THE ANALYSIS OF MICRONUTRIENT STATUS OF PREGNANT WOMEN WITH CONGENITAL MALFORMATIONS OF THE FETUS - COGI 2023 The 31st World Congress on Controversies in Obstetrics, Gynecology & Infertility

Margarita Shengeliia ¹ Olesya Bespalova ¹ Yulia Milyutina ² Nodari Shengeliia ¹ Aleksandra Blazhenko ³ Olga Pachuliia ¹ Kirill Denisov ¹ Anastasia Sazonova ¹ Andrey Korenevsky ²

¹Department of Obstetrics and Perinatology, The Research Institute of Obstetrics, Gynecology and Reproductology Named After D.o.ott, Saint-Petersburg
²Department of Biochemistry Group, The Research Institute of Obstetrics, Gynecology and Reproductology Named After D.o.ott, Saint-Petersburg
³Department of the pharmacology group, The Research Institute of Obstetrics, Gynecology and Reproductology Named After D.o.ott, Saint-Petersburg

Problem statement. Congenital malformations (CM) of the central nervous system have extremely severe consequences, which makes it important to study their development and diagnosis in the process of embryogenesis. Particularly relevant are studies in the field of prevention of the formation of CM of the fetus. Objective - to assess the micronutrient status (vitaminD, homocysteine, serum and erythrocyte folic acid, vitaminB12) in women with induced abortion in the second trimester based on CМ.

Methods. A prospective cohort study was conducted in 53 women with induced abortion for medical reasons from the fetus in the second trimester of gestation. All pregnant women were divided into 2 groups: group 1 (n=28) - without an established chromosomal abnormality (СhA-) in the fetus (with fetal CM without neural tube defects (NTD-) (n=16) and with CM of the fetus with a defect in the neural tubes (NTD+) (n=12), group 2 (n=25) - pregnant women with established chromosomal abnormalities (ChA+) in the fetus.

Results. It was shown that in pregnant women with congenital malformations and fetal NTD, the content of vitamin B12 in the blood serum correlates with the level of folic acid in erythrocytes, and is also significantly lower compared to women with congenital malformations, but without NTD (p<0.05). No significant differences were found for other parameters. It has been shown that in pregnant women with fetal CM, the level of homocysteine does not differ from that in women with normal fetal development at this stage of pregnancy. At the same time, the levels of folic acid and vitamin B12 in women with congenital malformations are significantly lower compared to pregnant women without this pathology (p<0.001).

Conclusion. Found in patients with CM with NTD, the features of the micronutrient status, as well as the relationship between its individual indicators, indicate a complex etiology of the development of these pathologies. The obtained results indicate the expediency of assessing indicators of one-carbon metabolism disorders in the mother not only during pregnancy, but also at the stage of preconception preparation.