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Randomized Controlled Trial
. 2017 Jul:58:66-77.
doi: 10.1016/j.cct.2017.05.008. Epub 2017 May 8.

Vitamin C to Decrease the Effects of Smoking in Pregnancy on Infant Lung Function (VCSIP): Rationale, design, and methods of a randomized, controlled trial of vitamin C supplementation in pregnancy for the primary prevention of effects of in utero tobacco smoke exposure on infant lung function and respiratory health

Cindy T McEvoy  1 , Kristin F Milner  2 , Ashley J Scherman  2 , Diane G Schilling  2 , Christina J Tiller  3 , Brittany Vuylsteke  2 , Lyndsey E Shorey-Kendrick  4 , Eliot R Spindel  4 , Robert Schuff  5 , Julie Mitchell  6 , Dawn Peters  7 , Jill Metz  8 , David Haas  9 , Keith Jackson  10 , Robert S Tepper  3 , Cynthia D Morris  5
Affiliations
Randomized Controlled Trial

Vitamin C to Decrease the Effects of Smoking in Pregnancy on Infant Lung Function (VCSIP): Rationale, design, and methods of a randomized, controlled trial of vitamin C supplementation in pregnancy for the primary prevention of effects of in utero tobacco smoke exposure on infant lung function and respiratory health

Cindy T McEvoy et al. Contemp Clin Trials. 2017 Jul.

Abstract

Despite strong anti-smoking efforts, at least 12% of American women cannot quit smoking when pregnant resulting in >450,000 smoke-exposed infants born yearly. Smoking during pregnancy is the largest preventable cause of childhood respiratory illness including wheezing and asthma. Recent studies have shown a protective effect of vitamin C supplementation on the lung function of offspring exposed to in utero smoke in a non-human primate model and an initial human trial. Vitamin C to Decrease the Effects of Smoking in Pregnancy on Infant Lung Function (VCSIP) is a randomized, double-blind, placebo-controlled trial to evaluate pulmonary function at 3months of age in infants delivered to pregnant smokers randomized to 500mg/day of vitamin C versus placebo during pregnancy. Secondary aims evaluate the incidence of wheezing through 12months and pulmonary function testing at 12months of age. Women are randomized between 13 and 23weeks gestation from clinical sites in Portland, Oregon at Oregon Health & Science University and PeaceHealth Southwest Medical Center and in Indianapolis, Indiana at Indiana University and Wishard Hospital. Vitamin C supplementation occurs from randomization to delivery. Monthly contact with participants and monitoring of medical records is performed to document medication adherence, changes in smoking and medical history, and adverse events. Pulmonary function testing of offspring occurs at 3 and 12months of age and incidence of wheezing and respiratory illness through 12months is captured via at least quarterly questionnaires. Ancillary studies are investigating the impact of vitamin C on placental blood flow and DNA methylation.

Keywords: Asthma; Forced expiratory flows; In utero smoke; Lung development; Pulmonary function test; Vitamin C; Wheeze.

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Figures

Figure 1
Figure 1
Forced expiratory flows in non-human primates treated as shown (Mean ± SEM). *p< 0.05 for overall comparison of Nicotine-treated group to control and Nicotine + vitamin C-treated groups by MANOVA. FEF25%–75% = the average flow between 25% and 75% of forced expired volume. N= 20 total animals. Used by permission from Proskocil et al.
Figure 2
Figure 2
The VCSIP Study Design Abbreviations: PNV: prenatal vitamin; PFT: pulmonary function test
Figure 3
Figure 3
Original projection of study recruitment
See this image and copyright information in PMC

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