The state of bone and mineral metabolism in underweight pregnant women L. P. Shelestova

In the available literature there are various data about changes in calcium-phosphorus and bone metabolism during pregnancy. The aim of the research – to study the state of bone-mineral metabolism in underweight pregnant women. Materials and methods. The research included 41 pregnant women with body weight deficiency at the beginning of pregnancy and 37 of them before labor, and also 35 pregnant women with normal body weight. The content of total calcium, nonorganic phosphorus, parathyroid hormone, osteocalcin, vitamin D total (25(OH)D) were defined in blood serum. The study of bone tissue mineral density was held with the use of ultrasound densitometry. Results. It has been found the statistically considerable decreasing of total calcium content in the underweight pregnant women pregnant in comparison with women who have normal body weight at the beginning of pregnancy – 2.25 (2.21; 2.32) against 2.34 (2.36; 2.41) mmol/l, P = 0.001 and before labor – 2.20 (2.07; 2.30) against 2.27 (2.23; 2.35) mmol/l, P = 0.003), phosphorus (1.18 (1.12; 1.24) against 1.21 (1.17; 1.29) mmol/l, P = 0.024 and 1.16 (1.08; 1.21) against 1.20 (1.14; 1.25) mmol/l, P = 0.027), parathyroid hormone (19.4 (14.9; 28.9) against 34.5 (30.8; 38.6) pg/ml, P < 0.001 and 14.8 (13.5; 24.4) against 30.5 (18.1; 34.3) pg/ml, P < 0.001), osteocalcin (13.8 (9.3; 18.2) against 21.2 (15.4; 23.8) ng/ml, P < 0.001 and 12.3 (8.8; 16.9) against 18.3 (15.2; 20.3) ng/ml, P < 0.001), vitamin D (27.1 (24.1; 30.0) against 29.9 (27.8; 33.3) ng/ml, P = 0.004 and 23.8 (20.5; 27.8) against 28.0 (25.8; 29.9) ng/ml, P < 0.001). At the beginning of pregnancy 36.6 % women with body weight deficiency and 5.7% women with normal body weight (P = 0.003) had signs of osteopenic syndrome, before labor their amount increased up to 51.4 and 11.4 % (P < 0.001) respectively. Conclusions. The gestation in underweight women develops with affection of bone and mineral metabolism, as evidenced by the statistically considerable decrease of calcium-phosphorus indexes and bone tissue markers and the existence of osteopenic syndrome signs. Aggravation of these changes takes place before delivery. body weight; pregnancy; bone density; densitometr