RESUMO
The aim was to study the prevalence of overweight and obesity in Moscow pregnant women, as well as to conduct a comparative study of normal and excessive women`s body weight influence on the course and outcome of pregnancy and delivery, anthropometric indices and state of newborn`s health, to assess women's dietary intake and to develop approaches to nutritional correction of overweight and obesity in pregnant women. The prevalence of overweight and obesity among pregnant women in Moscow in 2009-2011 was 8.3% of the total number of pregnant women observed. The average weight gain during pregnancy in women with overweight and obesity amounted to 13.8±5.2 kg, that was higher then the weight gain in women with normal body weight (11.7±4.5 kg). In women with overweight and obesity there was an increased risk of complications during pregnancy (preeclampsia, anemia), delivery (more frequent operational, premature and delayed delivery), as well as 2-3 times more frequent birth of children with significantly enhanced birthweight, including macrosomia. A study of dietary intake of women surveyed showed a deviation of diets of pregnant women with overweight and obesity from the physiological standards, which is the increase of fat and saturated fatty acids by 25%, reduced carbohydrate content up to 30%, and the reduction in the diet of women of some micronutrients (folic acid, vitamin A, ß-carotene). The main principles of nutritional correction of diets of pregnant women who are overweight and obese have been presented as well as recommended set of products and exemplary diet for this category of women.
RESUMO
Supporting of bone health is one of the main approaches to provide health in pregnant women considering intensive calcium and other mineral mobilization from mass bone that is necessary forforming fetus bone. This mobilization may lead to decrease of bone mineral density and development of osteopenia and osteoporosis. The important factors of development of bone impairment in pregnancy are nutrition and particular deficient consumption of protein, Ca, vitamin D. The possible role of reduced intake of pregnant women other nutrients remains unexplored. The aim of the research was estimating the prevalence of bone mineral density decrease in regard to the particular course of pregnancy and studying possible effects of key nutrients on bone mineral density in pregnant women. 131 women at different stages of pregnancy were involved in the survey. The bone density assessment was conducted using Bone Densitometer Omnisense 7000. As a criterion for bone density decrease in women used a Z-score, which was considered as normal to -1.0, as reduced from -1.0 to -2,0, and as significantly reduced when Z-score was less than -2,0. Analysis of the actual nutrition was performed by a 24-hour recording of 58 pregnant women. Normal bone mineral density was detected in 54 women or 41% of the total number of women surveyed. In 51 (39%) pregnant women reduced bone mineral density was discovered, and in 26 (20%) patients--significantly reduced bone density. There was a considerable deviation in pregnant patients' diet from the nutrition guidelines, which include, in particular, the high content of fat and saturated fatty acid, reduced intake of some micronutrients such as calcium, zinc, folic acid, ß-carotene, vitamins A, B1, E. However, differences in the actual consumption of nutrients in women with varying bone mineral density have been identified only in case of consumption of fat and energy value of diets, also Mn and I. So, it may be suggested that the differences in bone mineral density between women in our study are caused by genetic polymorphism, which leads to differences in the actual demand for nutrients, sufficient for prevention of bone decrease, in individuals.
