Micronutrient status of pregnant women with fetal congenital malformations

Abstract

BACKGROUND: Congenital malformations of the central nervous system have extremely severe consequences, which makes it important to study their development and diagnosis during embryogenesis. Therefore, particularly relevant are studies in the field of prevention of fetal сongenital malformations.

AIM: The aim of this study was to assess the micronutrient status (vitamin D, serum and erythrocyte folic acid, vitamin B₁₂) and homocysteine levels in women with induced abortion in the second trimester of pregnancy based on fetal indications (fetal сongenital malformations).

MATERIALS AND METHODS: This prospective cohort study enrolled 53 women with induced abortion for medical reasons from the fetus in the second trimester of gestation. All pregnant women were divided into two groups. Group 1 included 28 individuals without an established chromosomal abnormality in the fetus: with fetal сongenital malformations and no neural tube defects (n = 16) or with fetal сongenital malformations and neural tube defects (n = 12). Group 2 consisted of 25 pregnant women with established chromosomal abnormalities in the fetus.

RESULTS: In pregnant women with fetal сongenital malformations and neural tube defects, blood serum vitamin B₁₂ level correlated with erythrocyte folic acid level and was lower compared with women with fetal сongenital malformations and no neural tube defects (p < 0.05). No significant differences were found for other parameters. In pregnant women with fetal сongenital malformations, homocysteine level did not differ from that in women with normal fetal development at this stage of pregnancy. Meanwhile, folic acid and vitamin B₁₂ levels in women with fetal сongenital malformations were lower compared with pregnant women without this pathology (p < 0.001).

CONCLUSIONS: The features of micronutrient status found in patients with fetal сongenital malformations, in particular with neural tube defects, and the relationships between its individual parameters indicate complex etiologies of these pathologies. The data obtained indicate the expediency of assessing one-carbon metabolic parameters in the mother not only during pregnancy, but also at the stage of preconception preparation, as well as the need for additional research related to adequate control of vitamin intake and assessment of methionine cycle gene polymorphism.

Keywords

fetal congenital malformations / neural tube defect / abortion / micronutrient status / vitamins / II trimester / pregnancy

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