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Published on: June 24, 2020
Vitamin C supplementation to prevent premature rupture of the chorioamniotic membranes: a randomized trial
Esther Casanueva1, Carmina Ripoll, Maricruz Tolentino
1Public Health Research Branch, National Institute of Perinatology, Mexico City, Mexico. casanuev@servidor.unam.mx
Insights
Daily vitamin C (ascorbic acid) supplementation in pregnancy significantly reduced the risk of premature rupture of the chorioamniotic membranes (PROM). This intervention is effective in preventing PROM when initiated after 20 weeks of gestation.
Area of Science:
- Obstetrics and Gynecology
- Nutritional Science
- Biochemistry
Background:
- Vitamin C (ascorbic acid) is crucial for collagen synthesis and maintaining chorioamniotic membrane integrity.
- Low vitamin C levels during pregnancy are a potential risk factor for premature rupture of membranes (PROM).
Purpose of the Study:
- To determine if 100 mg of daily vitamin C supplementation can prevent PROM.
Main Methods:
- A double-blind, placebo-controlled trial involving 120 pregnant women from the 20th week of gestation.
- Participants were randomized to receive either 100 mg vitamin C daily or a placebo.
- Plasma and leukocyte vitamin C levels were monitored, along with cervicovaginal infections, throughout the study.
Main Results:
- Leukocyte vitamin C levels increased significantly in the supplemented group compared to the placebo group between weeks 20 and 36.
- The incidence of PROM was substantially lower in the vitamin C group (7.69%) compared to the placebo group (24.5%).
- Supplementation demonstrated a relative risk of 0.26 for PROM.
Conclusions:
- Daily vitamin C supplementation of 100 mg after 20 weeks of gestation effectively reduces the incidence of PROM.
- Vitamin C plays a vital role in maintaining the structural integrity of chorioamniotic membranes during pregnancy.
Background:
Vitamin C is involved in the synthesis and degradation of collagen and is important for maintenance of the chorioamniotic membranes. Inadequate availability of ascorbic acid during pregnancy has been proposed as a risk factor for premature rupture of the chorioamniotic membranes (PROM).
Objective:
The objective of the study was to evaluate the effectiveness of 100 mg vitamin C/d in preventing PROM.
Design:
A controlled double-blind trial was performed. Pregnant women (n = 126) in their 20th wk of gestation were invited; 120 accepted and were randomly assigned to 2 groups (100 mg vitamin C/d or placebo). Every 4 wk, plasma and leukocyte vitamin C concentrations were measured, and each subject was evaluated for cervicovaginal infection. The incidence of PROM was recorded for each group as an indicator of the protective effect of vitamin C supplementation.
Results:
One hundred nine patients finished the study. Mean plasma vitamin C concentrations decreased significantly throughout the pregnancy in both groups (P = 0.001), and there were no significant differences between groups. Between weeks 20 and 36, mean leukocyte vitamin C concentrations decreased from 17.5 to 15.23 microg/10(8) cells in the placebo group and increased from 17.26 to 22.17 microg/10(8) cells in the supplemented group (within- and between-group differences: P = 0.001). The incidence of PROM was 14 per 57 pregnancies (24.5%) in the placebo group and 4 per 52 pregnancies (7.69%) in the supplemented group (relative risk: 0.26; 95% CI: 0.078, 0.837).
Conclusion:
Daily supplementation with 100 mg vitamin C after 20 wk of gestation effectively lessens the incidence of PROM.
