medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/ms2024-366medsovet-8652Research ArticleРЕПРОДУКТИВНОЕ ЗДОРОВЬЕ И ВРТREPRODUCTIVE HEALTH AND ARTРоль холина в физиологии репродукцииThe role of choline in the physiology of reproductivityhttps://orcid.org/0000-0001-9524-8962ДиккеГ. Б.DikkeG. B.

Дикке Галина Борисовна, д.м.н., профессор кафедры акушерства и гинекологии с курсом репродуктивной медицины

190013, Санкт-Петербург, Московский проспект, д. 22

Galina B. Dikke, Dr. Sci. (Med.), Professor of the Department of Obstetrics and Gynecology with a Course in Reproductive Medicine

22, Letter M, Moskovsky Ave., St Petersburg, 190013

galadikke@yandex.ruАкадемия медицинского образования имени Ф.И. ИноземцеваРоссияAcademy of Medical Education named after F.I. InozemtsevRussian Federation2024071120240172533Copyright © Дикке Г.Б., 20242024Дикке Г.Б.Dikke G.B.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/8652

Холин – незаменимое питательное вещество, однако потребление его беременными женщинами является недостаточным: только 7% из них потребляют адекватные количества холина. Несоответствие между потребностями в холине и его фактическим потреблением поднимает вопросы о необходимости добавок и их потенциальных преимуществах для беременных женщин. Диета будущей матери, богатая холином, в прегравидарном периоде обеспечивает фолликулогенез и лучшее качество ооцитов, изменяет фетальный эпигеном, оказывая противодействие геномным дефектам в период внутриутробного развития и снижая предрасположенность к метаболическим изменениям во взрослой жизни. Холин является источником метильных групп, и его потребление снижает риск дефектов нервной трубки плода в 7 раз, поэтому перспективным трендом в нутрициальной поддержке беременности и профилактике дефектов нервной трубки является прием фолатов и холина в сочетании с другими микронутриентами. Холин способствует росту, пролиферации и функционированию клеток плаценты, транспорту макронутриентов, оказывает противовоспалительное действие. Риск низкой массы тела плода при добавлении холина к обычному рациону питания матери снижается на 69%. Показана значительная связь между высокими уровнями холина у матери и снижением риска развития преэклампсии, преждевременных родов в 2 раза, значимое влияние на нервное развитие и психическое здоровье ребенка – улучшение нейрокогнитивных функций и снижение риска аутизма и синдрома дефицита внимания с гиперактивностью. Добавка холина в дозе 130 мг/сут в составе витаминноминерального комплекса Фемибион 1 достаточна для удовлетворения потребностей в этом нутриенте в период прегравидарной подготовки и в первом триместре беременности. Необходимость дотации холина в прегравидарном периоде и первом триместре беременности обусловлена влиянием на фолликулогенез и протекцию ооцитов, эпигенетическим программированием, эффективностью профилактики врожденных пороков развития плода, участием в метаболических и физиологических процессах в плаценте, снижением риска плацента-ассоциированных осложнений, влиянием на развитие нервной ткани и головного мозга плода и новорожденного.

Choline is an essential nutrient, but intake among pregnant women is insufficient – only 7% of them consume adequate amounts of choline. The discrepancy between choline requirements and actual intake raises questions about the need for choline supplementation and its potential benefits for pregnant women. The diet of the expectant mother, rich in choline, in the preconception period ensures folliculogenesis and better quality of oocytes, changes the foetal epigenome, counteracting genomic defects during intrauterine development and reducing the susceptibility to metabolic changes in adulthood. Choline is a source of methyl groups and its consumption reduces the risk of NTDs by 7 times, so a promising trend in nutritional support of pregnancy and prevention of NTDs is the intake of folates and choline in combination with other micronutrients. Choline promotes the growth, proliferation and functioning of placental cells, transport of macronutrients, and has an anti-inflammatory effect. The risk of low foetal weight is reduced by 69% when choline is added to the mother’s regular diet. A significant connection has been shown between high levels of choline in the mother and a 2-fold reduction in the risk of preeclampsia, premature birth and a significant effect on the neurodevelopment and mental health of the child – improving neurocognitive functions and reducing the risk of autism and attention deficit hyperactivity disorder. A choline supplement at a dose of 130 mg/day as part of the vitamin-mineral complex Femibion 1 is sufficient to meet the needs for this nutrient during the preconception period and in the first trimester of pregnancy. The need for choline supplementation in the pregravid period and the first trimester of pregnancy is because on folliculogenesis and oocyte protection, epigenetic programming, the effectiveness of preventing congenital malformations of the foetus, participation in metabolic and physiological processes in the placenta, reducing the risk of placenta-associated complications, influence on the development of nervous tissue and brain of the foetus and newborn.

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The authors declare that there are no conflicts of interest present.