ABSTRACT
Fetal growth restriction (FGR) is a complication of pregnancy connected with increased risk of intrauterine fetal demise. To increase the diagnostic accuracy, the cerebral placental ratio (CPR) is used. Vitamin D may play a role in the regulation of vascular flow in the fetus. The aim is to assess the relationship between CPR and vitamin D supplementation in fetuses with early FGR. It is a prospective cohort study. Pregnant females were divided into groups with 2000 IU and <500 IU of vitamin D. Both groups were observed for 14 days; USG was performed three times with one-week intervals. EFW and CPR were measured. Absolute CPR values were initially observed to differ significantly (p = 0.0032). Measurements on the seventh day of observation indicated that CPR was significantly higher (p = 0.0455) in fetuses of patients receiving vitamin D at a dose of 2000 IU 1.75 (IQR: 1.47; 2.06) vs. <500 IU group 1.55 (IQR: 1.04; 1.52). Similarly, on day 14: (p < 0.0001)2.39 (IQR: 1.82; 2.69) vs. 1.21 (IQR: 0.98; 1.52). Supplementation with vitamin D at a dose of 2000 IU may have an influence on the increase in the CPR in fetuses with early FGR.
ABSTRACT
BACKGROUND: Fetal growth restriction (FGR) increases the risk of intrauterine fetal death, infant death and complications in childhood, and diseases that appear in adulthood. Vitamin D may affect fetal vascular flow. The aim of the study was to check if the rate of fetal growth in pregnant women with FGR differs depending on whether the patient was supplemented with vitamin D in the recommended dose of 2000 IU, not supplemented at all, or supplemented with vitamin D in low doses. METHODS: Patients were divided into two groups: suboptimal vitamin D dosage and an accurate dosage of 2000 IU. Fetal growth progress was observed for 14 days. RESULTS: Fetal weight was higher at the beginning, after 1 and 2 weeks of observation in the optimal vit. D group compared with the suboptimal group. The analysis was adjusted to the mother's age, gestational week, and the number of pregnancies. CONCLUSIONS: Greater fetal weight gain can be observed in women with FGR (fetal growth restriction) who intake vitamin D at the recommended dose of 2000 IU compared with women with FGR and with a vitamin D intake dosage lower than 500 IU.
ABSTRACT
OBJECTIVES: Hyperglycemia in pregnancy (HIP) is one of the most common complications of pregnancy. Recently adopted new criteria for the diagnosis of HIP as well as the greater prevalence of risk factors could have a significant impact on HIP prevalence. The objective of the study was to assess the rates of HIP and the associated complications. MATERIAL AND METHODS: This was a retrospective analysis of clinical records from pregnant women who delivered in eight tertiary hospitals in Poland in 2016. RESULTS: The number of pregnant women with hyperglycemia totaled 1280 (7.25%), including gestational diabetes mellitus (GDM) in 1169 (6.62%) women and pregestational diabetes mellitus (PGDM) in 111 (0.63%). In addition to dietary modifications, 477 (41% of the GDM group) women received medical treatment (GDMG2). In women with PGDM multiple daily insulin injections (MDI) were used in 53 (47.7%) cases, continuous subcutaneous insulin infusions (CSII) in 57 (51.3%) cases and one woman was treated with metformin. The rate of cesarean sections was 69.4% and 62.9% for PGDM and GDM, respectively. Large-for-gestational-age (LGA) infants accounted for 38% and 21% of births in the PGDM and GDM groups, respectively. Of note are high rates of hyperbilirubinemia in infants born to mothers treated with insulin (13.5% for PGDM and 14.4% for GDMG2) vs infants born to mothers with diet (GDMG1) (3.4%). CONCLUSIONS: In Poland, the prevalence of HIP has nearly doubled in the past twenty years. Even with appropriate management, HIP is a significant risk factor for a cesarean section delivery, bearing an LGA infant and adverse neonatal outcomes.
