Mineral metabolism at pregnancy and its adequate correction
Keywords:mineral metabolism, bone metabolism, pregnancy, calcium, vitamin D
Disorders of bone and mineral metabolism during gestation affect bone health in women (vitamin D and gestational diabetes, pre-eclampsia, infection associations with pregnancy are established) and fetus, leading to fetal growth retardation, low birth weight and birth children with symptoms of bone mineralization insufficiency. This is due to the calcium redistribution in pregnancy and prerequisites for changing bone mineral metabolism, that may lead to a decrease in bone mineral density, i.e. osteopenia.
It is proved that supplementation with calcium and vitamin D during pregnancy can significantly reduce the level of obstetrical and perinatal complications. Women who plan to become pregnant should start/continue to take vitamin D at doses as recommended for adults (200–2000 IU/day (20.0–50.0 mg/day) depending on body weight). Vitamin D at 1500–2000 IU/day (37.5–50.0 micrograms/day) is prescribed at least to II trimester. If possible, it is necessary to periodically monitor the 25(OH)D level in the blood serum to determine the optimal dose of the drug and test its effectiveness.
Prophylactic therapy should include pharmacological preparations containing a sufficient concentration of elemental calcium in the composition of high-salt biological availability.
Combination of calcium carbonate with physiological doses vitamin D is particularly advantageous, because the results of comparative observations showed calcium carbonate as a most effective and bioavailable form that makes it the drug of choice in pregnancy. Given the combination of nutrient deficiency of mineral and vitamin a Calcium-D3 Nycomed is a drug of choice. In pharmacoeconomic analysis and randomized multicentral clinical study this drug have been demonstrated efficacy and safety of long-term use, and high adherence to treatment by patients.
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