Randomized Controlled Trial

. 2015 Dec;122(13):1740-7.

doi: 10.1111/1471-0528.13201. Epub 2014 Dec 17.

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

Collaborators, Affiliations

Collaborators

Eunice Kennedy Shriver National Institute of Child Health Human Development Maternal-Fetal Medicine Units Network:
J Hauth, D J Rouse, A Northen, P Files, J Grant, M Wallace, K Bailey, J Roberts, S Caritis, T Kamon, M Cotroneo, D Fischer, M Varner, P Reed, S Quinn, V Morby, F Porter, R Silver, J Miller, K Hill, S Bousleiman, R Alcon, K Saravia, F Loffredo, A Bayless, C Perez, M Lake, M Talucci, K Boggess, K Dorman, J Mitchell, K Clark, S Timlin, J Bailit, C Milluzzi, W Dalton, C Brezine, D Bazzo, J Sheffield, L Moseley, M Santillan, K Buentipo, J Price, L S Hermann, C Melton, Y Gloria-McCutchen, B Espino, M Dinsmoor, T Matson-Manning, G Mallett, S Ramin, S Blackwell, K Cannon, S Lege-Humbert, Z Spears, M Carpenter, J Tillinghast, M Seebeck, J Iams, F Johnson, S Fyffe, C Latimer, S Frantz, S Wylie, M Talucci, M Hoffman, J Benson, Z Reid, C Tocci, P Meis, M Swain, J Tolosa, W Smith, L Davis, E Lairson, S Butcher, S Maxwell, D Fisher, J Moss, B Stratton, G Hankins, J Brandon, C Nelson-Becker, G Olson, L Pacheco, G Norman, S Blackwell, P Lockhart, D Driscoll, M Dombrowski, E Thom, T Boekhoudt, G Pearson, V Pemberton, J Cutler, W Barouch, C Spong, S Tolivaisa, G D Anderson

Affiliations

¹ Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, AL, USA.
² Department of Obstetrics and Gynecology, University of Pittsburgh, Pittsburgh, PA, USA.
³ Department of Obstetrics and Gynecology, The George Washington University Biostatistics Center, Washington, DC, USA.
⁴ Department of Obstetrics and Gynecology, Southwestern Medical Center, University of Texas, Dallas, TX, USA.
⁵ Department of Obstetrics and Gynecology, University of Cincinnati, Cincinnati, OH, USA.
⁶ Department of Obstetrics and Gynecology, Columbia University, New York, NY, USA.
⁷ Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
⁸ Department of Obstetrics and Gynecology, Case Western Reserve University-MetroHealth Medical Center, Cleveland, OH, USA.
⁹ Department of Obstetrics and Gynecology, Northwestern University, Chicago, IL, USA.
¹⁰ Department of Obstetrics and Gynecology, The Ohio State University, Columbus, OH, USA.
¹¹ Department of Obstetrics and Gynecology, Drexel University, Philadelphia, PA, USA.
¹² Department of Obstetrics and Gynecology, Wake Forest University Health Sciences, Winston-Salem, NC, USA.
¹³ Department of Obstetrics and Gynecology, University of Texas Medical Branch, Galveston, TX, USA.
¹⁴ Department of Obstetrics and Gynecology, Wayne State University, Detroit, MI, USA.

PMID: 25516497
PMCID: PMC4470874
DOI: 10.1111/1471-0528.13201

Randomized Controlled Trial

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

A Abramovici et al. BJOG. 2015 Dec.

. 2015 Dec;122(13):1740-7.

doi: 10.1111/1471-0528.13201. Epub 2014 Dec 17.

Authors

Collaborators

Eunice Kennedy Shriver National Institute of Child Health Human Development Maternal-Fetal Medicine Units Network:
J Hauth, D J Rouse, A Northen, P Files, J Grant, M Wallace, K Bailey, J Roberts, S Caritis, T Kamon, M Cotroneo, D Fischer, M Varner, P Reed, S Quinn, V Morby, F Porter, R Silver, J Miller, K Hill, S Bousleiman, R Alcon, K Saravia, F Loffredo, A Bayless, C Perez, M Lake, M Talucci, K Boggess, K Dorman, J Mitchell, K Clark, S Timlin, J Bailit, C Milluzzi, W Dalton, C Brezine, D Bazzo, J Sheffield, L Moseley, M Santillan, K Buentipo, J Price, L S Hermann, C Melton, Y Gloria-McCutchen, B Espino, M Dinsmoor, T Matson-Manning, G Mallett, S Ramin, S Blackwell, K Cannon, S Lege-Humbert, Z Spears, M Carpenter, J Tillinghast, M Seebeck, J Iams, F Johnson, S Fyffe, C Latimer, S Frantz, S Wylie, M Talucci, M Hoffman, J Benson, Z Reid, C Tocci, P Meis, M Swain, J Tolosa, W Smith, L Davis, E Lairson, S Butcher, S Maxwell, D Fisher, J Moss, B Stratton, G Hankins, J Brandon, C Nelson-Becker, G Olson, L Pacheco, G Norman, S Blackwell, P Lockhart, D Driscoll, M Dombrowski, E Thom, T Boekhoudt, G Pearson, V Pemberton, J Cutler, W Barouch, C Spong, S Tolivaisa, G D Anderson

Affiliations

¹ Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, AL, USA.
² Department of Obstetrics and Gynecology, University of Pittsburgh, Pittsburgh, PA, USA.
³ Department of Obstetrics and Gynecology, The George Washington University Biostatistics Center, Washington, DC, USA.
⁴ Department of Obstetrics and Gynecology, Southwestern Medical Center, University of Texas, Dallas, TX, USA.
⁵ Department of Obstetrics and Gynecology, University of Cincinnati, Cincinnati, OH, USA.
⁶ Department of Obstetrics and Gynecology, Columbia University, New York, NY, USA.
⁷ Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
⁸ Department of Obstetrics and Gynecology, Case Western Reserve University-MetroHealth Medical Center, Cleveland, OH, USA.
⁹ Department of Obstetrics and Gynecology, Northwestern University, Chicago, IL, USA.
¹⁰ Department of Obstetrics and Gynecology, The Ohio State University, Columbus, OH, USA.
¹¹ Department of Obstetrics and Gynecology, Drexel University, Philadelphia, PA, USA.
¹² Department of Obstetrics and Gynecology, Wake Forest University Health Sciences, Winston-Salem, NC, USA.
¹³ Department of Obstetrics and Gynecology, University of Texas Medical Branch, Galveston, TX, USA.
¹⁴ Department of Obstetrics and Gynecology, Wayne State University, Detroit, MI, USA.

PMID: 25516497
PMCID: PMC4470874
DOI: 10.1111/1471-0528.13201

Abstract

Objective: 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.

Design/setting/population: 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.

Methods: We examined the effect of vitamin C/E by smoking status at randomisation using the Breslow-Day test for interaction.

Main outcome measures: 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.

Results: 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).

Conclusion: 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.

Keywords: Placental abruption; preterm birth; smoking.

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Conflict of interest statement

Disclosure of interests: The authors have no relevant conflict of interests to disclose

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

Collaborators

Affiliations

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

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Abstract

Conflict of interest statement

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