FUNDAMENTAL'NYE ISSLEDOVANIYa, DOKAZATEL'NAYa MEDITsINA I PERSPEKTIVY ISPOL'ZOVANIYa AKTIVNYKh FORM FOLATOV V AKUShERSTVE I GINEKOLOGII


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During pregnancy, folate deficiency leads to a significant increase in the frequency of congenital abnormalities due to violations of DNA methylation. Compensation of folate deficiency only with synthetic folic acid (FA) is not always successful, because it has to be transformed to the active form of folate (tetrahydrofolate) through specific enzyme systems. In many women, these systems may be lost due to genetic defects, drugs that block these enzymes, and other reasons. This necessitates the use of active folate (AF) for the improvement of efficiency and safety of compensation of folate deficiency, especially in the relevant risk groups. This review presents the results of a systematic analysis of fundamental and clinical medicine, indicating the perspectiveness of use of AF for the nutrient supplementation in pregnancy and for other indications in the field of obstetrics, and gynecology. It is shown that AF is characterized by pronounced antiteratogenic effect and significantly neutralizes the negative effects of retinoids, nitrogen oxides, valproic acid and methotrexate on the growing embryo. In contrast to the inactive FA, the excess of which leads to blockage of folate metabolism, excess of AF has no such effect. Therefore AF has no side effects typical of excessive consumption of FA, and has a positive impact in any genotype of folate biotransformation enzyme systems.

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