The modern clinical features of effective prevention of gestational and fetal pathology

Abstract

Aim of the literature review: to evaluate the prophylactic clinical effect of oral vitamin and mineral supplementation (VMS) in pregnancy on perinatal and neonatal outcomes. Materials and methods. Authors were searched Cochrane Review, WHO platform, clinical guidelines, and reference lists of retrieved studies on Medline. All prospective randomized controlled trials evaluating VMS with folic acid, vitamin D, iron, iodine, vitamin A, ω-3 long chain polyunsaturated fatty acids, zinc, calcium, vitamin E and C during pregnancy and its effects on pregnancy outcomes were eligible, irrespective of language or the publication status of trials. Trial reports that were published as abstracts were eligible. Results. Complex using of VMS led to reduction in congenital fetal anomalies, maternal anemia. Authors did not find an important effect on results of perinatal and neonatal mortality. VMS in pregnancy probably led to slightly fewer stillbirths, prevent of gestational diabetes, a reduction in babies considered low birth weight, and slight led to a reduction in babies considered small gestational age. Authors were observed a little or no difference for other maternal, fetal and infant outcomes: preeclampsia, maternal mortality, miscarriage, autism, and spinal cord tumor for infant. VMS probably led to reduction in very early preterm births, although there was no difference identified in induction of labor for post-term pregnancies, and no impact on the rates of cesarean sections. Authors didn’t find any information that VMS increases rates cases of macrosomia. There were no cases of side effects of VMS in optimal doses on mother, fetus and child. Аuthors were unable to assess a number of prespecified, clinically important outcomes due to insufficient or non-available data. Conclusions. Аuthors findings suggest a positive preventive impact of VMS with folic acid, vitamin D, iron, iodine, zinc, vitamin A, ω-3 fatty acids on several birth outcomes (congenital fetal anomalies, maternal anemia, stillbirths, low birth weight, and preterm birth). No important benefits or harms of VMS were found for mortality outcomes (perinatal and neonatal mortality). These findings may provide some basis to guide the replacement of monocomponent supplements with complex VMS for pregnant women residing in Ukraine.

Keywords

• vitamin and mineral supplementation
• folic acid
• metafolin
• vitamin d
• iron supplementation
• iodine supplementation
• pregnancy
• congenital fetal anomalies
• maternal anemia
• preterm birth
• preeclampsia