Study objective: to determine the most important maternal factors for the pre-eclampsia (PE) prediction, which are used in screening of women when registered for pregnancy.Materials and methods. A prospective cohort study included 91 pregnant women in their first trimester; study period 2018–2020. The main group included 56 (61.54%) women with a number of maternal factors for PE development, and 35 (38.46%) were healthy females in the control group. Subgroups of women formed for females with and without PE – 28.57% and 71.43%, respectively.Results. Statistically significant values in the study of maternal factors were observed between subgroups of patients with and without PE for body mass index (BMI) prior to pregnancy (26.83 ± 1.29 and 26.03 ± 1.05) and height of pregnant women (163.35 ± 1.26 cm and 167.23 ± 1.02 cm), p <0.05. Among the risk factors that led to PE, statistically significant results were observed when combining the first pregnancy with a history of kidney disease (p = 0.033). Recurrent PE was observed when combined with PE history in mother (p = 0.011). Impact of chronic hypertension on the PE development was noted when the disease history was over 5 years. The combination of interval between pregnancies of 10 years and more and age >35 years was associated with PE (p = 0.008).During IVF PE developed in combination with such factors as BMI 30 kg/m2 and the interval between pregnancies over 10 years, 1.1% females had no other factors. History of renal disease and the age >35 years had an impact on the PE development in patients with anti-phospholipid syndrome. Analysis of the odds ratio of the isolated maternal factor showed the following indicators: PE during previous pregnancy – 6, multiple pregnancy – 2.56, anti-phospholipid syndrome – 2.56, first pregnancy – 1.83, in vitro fertilization – 1.72, obesity >30 kg/m2 – 1.65, PE in the mother – 1.57, age >35 years – 1.08, history of renal disease – 1, interval between pregnancies >10 years – 0.77 and chronic hypertension – 0.18.Conclusion. Thorough monitoring of maternal risk factors for PE should focus on PE during previous pregnancy. The second position is occupied by multiple pregnancy and anti-phospholipid syndrome. PE risk is increased for a combination of factors, especially with chronic renal disease and/or elevated BMI.

Оригінальні статті Original Articles Вступ Прееклампсія (ПЕ) є складним багатосистемним ускладненням вагітності, що відбувається в другій половині гестації та характеризується гіпертонією і протеїнурією, що сприяє значній материнській і перинатальній захворюваності та смертності [1]. Суттєвими компонентами в патогенезі прееклампсії є ішемія плаценти, що виникає внаслідок порушення ендоваскулярної трофобластної інвазії і при недо-статньому ремоделюванні спіральних артерій матки, та ренальна дисфункція. Для забезпечення своєчасного розродження та мінімізації ускладнень під час вагітності важливо застосовувати ретельний контроль функції нирок, що дозволить діагностувати розвиток ПЕ на доклінічному етапі реалізації. Щоб оцінити ступінь пошкодження нирок, у клінічній практиці найбільш доступними методами є контроль добового діурезу та визначення протеїнурії, вимір

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The frequency and severity of congenital malformations (CMF) do not tend to decline in modern society. CMF for etiologic factors are referred to the pathologies of a multifactorial nature. Among the many causative factors of CMF there is a hereditary predisposition. The objective of the study was to increase the effectiveness of complex individualized prophylaxis of congenital malformations in women with polymorphic alleles of genes of folate cycle enzymes, the second phase of the detoxification system through the use of diagnostic, preventive, and therapeutic measures. Materials and methods. 120 women of reproductive age who live in the city of Odessa and the Odessa region were examined. The alleles of the genes of the folate cycle enzymes of methylenetetrahydrofolate reductase (MTHFR), 5-methyltetrahydrofolate homocysteine methyltransferase reductase (MTRR), glutathione-S-transferase M1 (GSTM1), folate acid, cyanocobalamin were determined. Results. The determination of the polymorphic alleles of the genes of the folate cycle enzymes of methylenetetrahydrofolate reductase (MTHFR), 5-methyltetrahydrofolate homocysteine methyltransferase reductase (MTRR), glutathione-S-transferase M1 (GSTM1), low folate, cyanocobalamin indicates the presence of a hereditary predisposition to the emergence of CMF, before and during pregnancy. Polymorphism of genes that control the synthesis of GSTM1 may alter the activity of detoxification enzymes. Expression of genes of GSTM1 enzymes begins in the embryonic period. Glutathione-dependent detoxification plays a key role in disinfecting of DNA peroxides. Mistakes of metabolism, functions of the corresponding enzymes are realized by chromosomal abnormalities and the risk of the occurrence of CMF, which requires the use of antioxidant therapy before and during pregnancy. Conclusions. It was found that a high (about 55%) frequency of the polymorphic alleles of the genes of folate cycle enzymes MTHFR (homozygous -10.0%, heterozygous -16.7%), 5 MTRR (homozygous 12.5%, heterozygous -15.5%) , the second phase of the GSTM1 detoxification system (homozygous -13.3%, heterozygous -15.8%), the content below the reference values of folic acid in 26.7%, cyanocobalamin -in 63.4% of observations indicates a hereditary predisposition and may contribute the emergence of CMF, which explains the expediency of timely use of preventive measures including folates, antioxidants. Keywords MTHFR; MTRR; GSTM1; folic acid; vitamins B12; pregnancy; preventionOdessa National Medical University, Odessa Ukraine *Corresponding author: anna.lavrinenko.doc@gmail.com Problem statement and analysis of the recent researchPrevention of congenital malformations (CMF) is one of the most urgent tasks of modern medicine and society as a whole. The urgency of this problem lies in the high frequency of occurrence of CMF (stable morphological changes in the organ, organs that arise as a result of disturbances in morphogenesis in the antenatal period), congenital anomalies of development (structural, functional, metaboli...