Features of the exchange of connective tissue and certain microelements in pregnant women with a risk of postterm pregnancy
Keywords:postterm pregnancy, cervix, calcium, vitamin D, connective tissue
Purpose of the study: to investigate the serum content of certain trace elements and synthesis markers (Total P1NP) and collagen resorption (β-CrossLaps) in pregnant women with a risk of postterm pregnancy and their role in this pathology.
Materials and methods. Main group included 80 pregnant women with a risk of postterm pregnancy. Control group consisted of 34 pregnant women without a risk of postterm pregnancy demostrating physiologic cervical maturation. Enzyme immunoassay was used for measurement of synthesis markers (Total P1NP - N-terminal propeptide of type I collagen), connective tissue resorption (ß-CrossLaps), and trace elements - Na, K, Mg, P, total and ionized Ca.
Results. Significant decrease in the concentration of Total P1NP was noted In pregnant women with a risk of postterm pregnancy compared with the control group (50.90 ± 4.27 ng/ml, p <0.05). The average value of connective tissue resorption marker β-CrossLaps in pregnant women of the main group was significantly higher than in the control ones (0.420 ± 0.02 ng/ml and 0.300 ± 0.02 ng/ml respectively). The total Ca was 1.98 ± 0.03 mmol/L that is 7.9% and 10.4% less than the lower limit of the physiological norm and in the control group (2.21 ± 0.04 mmol/l, p < 0.05) respectively. Mg in the main group was 0.68 ± 0.02 mmol/L, that is at the lower limit of the norm, and 20.9% less than in the control group (0.86 ± 0.03 mmol/L; < 0.05). The total serum vitamin D in pregnant women of the main group was 25.4% less than in the control group (23.62 ± 1.61 ng/ml, p <0.05).
Conclusions. An imbalance of the most microelements significant for the normal functioning of connective tissue and processes of transmission of nervous excitation in combination with a deficiency of vitamin D contributes to a cascade of reactions that inhibit the timely restructuring of the cervix structure before childbirth. Pregnant women with a risk of overexposure are characterized by a predominance of type I collagen resorption processes over its synthesis processes, which is probably one of the reasons for the insufficient maturation of the cervix on the eve of childbirth.
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