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BACKGROUND: Endotoxicosis is a multifaceted pathophysiological process that can have a major impact on the mother-placenta-fetus system during gestation. The abuse of alcohol–containing products is a likely aggravating factor for the health of pregnant women, which may be accompanied by biochemical disorders in both the mother and fetus, including an increased risk of endotoxicosis.

AIM: To evaluate endogenous intoxication in women at different stages of pregnancy by the content of medium-weight molecules in venous blood and its dependence on serum phosphatidylethanol levels.

MATHERIALS AND METHODS: The level of endogenous intoxication was assessed by the content of medium-weight molecules (MSM) in pregnant women (N=163). Depending on the concentration of PEth 16:0/18:1, groups of women consuming different doses of alcohol were identified: Group 1 - PEth value ≤ 8 ng/ml (non-drinkers, control), Group 2 - from 8 to 45 (drinkers less than 1 dose), Group 3 - ≥ 45 (drinkers more than 1 dose). The indicators were evaluated at 4 gestational stages: 6-12, 18-22, 28-32, 38-40 weeks. Blood plasma was used as the material for the study. The MSM level was determined at λ=238, 254, 260 and 280 nm, followed by the calculation of the distribution coefficients (238/260, 238/280, 280/254).

RESULTS: Compared with the control, a reliable decrease in the level of MSM λ=238 nm was found in pregnant women consuming alcohol at 28-32 weeks of gestation in both the 2nd (p=0.013) and 3rd groups (p=0.003). Before childbirth, their level was lower in the 3rd group of women compared with the control (р=0.004). A significant decrease in the level of MSM λ=280 nm was revealed in the 3rd group of pregnant women compared with the 2nd group (р=0.017).Women who drink alcohol, regardless of the PEth 16:0/18:1 level, had significantly lower values of the peptide-nucleotide distribution coefficient 238/260 (p=0.007 and p<0.001 in the 2nd and 3rd groups, respectively) and the aromaticity coefficient 238/280 (p=0.002 and p<0.001 in the 2nd and 3rd groups, respectively) nm compared with the control group of 28-32 weeks pregnancy. Before childbirth, a decrease in these coefficients was noted only in the 2nd group of pregnant women ( p=0.006 for 238/260 and p=0.015 for 238/280). In the groups of female drinkers, the distribution coefficient of 280/254 nm was higher at 28-32 weeks. compared with the control ( p=0.003 and p=0.014 in the 2nd and 3rd groups, respectively).

CONCLUSION: The results obtained indicate a decrease in the content of individual fractions of medium-molecular toxins, reflecting both anabolic and catabolic pools, in the group of women who drink alcohol, which may be associated with the development of serious metabolic disorders in the "mother-placenta-fetus" system. The distribution coefficients proved to be sensitive markers for tracking the level of endogenous intoxication in groups of pregnant women, indicating the prevalence of catabolic processes with the accumulation of catabolism products and the possible risk of premature birth when drinking alcohol regardless of the dose.