” (VD/VDR) is involved in the regulation of numerous physiological processes. VD lack or deficiency is associated with a number of different diseases, including pregnancy complications.Purpose of the study: to determine VD status and its effect on the course of the gestational process in women from the southern region of Ukraine.Materials and methods. 459 women were examined, 318 (69.3%) of them were the main group and 141 (30.7%) were the comparison group.In addition to standard general clinical examinations, ELISA on a COBAS Integra 400 Plus analyzer (Roche Diagnostics, Switzerland) the VD level was determined in the blood.Results and discussion. 49.9% of the pregnant women in the main group had insufficient VD level (25.45 ± 4.63 ng/ml), in 19.4% it corresponded to a deficit (15.28 ± 4.78 ng/ml). VD concentration in the comparison group was 43.38 ± 9.67 ng/ml (p <0.01). Significantly more frequent pregnancy complications in the main group were threatening abortion (45.6% VS 9.9%; F = 0.00001; p <0.01), preeclampsia (13.5% VS 2.8%; F = 0.0093; p <0, 05), placental dysfunction (32% VS 7%; F = 0.00001; p <0.01), vaginal dysbiosis (64.4% VS 18.4%; F = 0.00001; p <0.01), pregnant anemia (43.7% VS 20.6%; F = 0.0008; p <0.01) and signs of inflammation of the amniotic membranes (38.3% VS 13.4%). Syndrome of intrauterine growth retardation diagnosed in 9% women in the main group; in the comparison group none case was noted.Conclusion. 70% of pregnant women in Odesa region have a lack or deficiency of VD. Pregnancy course is characterized by a significantly greater frequency of preeclampsia (4.8 times more often), placental dysfunction (4.5 times), threat of miscarriage (4.6 times more often), intrauterine infection (2.8 times more often), gestational anemia (2.5 times more). It seems promising to conduct further research on the possibility of preventing complications of the gestational process by correcting VD status.
Highlights
The latest findings demonstrate that biological role of hormonal system“vitamin D/vitamin D receptor” (VD/VDR system) is not limited to its classical effect on bone-mineral metabolism
Exclusion criteria were the presence of severe extragenital pathology, impaired fat metabolism, skin diseases, autoimmune diseases, thyroid and parathyroid glands diseases, which can have a significant effect on the metabolism and level of VD in blood serum
OF THE RESULTS The data of a high incidence of VD deficiency/shortage in pregnant women dwelling in a region with high levels of solar insolation are probably a reflection of general population-based behavioral characteristics, in particular a commitment to the widespread use of sunscreens, on the one hand, and a limited time spent in the sun, on the other hand, which leads to a decrease of cholecalciferol synthesis in the skin [13, 16]
Summary
The latest findings demonstrate that biological role of hormonal system“vitamin D/vitamin D receptor” (VD/VDR system) is not limited to its classical effect on bone-mineral metabolism. It was ascertained that calcitriol as a classical steroid hormone involved in the regulation of a number of physiological processes by auto-, para- and endocrine pathways, and discovery of more than 2200 genes encoding its receptors in many organs and tissues and controlling more than 3% of human’s genome allowed us to state that VD lack or deficiency is associated with a number of diseases that are not associated with its participation in calcium homeostasis regulation [1, 8, 12]. Studies of VD role in the pathomechanisms of the formation and development of the reproductive system organs various diseases, as well as pregnancy complications, are one of the important directions of modern reproductology, obstetrics and prenatology [2, 9, 20]. Purpose of the study: to determine VD status and its effect on the course of gestational process in the women dwelling in the southern region of Ukraine
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