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Prenatal vitamin C and E supplementation in smokers is associated with reduced placental abruption and preterm birth: a secondary analysis.

Authors :
Abramovici, A
Gandley, RE
Clifton, RG
Leveno, KJ
Myatt, L
Wapner, RJ
Thorp, JM
Mercer, BM
Peaceman, AM
Samuels, P
Sciscione, A
Harper, M
Saade, G
Sorokin, Y
Gandley, R E
Clifton, R G
Leveno, K J
Wapner, R J
Thorp, J M Jr
Mercer, B M
Source :
BJOG: An International Journal of Obstetrics & Gynaecology; Dec2015, Vol. 122 Issue 13, p1740-1747, 8p
Publication Year :
2015

Abstract

<bold>Objective: </bold>Smoking and pre-eclampsia (PE) are associated with increases in preterm birth, placental abruption and low birthweight. We evaluated the relationship between prenatal vitamin C and E (C/E) supplementation and perinatal outcomes by maternal self-reported smoking status focusing on outcomes known to be impacted by maternal smoking.<bold>Design/setting/population: </bold>A secondary analysis of a multi-centre trial of vitamin C/E supplementation starting at 9-16 weeks in low-risk nulliparous women with singleton gestations.<bold>Methods: </bold>We examined the effect of vitamin C/E by smoking status at randomisation using the Breslow-Day test for interaction.<bold>Main Outcome Measures: </bold>The trial's primary outcomes were PE and a composite outcome of pregnancy-associated hypertension (PAH) with serious adverse outcomes. Perinatal outcomes included preterm birth and abruption.<bold>Results: </bold>There were no differences in baseline characteristics within subgroups (smokers versus nonsmokers) by vitamin supplementation status. The effect of prenatal vitamin C/E on the risk of PE (P = 0.66) or PAH composite outcome (P = 0.86) did not differ by smoking status. Vitamin C/E was protective for placental abruption in smokers (relative risk [RR] 0.09; 95% CI 0.00-0.87], but not in nonsmokers (RR 0.92; 95% CI 0.52-1.62) (P = 0.01), and for preterm birth in smokers (RR 0.76; 95% CI 0.58-0.99) but not in nonsmokers (RR 1.03; 95% CI 0.90-1.17) (P = 0.046).<bold>Conclusion: </bold>In this cohort of women, smoking was not associated with a reduction in PE or the composite outcome of PAH. Vitamin C/E supplementation appears to be associated with a reduction in placental abruption and preterm birth among smokers. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
14700328
Volume :
122
Issue :
13
Database :
Complementary Index
Journal :
BJOG: An International Journal of Obstetrics & Gynaecology
Publication Type :
Academic Journal
Accession number :
111116644
Full Text :
https://doi.org/10.1111/1471-0528.13201