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Vitamin C and E supplementation to prevent spontaneous preterm birth: a randomized controlled trial
John C Hauth1, Rebecca G Clifton, James M Roberts
1From the Departments of Obstetrics and Gynecology at the University of Alabama at Birmingham, Birmingham, Alabama; University of Pittsburgh, Pittsburgh, Pennsylvania; University of Cincinnati, Cincinnati, Ohio; University of Texas Southwestern Medical Center, Dallas, Texas; University of Utah, Salt Lake City, Utah; University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Case Western Reserve University, Cleveland, Ohio; Northwestern University, Chicago, Illinois; University of Texas Health Science Center at Houston, Houston, Texas; Drexel University, Philadelphia, Pennsylvania; Wake Forest University Health Sciences, Winston-Salem, North Carolina; Oregon Health and Science University, Portland, Oregon; University of Texas Medical Branch, Galveston, Texas; Wayne State University, Detroit, Michigan; University of Texas Medical Center, Galveston, Texas; The George Washington University Biostatistics Center, Washington, DC; National Heart, Lung, and Blood Institute, Bethesda, Maryland; Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland.
Maternal supplementation with vitamins C and E did not reduce spontaneous preterm birth risk in low-risk women. This randomized trial found no significant difference in overall spontaneous preterm births between vitamin and placebo groups.
Area of Science:
- Obstetrics and Gynecology
- Nutritional Science
- Maternal-Fetal Medicine
Background:
- Spontaneous preterm birth is a leading cause of neonatal morbidity and mortality.
- Maternal vitamin supplementation is explored as a potential preventative strategy.
- Previous research on antioxidant vitamins for preterm birth prevention has yielded mixed results.
Purpose of the Study:
- To evaluate the efficacy of maternal co-supplementation with vitamins C and E in reducing the incidence of spontaneous preterm birth.
- To assess the impact of these vitamins on preterm birth due to premature rupture of membranes (PROM) and spontaneous labor.
Main Methods:
- Secondary analysis of a randomized, double-masked, placebo-controlled trial involving nulliparous women at low risk.
- Participants received 1,000 mg vitamin C and 400 IU vitamin E or placebo daily from 9-16 weeks gestation until delivery.
- Primary outcomes included preterm birth from PROM and total spontaneous preterm births.
Main Results:
- No significant difference in total spontaneous preterm births was observed between the vitamin C and E group (7.1%) and the placebo group (6.9%).
- While births attributed to preterm PROM were similar overall, vitamin supplementation showed a trend towards fewer births before 32 weeks gestation (0.3% vs. 0.6%).
- The study included 9,968 women, with 1,038 (10.4%) experiencing preterm delivery.
Conclusions:
- Maternal supplementation with vitamins C and E, initiated in early gestation, does not decrease the overall risk of spontaneous preterm birth in low-risk nulliparous women.
- The findings do not support the routine use of these vitamins for preventing spontaneous preterm birth in this population.
- Further research may be needed to explore potential benefits in specific subgroups or for very preterm births.
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