Obesity and hypovitaminosis D3 as risk factor for puerperal complications

Abstract

Aim. To study the puerperal complications in women with disturbance of fat metabolism associated with hypovitaminosis D3.

Materials and methods. One hundred and two puerperal women were examined after giving birth to a child at the City Perinatal Center.

Results. The number of puerperal complications in the group of women with obesity and hypovitaminosis D occurred twice as more often than in women with normal body mass. From all complications, there prevailed lactostasis and hypogalactia. Only in the group of puerperas with high body mass index and low vitamin D content combined, there were detected subinvolution and puerperal endometriosis.

Conclusions. Patients with obesity and low vitamin D3 content need more thorough preparation to delivery and lactation at “The Mother’s School” when they are observed during pregnancy. Personnel of maternity hospital and patient’s relatives ought to take an active part in puerperal care and promote early activation of puerpera with obesity to reduce possible complications.

Keywords

obesity / puerperal complications / hypovitaminosis D

References

[1] Акушерство: справочник Калифорнийского университета. Под ред. К. Нисвандера, А. Эванса. М.: 1999; 704.

[2] Акушерство: нац. руководство. Под ред. Г.Т. Сухих, В.Е. Радзинского, Г.М. Савельевой. М.: ГЭОТАР-Медиа 2015; 1080.

[3] Голикова Т.П., Дурандин Ю.М. Осложнения беременности и родов у женщин с ожирением. Вестник Российской ассоциации акушеров-гинекологов 2009; 2: 12–14.

[4] Громова О.А., Торшин И.Ю. Витамин D – смена парадигмы. М.: ГЭОТАР-Медиа 2017; 568.

[5] Макарова Е.Л., Терехина Н.А., Падруль М.М. Статус адипокинов в сыворотке крови беременных с ожирением. Клиническая лабораторная диагностика 2015; 9 (60): 61–62.

[6] Мальцева Л.И., Васильева Э.Н. Новые подходы к оценке роли витамина Д в репродуктивном здоровье женщины. Практическая медицина 2013; 7: 12–19.

[7] Сычева О.Ю. Оценка течения беременности и исхода родов при ожирении: ретроспективное когортное исследование. Проблемы женского здоровья 2011; 6 (4): 41–45.

[8] Jevitt C., Hernandez I., Groer M. Lactation complicated by overweight and obesity: Supporting the mother and newborn. Journal of Midwifery & Women’s Health 2007; 6 (52): 606–613.

[9] Lewis S., Lucas R.M., Halliday J., Ponsonby A.L. Vitamin D deficiency and pregnancy: From preconception to birth. Molecular Nutrtion and Food Research. 2010; 8 (54): 1092–1102.

[10] Vimaleswaran K.S., Berry O.J., Lu Chen, Tikkanen E. et al. Causal relationship between obesity and vitamin D status: bi-directional Mendelian randomization analysis of multiple cohorts. PLoS Med. 2013, available at: https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1001383.

[11] Wortsman J., Matsuoka L.Y., Chen T.C., Lu Z., Holick M.F. Decreased bioavailability of vitamin D in obesity. American Journal of Clinical Nutrition 2000; 72 (3): 690–693.

RIGHTS & PERMISSIONS

Makarova E.L., Padrul M.M.