The peculiarities of vitamin D status and clinical characteristic in women with moderate obesity in gestational endotheliopathy

Abstract

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.