Vitamin C supplementation to prevent premature rupture of the chorioamniotic membranes: a randomized trial
Vitamin C supplementation to prevent premature rupture of the chorioamniotic membranes: a randomized trial
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DOI：
10.1093/ajcn/81.4.859
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发表时间：
2005-04-01
影响因子：
7.1
通讯作者：
Vadillo-Ortega, F
中科院分区：
文献类型：
--
作者：
Casanueva, E;Ripoll, C;Vadillo-Ortega, F
背景：维生素C参与胶原蛋白的合成和降解，对绒毛膜羊膜的维持很重要。在怀孕期间的抗坏血酸的可用性不足已被提出作为一个危险因素的绒毛膜羊膜（PROM）的早产儿破裂。目的：本研究的目的是评估100毫克维生素C/d在预防PROM的有效性。设计：进行了一项对照双盲试验。妊娠20周的孕妇（n = 126）被邀请; 120人接受并随机分配到2组（100 mg维生素C/d或安慰剂）。每4周测量血浆和白细胞维生素C浓度，并对每个受试者进行宫颈阴道感染评估。记录各组胎膜早破的发生率，作为维生素C补充剂的保护作用的指标。在整个妊娠期间，两组的平均血浆维生素C浓度均显著降低（P = 0.001），组间无显著差异。在第20周和第36周之间，安慰剂组的平均白细胞维生素C浓度从17.5 μ g/10（8）个细胞降低到15.23 μ g/10（8）个细胞，而补充组的平均白细胞维生素C浓度从17.26 μ g/10（8）个细胞增加到22.17 μ g/10（8）个细胞（组内和组间差异：P = 0.001）。胎膜早破的发生率在安慰剂组为14/57（24.5%），在补充维生素C组为4/52（7.69%）（相对危险度：0.26，95%CI：0.078，0.837）。
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 mu g/10(8) cells in the placebo group and increased from 17.26 to 22.17 mu g/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.