Role of the hormonal system “Vitamin D/Vitamin D receptors” in the formation of some pregnancy complications

Authors

DOI:

https://doi.org/10.18370/2309-4117.2020.51.65-68

Keywords:

vitamin D hormone, vitamin D receptors, pregnancy complications, preeclampsia, placental dysfunction

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.

Author Biographies

G. S. Manasova, Odesa National Medical University, Odesa

MD, professor, Department of Obstetrics and Gynecology No. 2

A. G. Andrievsky, Odesa National Medical University, Odesa

MD, professor, head of the Department of Obstetrics and Gynecology No. 2

N. V. Didenkul, KU “City Clinical Hospital No. 1” Odesa National Medical University, Odesa

Obstetrician-gynecologist of the gynecological department

Graduate student of the Department of Obstetrics and Gynecology No. 2

I. V. Shpak, Odesa National Medical University Communal non-commercial enterprise “Maternity hospital No. 5”, Odesa

MD, professor, Department of Obstetrics and Gynecology No. 2

Director

M. I. Turchyn, Odesa National Medical University, Odesa

PhD, associate professor of the Department of professional pathology, clinical laboratory and functional diagnostics

N. V. Kuzmin, Communal non-commercial enterprise “Maternity hospital №5” Odesa National Medical University, Odesa

Obstetrician-gynecologist of the 2nd obstetric department

Graduate student of the Department of Obstetrics and Gynecology No. 2

References

  1. Gromova, O.A., Torshin, I.Y., Spirichev, V.B. “Full genome analysis of vitamin D receptor binding sites indicates a wide range of potential uses for vitamin D in therapy.” Medicinskij Sovet 1 (2016): 2–21.
  2. Kalinichenko, S.Y., Zhilenko, M.I., Gusakova, D.A., et al. “Vitamin D and Women's Reproductive Health.” Reproduction problems 4 (2016): 28–36.
  3. Kodencova, V.M., Mendel, O.I., Khotimchenko, S.A., et al. “Physiological need and effective doses of vitamin D to correct its deficiency. The current state of the problem.” Nutrition issues 86 (2017): 47–62.
  4. Barebring, L., Schoenmakers, I., Glantz, A., et al. “Vitamin D Status during Pregnancy in a Multi-Ethnic Population-Representative Swedish Cohort.” Nutrients 8 (2016): 655.
  5. Chan, S.Y., Susarla, R. “Vitamin D promotes human extravillous trophoblast invasion in vitro.” Placenta 36 (2015): 403–9.
  6. Chirumbolo, S., Bjorklund, G., Sboarina, A., Vella, A. “The Role of Vitamin D in the Immune System as a Pro-survival Molecule.” Clin Ther 39 (2017): 894–916.
  7. Christakos, S., Dhawan, P., Verstuyf, A., et al. “Vitamin D: metabolism, molecular mechanism of action, and pleiotropic effects.” Physiol Rev 96 (2016): 365–408.
  8. DeLuca, H.F. “Overview of general physiologic features and functions of vitamin D.” Am J Clin Nutr 80 (2004): 1689–96.
  9. Dutra, L.V., Affonso-Kaufman, F.A., Cafeo, F.R., et al. “Association between vitamin D plasma concentrations and VDR gene variants and the risk of premature birth.” BMC Pregnancy Childbirth 30 (2019).
  10. Friedman, A.M., Cleary, K.L. “Prediction and prevention of ischemic placental disease.” Semin Perinatol 38 (2014): 177–82.
  11. Grayson, R., Hawison, M. “Vitamin D and human pregnancy.” Fetal Maternal Med Rev 22 (2011): 67–90.
  12. Haussler, M.R., Jurutka, P.W., Mizwicki, M., Norman, A.W. “Vitamin D receptor (VDR)-mediated actions of 1α,25(OH)₂vitamin D₃: genomic and non-genomic mechanisms.” Best Pract Res Clin Endocrinol Metab 25 (2011): 543–59.
  13. Holick, M.F., Binkley, N.C., Bischoff-Ferrari, H.A., et al. “Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline.” J Clin Endocrinol Metab 96 (2011): 1911–30.
  14. Javorski, N., Lima, C.A.D., Silva, L.V.C., et al. “Vitamin D receptor (VDR) polymorphisms are associated to spontaneous preterm birth and maternal aspects.” Gene 642 (2017): 58–63.
  15. La Marca, B., Amaral, L.M., Harmon, A.C., et al. “Placental Ischemia and Resultant Phenotype in Animal Models of Preeclampsia.” Jr Curr Hypertens Rep 18 (2016): 38.
  16. LeFevre, M. “Screening for vitamin D deficiency in adults: U.S. preventive services task force recommendation statement.” Ann Intern Med 162 (2015): 133–41.
  17. Liu, N.Q. “Vitamin D and regulation of placental inflammation.” J Immunol 10 (2011): 5968–74.
  18. Merhi, Z., Doswell, A., Krebs, K., Cipolla, M. “Vitamin D alters genes involved in follicular development and steroidogenesis in human cumulus granulosa cells.” J Clin Endocrinol Metab 99 (2014): 1137–45.
  19. Morris, H.A., Anderson, P.H. “Autocrine and paracrine actions of vitamin D.” Clin Biochem Rev 31 (2010): 129–38.
  20. Palacios, C., Kostiuk, L.K., Peña-Rosas, J.P. “Vitamin D supplementation for women during pregnancy.” Cochrane Database Syst Rev 26 (2019): CD008873.
  21. Van Oostrum, N., De Sutter, P., Meys, J., Verstraelen, H. “Risks associated with bacterial vaginosis in infertility patients: a systematic review and meta-analysis.” Hum Reprod 28 (2013): 1809–15.
  22. Wacker, M., Holick, M.F. “Vitamin D – Effects on Skeletal and Extraskeletal Health and the Need for Supplementation.” Nutrients 5 (2013): 111–48.
  23. Wuertz, C., Gilbert, P., Baier, W., Kunz, C. “Cross-sectional study of factors that influence the 25-hydroxyvitamin D status in pregnant women and in cord blood in Germany.” Br J Nutr 110 (2013): 1895–902.
  24. Pludowski, P., Karczmarewicz, E., Bayer, M., et al. “Practical guidelines for the supplementation of vitamin D and the treatment of deficits in Central Europe – recommended vitamin D intakes in the general population and groups at risk of vitamin D deficiency.” Endokrynol Pol 64.4 (2013): 319–27.

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Published

2020-03-25

How to Cite

Manasova, G. S., Andrievsky, A. G., Didenkul, N. V., Shpak, I. V., Turchyn, M. I., & Kuzmin, N. V. (2020). Role of the hormonal system “Vitamin D/Vitamin D receptors” in the formation of some pregnancy complications. REPRODUCTIVE ENDOCRINOLOGY, (51), 65–68. https://doi.org/10.18370/2309-4117.2020.51.65-68

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Interdisciplinary consilium