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Профилактика недостатка цинка у беременных женщин
Профилактика недостатка цинка у беременных женщин
Ших Е.В., Махова А.А., Гребенщикова Л.Ю. Профилактика недостатка цинка у беременных женщин. Consilium Medicum. 2015; 17 (6): 32–36. DOI: 10.26442/2075-1753_2015.6.32-36
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Аннотация
Прием витаминно-минеральных комплексов (ВМК) во II и III триместрах беременности, а также на протяжении всего срока беременности обеспечивает в плазме крови родильниц физиологический уровень изучаемых микронутриентов (В1, В12, В9, цинк). Прием ВМК только в III триместре беременности является достаточным для обеспечения в плазме крови родильниц физиологического уровня витаминов С, В2, В6, А, Е и недостаточным для обеспечения физиологического уровня витаминов В1, В12, В9, цинка.
Одним из наиболее сложных микроэлементов в плане коррекции уровня является цинк. Прием цинка в составе Мульти-табс Перинатал в дозе, соответствующей пищевой суточной потребности (15 мг), приводит к достоверному повышению концентрации в плазме крови через 2–3 ч после приема. Для обеспечения физиологического уровня необходимо, начиная не позже чем со II триместра беременности, проводить прием ВМК, содержащих цинк в дозе, не превышающей пищевую суточную потребность.
Ключевые слова: витаминно-минеральный статус, беременность, цинк, продолжительность приема, витаминно-минеральные комплексы.
Одним из наиболее сложных микроэлементов в плане коррекции уровня является цинк. Прием цинка в составе Мульти-табс Перинатал в дозе, соответствующей пищевой суточной потребности (15 мг), приводит к достоверному повышению концентрации в плазме крови через 2–3 ч после приема. Для обеспечения физиологического уровня необходимо, начиная не позже чем со II триместра беременности, проводить прием ВМК, содержащих цинк в дозе, не превышающей пищевую суточную потребность.
Ключевые слова: витаминно-минеральный статус, беременность, цинк, продолжительность приема, витаминно-минеральные комплексы.
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Vitamin-mineral complexes (VMC) in the II and III trimester of pregnancy and during the whole period of pregnancy provides in a blood plasma the physiological levels of micronutrients studied (В1, В12, В9, zinc). Receiving only VMC in the III trimester is sufficient to provide a blood plasma with physiological levels of vitamins C, В2, В6, A, E, and insufficient to provide a physiological level В1, В12, В9, zinc.
One of the most difficult in terms of trace elements level correction is zinc. Receiving zinc composition Multi-tabs Perinatal at a dose corresponding to daily food requirement (15 mg), results in a significant increase in plasma concentrations 2–3 h after intake. To ensure the necessary physiological level, starting no later than in the II trimester a VMC containing zinc at a dose not exceeding the daily nutritional requirement.
Key words: vitamin and mineral status, pregnancy, zinc, duration of administration, vitamins and minerals.
One of the most difficult in terms of trace elements level correction is zinc. Receiving zinc composition Multi-tabs Perinatal at a dose corresponding to daily food requirement (15 mg), results in a significant increase in plasma concentrations 2–3 h after intake. To ensure the necessary physiological level, starting no later than in the II trimester a VMC containing zinc at a dose not exceeding the daily nutritional requirement.
Key words: vitamin and mineral status, pregnancy, zinc, duration of administration, vitamins and minerals.
Полный текст
Список литературы
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14. Apgar J. Effect of zinc repletion late in gestation on parturition in the zinc-deficient rat. J Nutr 1973; 103: 973–81.
15. Воulеt SL, Аlехаndег GR, Salihu НМ, Раss М. Масrosomic births in the united states: determinants, outcomes, snd proposed grades of risk. Am J Obstet Gynecol 2003; 188: 1372.
16. Sikorski S, Juszkiewicz T, Paszkowski T. Zinc status in women with premature rupture of membranes at term. Obstet Gynecol 1990; 76: 675–7.
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20. Krebs NF. Update on zinc deficiency and excess in clinical pediatric practice. Ann Nutr Metabol 2013; (62 Suppl. 1): 19–29.
21. Sadeh-Mestechkin D, Walfisch A, Shachar R. Suspected macrosomia? Better not tell. Arch Gynecol Obstet 2008; 278 (3): 225–30.
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24. Ахмина Н.И., Охлопков К.А. Значение витаминов и микроэлементов при беременности. Лечащий врач. 2005; 10: 7–14. / Akhmina N.I., Okhlopkov K.A. Znachenie vitaminov i mikroelementov pri beremennosti. Lechashchii vrach. 2005; 10: 7–14. [in Russian]
2. Lutsenko N.N. Polivitaminy i mineraly kak neot"emlemaia chast' v ratsional'nom pitanii zhenshchiny do, vo vremia i posle beremennosti. Rus. med. zhurn. 2006; 12 (13): 815–8. [in Russian]
3. Allen L. Multiple micronutrients in pregnancy and lactation: anoverview. Am J Clin Nutr 2005; 81 (5): 1206S–1212S.
4. Shikh E.V., Grebenshchikova L.Iu. Korrektsiia vitaminno-mineral'nogo statusa u beremennykh s vysokim riskom makrosomii. Ginekologiia. 2013 (4): 59–64. [in Russian]
5. Krebs NF. Update on zinc deficiency and excess in clinical pediatric practice. Ann Nutr Metabol 2013; 62 (Suppl. 1): 19–29.
6. Jameson S. Zinc status in pregnancy: the effect of zinc therapy on perinatal mortality, prematurity, and placental ablation. Ann N Y Acad Sci 1993; 678: 178–92.
7. Apgar J, Everett GA. Low zinc intake affects maintenance of pregnancy in guinea pigs. J Nutr 1991; 121: 192–200.
8. Bunce GE, Lytton F, Gunesekera B et al. Molecular basis for abnormal parturition in zinc deficiency in rats. In: Allen LH, King J, Lonnerdal B, eds. Nutrient regulation during pregnancy, lactation, and infant growth. New York: Plenum Press, 1994; p. 209–14.
9. Goldenberg RL, Tamura T, Neggers Y et al. The effect of zinc supplementation on pregnancy outcome. JAMA 1995; 274: 463–8.
10. Golub M, Keen CL, Gershwin ME, Hendrickx AG. Developmental zinc deficiency and behavior. J Nutr 1995; 125: 2263S–71S.
11. Golub MS, Gershwin ME, Hurley LS, Hendrickx AG. Studies of marginal zinc deprivation in rhesus monkeys. VIII. Effects on early adolescence. Am J Clin Nutr 1988; 47: 1046–51.
12. Krebs NF. Update on zinc deficiency and excess in clinical pediatric practice. Ann Nutr Metabol 2013; 62 (Suppl. 1): 19–29.
13. Shankar AH, Prasad AS. Zinc and immune functions: the biological basis of altered resistance to infection. Am J Clin Nutr 1998; 68(Suppl.): 447S–63S.
14. Apgar J. Effect of zinc repletion late in gestation on parturition in the zinc-deficient rat. J Nutr 1973; 103: 973–81.
15. Воulеt SL, Аlехаndег GR, Salihu НМ, Раss М. Масrosomic births in the united states: determinants, outcomes, snd proposed grades of risk. Am J Obstet Gynecol 2003; 188: 1372.
16. Sikorski S, Juszkiewicz T, Paszkowski T. Zinc status in women with premature rupture of membranes at term. Obstet Gynecol 1990; 76: 675–7.
17. Lazebnik N, Kuhnert BR, Kuhnert PM, Thompson KL. Zinc status, pregnancy complications, and labor abnormalities. Am J Obstet Gynecol 1988; 158: 161–6.
18. Dura-Trave T, Puig-Abuli M, Monreal I, Villa-Elizaga I. Relation between maternal plasmatic zinc levels and uterine contractility. Gynecol Obstet Invest 1984; 17: 247–51.
19. Chelmow D, Kilpatrick SJ, Laros RK. Maternal and neonatal outcomes after prolonged latent phase. Obstet Gynecol 1993; 81: 486–91.
20. Krebs NF. Update on zinc deficiency and excess in clinical pediatric practice. Ann Nutr Metabol 2013; (62 Suppl. 1): 19–29.
21. Sadeh-Mestechkin D, Walfisch A, Shachar R. Suspected macrosomia? Better not tell. Arch Gynecol Obstet 2008; 278 (3): 225–30.
22. Donma MM. Macrosomia, top of the iceberg: the charm of underlying factors. Pediatr Int 2010.
23. Sidel'nikova V.M., Gromova O.A., Torshin I.Iu., Tetruashvili N.K. Nutritsial'nyi podkhod k profilaktike izbytochnoi massy tela novorozhdennykh. Ginekologiia. 2010; 5: 56–62. [in Russian]
24. Akhmina N.I., Okhlopkov K.A. Znachenie vitaminov i mikroelementov pri beremennosti. Lechashchii vrach. 2005; 10: 7–14. [in Russian]
2. Луценко Н.Н. Поливитамины и минералы как неотъемлемая часть в рациональном питании женщины до, во время и после беременности. Рус. мед. журн. 2006; 12 (13): 815–8. / Lutsenko N.N. Polivitaminy i mineraly kak neot"emlemaia chast' v ratsional'nom pitanii zhenshchiny do, vo vremia i posle beremennosti. Rus. med. zhurn. 2006; 12 (13): 815–8. [in Russian]
3. Allen L. Multiple micronutrients in pregnancy and lactation: anoverview. Am J Clin Nutr 2005; 81 (5): 1206S–1212S.
4. Ших Е.В., Гребенщикова Л.Ю. Коррекция витаминно-минерального статуса у беременных с высоким риском макросомии. Гинекология. 2013 (4): 59–64. / Shikh E.V., Grebenshchikova L.Iu. Korrektsiia vitaminno-mineral'nogo statusa u beremennykh s vysokim riskom makrosomii. Ginekologiia. 2013 (4): 59–64. [in Russian]
5. Krebs NF. Update on zinc deficiency and excess in clinical pediatric practice. Ann Nutr Metabol 2013; 62 (Suppl. 1): 19–29.
6. Jameson S. Zinc status in pregnancy: the effect of zinc therapy on perinatal mortality, prematurity, and placental ablation. Ann N Y Acad Sci 1993; 678: 178–92.
7. Apgar J, Everett GA. Low zinc intake affects maintenance of pregnancy in guinea pigs. J Nutr 1991; 121: 192–200.
8. Bunce GE, Lytton F, Gunesekera B et al. Molecular basis for abnormal parturition in zinc deficiency in rats. In: Allen LH, King J, Lonnerdal B, eds. Nutrient regulation during pregnancy, lactation, and infant growth. New York: Plenum Press, 1994; p. 209–14.
9. Goldenberg RL, Tamura T, Neggers Y et al. The effect of zinc supplementation on pregnancy outcome. JAMA 1995; 274: 463–8.
10. Golub M, Keen CL, Gershwin ME, Hendrickx AG. Developmental zinc deficiency and behavior. J Nutr 1995; 125: 2263S–71S.
11. Golub MS, Gershwin ME, Hurley LS, Hendrickx AG. Studies of marginal zinc deprivation in rhesus monkeys. VIII. Effects on early adolescence. Am J Clin Nutr 1988; 47: 1046–51.
12. Krebs NF. Update on zinc deficiency and excess in clinical pediatric practice. Ann Nutr Metabol 2013; 62 (Suppl. 1): 19–29.
13. Shankar AH, Prasad AS. Zinc and immune functions: the biological basis of altered resistance to infection. Am J Clin Nutr 1998; 68(Suppl.): 447S–63S.
14. Apgar J. Effect of zinc repletion late in gestation on parturition in the zinc-deficient rat. J Nutr 1973; 103: 973–81.
15. Воulеt SL, Аlехаndег GR, Salihu НМ, Раss М. Масrosomic births in the united states: determinants, outcomes, snd proposed grades of risk. Am J Obstet Gynecol 2003; 188: 1372.
16. Sikorski S, Juszkiewicz T, Paszkowski T. Zinc status in women with premature rupture of membranes at term. Obstet Gynecol 1990; 76: 675–7.
17. Lazebnik N, Kuhnert BR, Kuhnert PM, Thompson KL. Zinc status, pregnancy complications, and labor abnormalities. Am J Obstet Gynecol 1988; 158: 161–6.
18. Dura-Trave T, Puig-Abuli M, Monreal I, Villa-Elizaga I. Relation between maternal plasmatic zinc levels and uterine contractility. Gynecol Obstet Invest 1984; 17: 247–51.
19. Chelmow D, Kilpatrick SJ, Laros RK. Maternal and neonatal outcomes after prolonged latent phase. Obstet Gynecol 1993; 81: 486–91.
20. Krebs NF. Update on zinc deficiency and excess in clinical pediatric practice. Ann Nutr Metabol 2013; (62 Suppl. 1): 19–29.
21. Sadeh-Mestechkin D, Walfisch A, Shachar R. Suspected macrosomia? Better not tell. Arch Gynecol Obstet 2008; 278 (3): 225–30.
22. Donma MM. Macrosomia, top of the iceberg: the charm of underlying factors. Pediatr Int 2010.
23. Сидельникова В.М., Громова О.А., Торшин И.Ю., Тетруашвили Н.К. Нутрициальный подход к профилактике избыточной массы тела новорожденных. Гинекология. 2010; 5: 56–62. / Sidel'nikova V.M., Gromova O.A., Torshin I.Iu., Tetruashvili N.K. Nutritsial'nyi podkhod k profilaktike izbytochnoi massy tela novorozhdennykh. Ginekologiia. 2010; 5: 56–62. [in Russian]
24. Ахмина Н.И., Охлопков К.А. Значение витаминов и микроэлементов при беременности. Лечащий врач. 2005; 10: 7–14. / Akhmina N.I., Okhlopkov K.A. Znachenie vitaminov i mikroelementov pri beremennosti. Lechashchii vrach. 2005; 10: 7–14. [in Russian]
________________________________________________
2. Lutsenko N.N. Polivitaminy i mineraly kak neot"emlemaia chast' v ratsional'nom pitanii zhenshchiny do, vo vremia i posle beremennosti. Rus. med. zhurn. 2006; 12 (13): 815–8. [in Russian]
3. Allen L. Multiple micronutrients in pregnancy and lactation: anoverview. Am J Clin Nutr 2005; 81 (5): 1206S–1212S.
4. Shikh E.V., Grebenshchikova L.Iu. Korrektsiia vitaminno-mineral'nogo statusa u beremennykh s vysokim riskom makrosomii. Ginekologiia. 2013 (4): 59–64. [in Russian]
5. Krebs NF. Update on zinc deficiency and excess in clinical pediatric practice. Ann Nutr Metabol 2013; 62 (Suppl. 1): 19–29.
6. Jameson S. Zinc status in pregnancy: the effect of zinc therapy on perinatal mortality, prematurity, and placental ablation. Ann N Y Acad Sci 1993; 678: 178–92.
7. Apgar J, Everett GA. Low zinc intake affects maintenance of pregnancy in guinea pigs. J Nutr 1991; 121: 192–200.
8. Bunce GE, Lytton F, Gunesekera B et al. Molecular basis for abnormal parturition in zinc deficiency in rats. In: Allen LH, King J, Lonnerdal B, eds. Nutrient regulation during pregnancy, lactation, and infant growth. New York: Plenum Press, 1994; p. 209–14.
9. Goldenberg RL, Tamura T, Neggers Y et al. The effect of zinc supplementation on pregnancy outcome. JAMA 1995; 274: 463–8.
10. Golub M, Keen CL, Gershwin ME, Hendrickx AG. Developmental zinc deficiency and behavior. J Nutr 1995; 125: 2263S–71S.
11. Golub MS, Gershwin ME, Hurley LS, Hendrickx AG. Studies of marginal zinc deprivation in rhesus monkeys. VIII. Effects on early adolescence. Am J Clin Nutr 1988; 47: 1046–51.
12. Krebs NF. Update on zinc deficiency and excess in clinical pediatric practice. Ann Nutr Metabol 2013; 62 (Suppl. 1): 19–29.
13. Shankar AH, Prasad AS. Zinc and immune functions: the biological basis of altered resistance to infection. Am J Clin Nutr 1998; 68(Suppl.): 447S–63S.
14. Apgar J. Effect of zinc repletion late in gestation on parturition in the zinc-deficient rat. J Nutr 1973; 103: 973–81.
15. Воulеt SL, Аlехаndег GR, Salihu НМ, Раss М. Масrosomic births in the united states: determinants, outcomes, snd proposed grades of risk. Am J Obstet Gynecol 2003; 188: 1372.
16. Sikorski S, Juszkiewicz T, Paszkowski T. Zinc status in women with premature rupture of membranes at term. Obstet Gynecol 1990; 76: 675–7.
17. Lazebnik N, Kuhnert BR, Kuhnert PM, Thompson KL. Zinc status, pregnancy complications, and labor abnormalities. Am J Obstet Gynecol 1988; 158: 161–6.
18. Dura-Trave T, Puig-Abuli M, Monreal I, Villa-Elizaga I. Relation between maternal plasmatic zinc levels and uterine contractility. Gynecol Obstet Invest 1984; 17: 247–51.
19. Chelmow D, Kilpatrick SJ, Laros RK. Maternal and neonatal outcomes after prolonged latent phase. Obstet Gynecol 1993; 81: 486–91.
20. Krebs NF. Update on zinc deficiency and excess in clinical pediatric practice. Ann Nutr Metabol 2013; (62 Suppl. 1): 19–29.
21. Sadeh-Mestechkin D, Walfisch A, Shachar R. Suspected macrosomia? Better not tell. Arch Gynecol Obstet 2008; 278 (3): 225–30.
22. Donma MM. Macrosomia, top of the iceberg: the charm of underlying factors. Pediatr Int 2010.
23. Sidel'nikova V.M., Gromova O.A., Torshin I.Iu., Tetruashvili N.K. Nutritsial'nyi podkhod k profilaktike izbytochnoi massy tela novorozhdennykh. Ginekologiia. 2010; 5: 56–62. [in Russian]
24. Akhmina N.I., Okhlopkov K.A. Znachenie vitaminov i mikroelementov pri beremennosti. Lechashchii vrach. 2005; 10: 7–14. [in Russian]
Авторы
Е.В.Ших*1, А.А.Махова1, Л.Ю.Гребенщикова2
1 ГБОУ ВПО Первый Московский государственный университет им. И.М.Сеченова Минздрава России. 119991, Москва, ул. Трубецкая, 8, стр. 2;
2 ГБУЗ Областной клинический перинатальный центр им. Е.М.Бакуниной. 170036, Россия, Тверь, Санкт-Петербургское ш., д. 115, к. 3
*chih@mail.ru
1 ГБОУ ВПО Первый Московский государственный университет им. И.М.Сеченова Минздрава России. 119991, Москва, ул. Трубецкая, 8, стр. 2;
2 ГБУЗ Областной клинический перинатальный центр им. Е.М.Бакуниной. 170036, Россия, Тверь, Санкт-Петербургское ш., д. 115, к. 3
*chih@mail.ru
________________________________________________
E.V.Shikh*1, A.A.Makhova1, L.Yu.Grebenshchikova2
1 I.M.Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation. 119991, Russian Federation, Moscow, ul. Trubetskaya, d. 8, str. 2;
2 E.M.Bakunina Regional Clinical Perinatal Center. 170036, Russian Federation, Tver, Sankt-Peterburgskoe sh., d. 115, k. 3
*chih@mail.ru
1 I.M.Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation. 119991, Russian Federation, Moscow, ul. Trubetskaya, d. 8, str. 2;
2 E.M.Bakunina Regional Clinical Perinatal Center. 170036, Russian Federation, Tver, Sankt-Peterburgskoe sh., d. 115, k. 3
*chih@mail.ru
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