Journal
BJOG-AN INTERNATIONAL JOURNAL OF OBSTETRICS AND GYNAECOLOGY
Volume 116, Issue 6, Pages 780-788Publisher
WILEY
DOI: 10.1111/j.1471-0528.2009.02158.x
Keywords
Low birthweight; perinatal death; pre-eclampsia; small for gestational age; vitamins C and E
Categories
Funding
- UNDP/UNFPA/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction
- Department of Reproductive Health and Research
- World Health Organization
- The Cape Town, South Africa
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To determine if vitamin C and E supplementation in high-risk pregnant women with low nutritional status reduces pre-eclampsia. Multicentred, randomised, controlled, double-blinded trial. Antenatal care clinics and Hospitals in four countries. Pregnant women between 14 and 22 weeks' gestation. Randomised women received 1000 mg vitamin C and 400 iu of vitamin E or placebo daily until delivery. Pre-eclampsia, low birthweight, small for gestational age and perinatal death. Six hundred and eighty-seven women were randomised to the vitamin group and 678 to the placebo group. Groups had similar gestational ages (18.1; SD 2.4 weeks), socio-economic, clinical and demographical characteristics and blood pressure at trial entry. Risk factors for eligibility were similar, except for multiple pregnancies: placebo group (14.7%), vitamins group (11.8%). Previous pre-eclampsia, or its complications, was the most common risk factor at entry (vitamins 41.6%, placebo 41.3%). Treatment compliance was 87% in the two groups and loss to follow-up was low (vitamins 2.0%, placebo 1.3%). Supplementation was not associated with a reduction of pre-eclampsia (RR: 1.0; 95% CI: 0.9-1.3), eclampsia (RR: 1.5; 95% CI: 0.3-8.9), gestational hypertension (RR: 1.2; 95% CI: 0.9-1.7), nor any other maternal outcome. Low birthweight (RR: 0.9; 95% CI: 0.8-1.1), small for gestational age (RR: 0.9; 95% CI: 0.8-1.1) and perinatal deaths (RR: 0.8; 95% CI: 0.6-1.2) were also unaffected. Vitamins C and E at the doses used did not prevent pre-eclampsia in these high-risk women.
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