<?xml version="1.0" encoding="UTF-8"?>
<!DOCTYPE article PUBLIC "-//NLM//DTD JATS (Z39.96) Journal Publishing DTD v1.3 20210610//EN" "JATS-journalpublishing1-3.dtd">
<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">medsovet</journal-id><journal-title-group><journal-title xml:lang="ru">Медицинский Совет</journal-title><trans-title-group xml:lang="en"><trans-title>Meditsinskiy sovet = Medical Council</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">2079-701X</issn><issn pub-type="epub">2658-5790</issn><publisher><publisher-name>REMEDIUM GROUP Ltd.</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.21518/2079-701X-2021-3-50-53</article-id><article-id custom-type="elpub" pub-id-type="custom">medsovet-6073</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>ПРЕГРАВИДАРНАЯ ПОДГОТОВКА И БЕРЕМЕННОСТЬ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>PREGRAVID PREPARATION AND PREGNANCY</subject></subj-group></article-categories><title-group><article-title>Фолиевая кислота, прегравидарная подготовка и беременность: современные аспекты</article-title><trans-title-group xml:lang="en"><trans-title>Folic acid, periconceptional multivitamin supplementation and pregnancy: modern aspects</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-1821-8684</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Романов</surname><given-names>А. Ю.</given-names></name><name name-style="western" xml:lang="en"><surname>Romanov</surname><given-names>A. Yu.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Романов Андрей Юрьевич  - аспирант, научный сотрудник отдела наукометрии департамента организации научной деятельности.</p><p>117997, Москва, ул. Академика Опарина, д. 4</p></bio><bio xml:lang="en"><p>Andrey Yu. Romanov - Postgraduate Student, researcher of R&amp;D Department.</p><p>4, Academician Oparin St., Moscow, 117997</p></bio><email xlink:type="simple">romanov1553@yandex.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-1116-138X</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Долгушина</surname><given-names>Н. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Dolgushina</surname><given-names>N. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Долгушина Наталия Витальевна - доктор медицинских наук, профессор, заместитель директора - руководитель департамента организации научной деятельности.</p><p>117997, Москва, ул. Академика Опарина, д. 4</p></bio><bio xml:lang="en"><p>Nataliya V. Dolgushina - Dr. Sci. (Med.), Professor, Head of R&amp;D Department.</p><p>4, Academician Oparin St., Moscow, 117997</p></bio><email xlink:type="simple">n_dolgushina@oparina4.ru</email><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>Национальный медицинский исследовательский центр акушерства, гинекологии и перинатологии им. академика B.И. Кулакова</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Kulakov National Medical Research Center of Obstetrics, Gynecology and Perinatology</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2021</year></pub-date><pub-date pub-type="epub"><day>14</day><month>04</month><year>2021</year></pub-date><volume>0</volume><issue>3</issue><fpage>50</fpage><lpage>53</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Романов А.Ю., Долгушина Н.В., 2021</copyright-statement><copyright-year>2021</copyright-year><copyright-holder xml:lang="ru">Романов А.Ю., Долгушина Н.В.</copyright-holder><copyright-holder xml:lang="en">Romanov A.Y., Dolgushina N.V.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.med-sovet.pro/jour/article/view/6073">https://www.med-sovet.pro/jour/article/view/6073</self-uri><abstract><p>Фолиевая кислота (витамин B9) - водорастворимый витамин, необходимый для формирования, роста и развития кровеносной и иммунной систем. Ее дефицит является значимым фактором риска развития дефектов нервной трубки плода. Широкое внедрение препаратов и пищевых добавок, содержащих фолиевую кислоту, при подготовке к беременности и в первом триместре позволило значительно снизить частоту формирования дефектов нервной трубки плода.</p><p>Согласно существующим на сегодняшний день рекомендациям, прием фолиевой кислоты в дозировке 0,4 мг в сутки показан пациенткам, планирующим беременность, в течение 6 мес. до зачатия и в первом триместре беременности. Прием фолиевой кислоты в дозировке 4 мг показан пациенткам с дефектом нервной трубки плода в анамнезе.</p><p>Также существуют другие факторы риска развития дефектов нервной трубки плода. К ним относят семейный анамнез, ожирение, синдром мальабсорбции, полиморфизмы генов фолатного цикла, курение, употребление наркотиков, сахарный диабет (прегестационный), а также иные хронические заболевания. Определение необходимой дозировки фолиевой кислоты у пациенток с указанными факторами риска по-прежнему требует обсуждения и проведения клинических исследований.</p><p>Помимо дефектов нервной трубки, прием фолиевой кислоты связан со снижением риска формирования других пороков развития: атрезии пищевода, конотрункальных пороков сердца, волчьей пасти, пороков развития мочевыводящих путей и омфа-лоцеле, частоты некоторых поведенческих аномалий, в частности гиперактивности. Крайне важным является информирование населения о необходимости планирования беременности.</p></abstract><trans-abstract xml:lang="en"><p>Folic acid (vitamin B9) is a water-soluble vitamin, essential for the growth and development of the blood and immune systems. Its deficiency is a significant risk factor for fetal neural tube defects. The widespread implementation of drugs and food supplements containing folic acid in preparation for pregnancy and in its first trimester has significantly reduced the incidence of fetal neural tube defects.</p><p>According to current recommendations, taking 0.4 mg of folic acid per day is indicated within 6 months before conception and in the first trimester of pregnancy. Taking folic acid at a dosage of 4 mg is indicated for patients with a history of a fetal neural tube defect.</p><p>There are also other risk factors for developing fetal neural tube defects. These include family history, obesity, malabsorption syndrome, folate cycle gene polymorphisms, smoking, drug use, diabetes mellitus (pre-gestational), and other chronic diseases. Determination of the required dosage of folic acid in these categories of patients still requires discussion and clinical trials. Also, folic acid intake is associated with a decreased risk of esophageal atresia, conotruncal heart disease, cleft palate, urinary tract malformations, and omphalocele, reduces the incidence of some behavioral anomalies, in particular, hyperactivity, the need for planning a pregnancy.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>фолиевая кислота</kwd><kwd>витамин B9</kwd><kwd>диабет</kwd><kwd>преэклампсия</kwd><kwd>беременность</kwd><kwd>дефекты нервной трубки</kwd><kwd>пороки развития</kwd></kwd-group><kwd-group xml:lang="en"><kwd>folic acid</kwd><kwd>vitamin B9</kwd><kwd>diabetes</kwd><kwd>preeclampsia</kwd><kwd>pregnancy</kwd><kwd>neural tube defects</kwd><kwd>malformations</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Copp AJ., Stanier P., Greene N.D. Neural Tube Defects: Recent Advances, Unsolved Questions, and Controversies. Lancet Neurol. 2013;12(8):799—810. doi: 10.1016/S1474-4422(13)70110-8.</mixed-citation><mixed-citation xml:lang="en">Copp AJ., Stanier P., Greene N.D. Neural Tube Defects: Recent Advances, Unsolved Questions, and Controversies. Lancet Neurol. 2013;12(8):799-810. doi: 10.1016/S1474-4422(13)70110-8.</mixed-citation></citation-alternatives></ref><ref id="cit2"><label>2</label><citation-alternatives><mixed-citation xml:lang="ru">Громова О.А., Лиманова О.А., Керимкулова Н.В., Торшин И.Ю., Рудаков К.В. Дозирование фолиевой кислоты до, во время и после беременности: все точки над «i». Акушерство и гинекология. 2014;(6):88-95. Режим доступа: https://aig-journal.ru/articles/Dozirovanie-folievoi-kisloty-do-vo-vremya-i-posle-beremennosti-vse-tochki-nad-i.html.</mixed-citation><mixed-citation xml:lang="en">Gromova O.A., Limanova O.A., Kerimkulova N.V., Torshin I .Yu., Rudakov K.V. Dosing of Folic Acid Before, During and After Pregnancy: All Dots Above the i. Akusherstvo i ginekologiya = Obstetrics and Gynecology. 2014;(6):88-95. (In Russ.) Available at: https://aig-journal.ru/articles/ Dozirovanie-folievoi-kisloty-do-vo-vremya-i-posle-beremennosti-vse-tochki-nad-i.html.</mixed-citation></citation-alternatives></ref><ref id="cit3"><label>3</label><citation-alternatives><mixed-citation xml:lang="ru">Воеводин С.М., Шеманаева Т.В. Профилактика пороков развития. Медицинский совет. 2016;(2):26-31. doi: 10.21518/2079-701X-2016-2-26-31.</mixed-citation><mixed-citation xml:lang="en">Voevodin S.M., Shemanaeva T.V. Preventing Malformations. Meditsinskiy sovet = Medical Council. 2016;(2):26-31. (In Russ.) doi: 10.21518/2079-701X-2016-2-26-31.</mixed-citation></citation-alternatives></ref><ref id="cit4"><label>4</label><citation-alternatives><mixed-citation xml:lang="ru">Obeid R., Holzgreve W., Pietrzik K. Is 5-Methyltetrahydrofolate an Alternative to Folic Acid for the Prevention of Neural Tube Defects? J Perinat Med. 2013;41(5):469-483. doi: 10.1515/jpm-2012-0256.</mixed-citation><mixed-citation xml:lang="en">Obeid R., Holzgreve W., Pietrzik K. Is 5-Methyltetrahydrofolate an Alternative to Folic Acid for the Prevention of Neural Tube Defects? J Perinat Med. 2013;41(5):469-483. doi: 10.1515/jpm-2012-0256.</mixed-citation></citation-alternatives></ref><ref id="cit5"><label>5</label><citation-alternatives><mixed-citation xml:lang="ru">Долгушина Н.В., Аотымук Н.В., Белокреницкая Т.Е., Романов А.Ю., Волочаева М.В., Филиппов О.С., Адамян Л.В. Нормальная беременность: клинические рекомендации. М.: Министерство здравоохранения Российской Федерации; 2020. 80 с. Режим доступа: https://mosgorzdrav.ru/ru-RU/science/default/download/805.html.</mixed-citation><mixed-citation xml:lang="en">Dolgushina N.V., Aotymuk N.V., Belokrenitskaya T.E., Romanov A.Yu., Volochaeva M.V., Filippov O.S., Adamyan L.V. Normal Pregnancy: Clinical Guidelines. Moscow: Ministry of Health of the Russian Federation; 2020. 80 p. (In Russ.) Available at: https://mosgorzdrav.ru/ru-RU/science/default/download/805.html.</mixed-citation></citation-alternatives></ref><ref id="cit6"><label>6</label><citation-alternatives><mixed-citation xml:lang="ru">Li Z., Gindler J., Wang H., Berry RJ., Li S., Correa A. et al. Folic Acid Supplements during Early Pregnancy and Likelihood of Multiple Births: A Population-Based Cohort Study. Lancet. 2003;361(9355):380-384. doi: 10.1016/s0140-6736(03)12390-2.</mixed-citation><mixed-citation xml:lang="en">Li Z., Gindler J., Wang H., Berry RJ., Li S., Correa A. et al. Folic Acid Supplements during Early Pregnancy and Likelihood of Multiple Births: A Population-Based Cohort Study. Lancet. 2003;361(9355):380-384. doi: 10.1016/s0140-6736(03)12390-2.</mixed-citation></citation-alternatives></ref><ref id="cit7"><label>7</label><citation-alternatives><mixed-citation xml:lang="ru">De-Regil L.M., Pena-Rosas J.P., Fernandez-Gaxiola A.C., Rayco-Solon P. Effects and Safety of Periconceptional Oral Folate Supplementation for Preventing Birth Defects. Cochrane Database Syst Rev. 2015;(12):CD007950. doi: 10.1002/14651858.CD007950.pub3.</mixed-citation><mixed-citation xml:lang="en">De-Regil L.M., Pena-Rosas J.P., Fernandez-Gaxiola A.C., Rayco-Solon P. Effects and Safety of Periconceptional Oral Folate Supplementation for Preventing Birth Defects. Cochrane Database Syst Rev. 2015;(12):CD007950. doi: 10.1002/14651858.CD007950.pub3.</mixed-citation></citation-alternatives></ref><ref id="cit8"><label>8</label><citation-alternatives><mixed-citation xml:lang="ru">Valentin M., Coste Mazeau P., Zerah M., Ceccaldi P.F., Benachi A., Luton D. Acid Folic and Pregnancy: A Mandatory Supplementation. Ann Endocrinol (Paris). 2018;79(2):91-94. doi: 10.1016/j.ando.2017.10.001.</mixed-citation><mixed-citation xml:lang="en">Valentin M., Coste Mazeau P., Zerah M., Ceccaldi P.F., Benachi A., Luton D. Acid Folic and Pregnancy: A Mandatory Supplementation. Ann Endocrinol (Paris). 2018;79(2):91-94. doi: 10.1016/j.ando.2017.10.001.</mixed-citation></citation-alternatives></ref><ref id="cit9"><label>9</label><citation-alternatives><mixed-citation xml:lang="ru">Luton D., Forestier A., Courau S., Ceccaldi PF. Preconception Care in France. Int J Gynaecol Obstet. 2014;125(2):144-145. doi: 10.1016/j.ijgo.2013.10.019.</mixed-citation><mixed-citation xml:lang="en">Luton D., Forestier A., Courau S., Ceccaldi P.F. Preconception Care in France. Int J Gynaecol Obstet. 2014;125(2):144-145. doi: 10.1016/j.ijgo.2013.10.019.</mixed-citation></citation-alternatives></ref><ref id="cit10"><label>10</label><citation-alternatives><mixed-citation xml:lang="ru">Obeid R., Oexle K., Riftmann A., Pietrzik K., Koletzko B. Folate Status and Health: Challenges and Opportunities. J Perinat Med. 2016;44(3):261-268. doi: 10.1515/jpm-2014-0346.</mixed-citation><mixed-citation xml:lang="en">Obeid R., Oexle K., Riftmann A., Pietrzik K., Koletzko B. Folate Status and Health: Challenges and Opportunities. J Perinat Med. 2016;44(3):261-268. doi: 10.1515/jpm-2014-0346.</mixed-citation></citation-alternatives></ref><ref id="cit11"><label>11</label><citation-alternatives><mixed-citation xml:lang="ru">Bulloch R.E., Lovell A.L., Jordan V.M.B., McCowan L.M.E., Thompson J.M.D., Wall C.R. Maternal Folic Acid Supplementation for the Prevention of Preeclampsia: A Systematic Review and Meta-Analysis. Paediatr Perinat Epidemiol. 2018;32(4):346-357. doi: 10.1111/ppe.12476.</mixed-citation><mixed-citation xml:lang="en">Bulloch R.E., Lovell A.L., Jordan V.M.B., McCowan L.M.E., Thompson J.M.D., Wall C.R. Maternal Folic Acid Supplementation for the Prevention of Preeclampsia: A Systematic Review and Meta-Analysis. Paediatr Perinat Epidemiol. 2018;32(4):346-357. doi: 10.1111/ppe.12476.</mixed-citation></citation-alternatives></ref><ref id="cit12"><label>12</label><citation-alternatives><mixed-citation xml:lang="ru">Liu C., Liu C., Wang Q., Zhang Z. Supplementation of Folic Acid in Pregnancy and the Risk of Preeclampsia and Gestational Hypertension: A Meta-Analysis. Arch Gynecol Obstet. 2018;298(4):697-704. doi: 10.1007/s00404-018-4823-4.</mixed-citation><mixed-citation xml:lang="en">Liu C., Liu C., Wang Q., Zhang Z. Supplementation of Folic Acid in Pregnancy and the Risk of Preeclampsia and Gestational Hypertension: A Meta-Analysis. Arch Gynecol Obstet. 2018;298(4):697-704. doi: 10.1007/s00404-018-4823-4.</mixed-citation></citation-alternatives></ref><ref id="cit13"><label>13</label><citation-alternatives><mixed-citation xml:lang="ru">Wolf H.T., Hegaard H.K., Huusom L.D., Pinborg A.B. Multivitamin Use and Adverse birth Outcomes in High-Income Countries: A Systematic Review and Meta-Analysis. Am J Obstet Gynecol. 2017;217(4):404.e1-404.e30. doi: 10.1016/j.ajog.2017.03.029.</mixed-citation><mixed-citation xml:lang="en">Wolf H.T., Hegaard H.K., Huusom L.D., Pinborg A.B. Multivitamin Use and Adverse birth Outcomes in High-Income Countries: A Systematic Review and Meta-Analysis. Am J Obstet Gynecol. 2017;217(4):404.e1-404.e30. doi: 10.1016/j.ajog.2017.03.029.</mixed-citation></citation-alternatives></ref><ref id="cit14"><label>14</label><citation-alternatives><mixed-citation xml:lang="ru">Wilson R.D., Audibert F., Brock J.A., Carroll J., Cartier L., Gagnon A. et al. Pre-Conception Folic Acid and Multivitamin Supplementation for the Primary and Secondary Prevention of Neural Tube Defects and Other Folic Acid-Sensitive Congenital Anomalies. J Obstet Gynaecol Can. 2015;37(6):534—552. doi: 10.1016/s1701-2163(15)30230-9.</mixed-citation><mixed-citation xml:lang="en">Wilson R.D., Audibert F., Brock J.A., Carroll J., Cartier L., Gagnon A. et al. Pre-Conception Folic Acid and Multivitamin Supplementation for the Primary and Secondary Prevention of Neural Tube Defects and Other Folic Acid-Sensitive Congenital Anomalies. J Obstet Gynaecol Can. 2015;37(6):534-552. doi: 10.1016/s1701-2163(15)30230-9.</mixed-citation></citation-alternatives></ref><ref id="cit15"><label>15</label><citation-alternatives><mixed-citation xml:lang="ru">Liu S., Evans J., MacFarlane A. J., Ananth C.V., Little J., Kramer M.S., Joseph K.S. Association of Maternal Risk Factors with the Recent Rise of Neural Tube Defects in Canada. Paediatr Perinat Epidemiol. 2019;33(2):145-153. doi: 10.1111/ppe.12543.</mixed-citation><mixed-citation xml:lang="en">Liu S., Evans J., MacFarlane A. J., Ananth C.V., Little J., Kramer M.S., Joseph K.S. Association of Maternal Risk Factors with the Recent Rise of Neural Tube Defects in Canada. Paediatr Perinat Epidemiol. 2019;33(2):145-153. doi: 10.1111/ppe.12543.</mixed-citation></citation-alternatives></ref><ref id="cit16"><label>16</label><citation-alternatives><mixed-citation xml:lang="ru">Parker S.E., Yazdy M.M., Tinker S.C., Mitchell A.A., Werler M.M. The Impact of folic Acid Intake on the Association among Diabetes Mellitus, Obesity, and Spina Bifida. Am J Obstet Gynecol. 2013;209(3):239.e1-239.e8. doi: 10.1016/j.ajog.2013.05.047.</mixed-citation><mixed-citation xml:lang="en">Parker S.E., Yazdy M.M., Tinker S.C., Mitchell A.A., Werler M.M. The Impact of folic Acid Intake on the Association among Diabetes Mellitus, Obesity, and Spina Bifida. Am J Obstet Gynecol. 2013;209(3):239.e1-239.e8. doi: 10.1016/j.ajog.2013.05.047.</mixed-citation></citation-alternatives></ref><ref id="cit17"><label>17</label><citation-alternatives><mixed-citation xml:lang="ru">Petersen J.M., Parker S.E., Benedum C.M., Mitchell A.A., Tinker S.C., Werler M.M. Periconceptional Folic Acid and Risk for Neural Tube Defects among Higher Risk Pregnancies. Birth Defects Res. 2019;111(19):1501-1512. doi: 10.1002/bdr2.1579.</mixed-citation><mixed-citation xml:lang="en">Petersen J.M., Parker S.E., Benedum C.M., Mitchell A.A., Tinker S.C., Werler M.M. Periconceptional Folic Acid and Risk for Neural Tube Defects among Higher Risk Pregnancies. Birth Defects Res. 2019;111(19):1501-1512. doi: 10.1002/bdr2.1579.</mixed-citation></citation-alternatives></ref><ref id="cit18"><label>18</label><citation-alternatives><mixed-citation xml:lang="ru">Chitayat D., Matsui D., Amitai Y., Kennedy D., Vohra S., Rieder M., Koren G. Folic Acid Supplementation for Pregnant Women and Those Planning Pregnancy: 2015 Update. J Clin Pharmacol. 2016;56(2):170—175. doi: 10.1002/jcph.616.</mixed-citation><mixed-citation xml:lang="en">Chitayat D., Matsui D., Amitai Y., Kennedy D., Vohra S., Rieder M., Koren G. Folic Acid Supplementation for Pregnant Women and Those Planning Pregnancy: 2015 Update. J Clin Pharmacol. 2016;56(2):170-175. doi: 10.1002/jcph.616.</mixed-citation></citation-alternatives></ref><ref id="cit19"><label>19</label><citation-alternatives><mixed-citation xml:lang="ru">Макарова Е.Л., Олина А.А., Терехина Н.А. Роль комплексной программы прегравидарной подготовки женщин с ожирением в профилактике гестационных осложнений. Акушерство и гинекология. 2020;(4):182-188. doi: 10.18565/aig.2020.4.182-188.</mixed-citation><mixed-citation xml:lang="en">Makarova E.L., Olina A.A., Terekhina N.A. The Role of a Comprehensive Program of Pregravid Training for Obese Women in the Prevention of Gestational Complications. Akusherstvo i ginekologiya = Obstetrics and Gynecology 2020;(4):182-188. (In Russ.) doi: 10.18565/aig.2020.4.182-188.</mixed-citation></citation-alternatives></ref></ref-list><fn-group><fn fn-type="conflict"><p>The authors declare that there are no conflicts of interest present.</p></fn></fn-group></back></article>
