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Previous Volume 354:1796-1806 April 27, 2006 Number 17 Next

	Full Text PDF PDA Full Text PowerPoint Slide Set Editorial by Jeyabalan, A. Letters Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited E-mail When Letters Appear PubMed Citation

ABSTRACT

Background Supplementation with antioxidant vitamins has been proposed to reduce the risk of preeclampsia and perinatal complications, but the effects of this intervention are uncertain.

Methods We conducted a multicenter, randomized trial of nulliparous women between 14 and 22 weeks of gestation. Women were assigned to daily supplementation with 1000 mg of vitamin C and 400 IU of vitamin E or placebo (microcrystalline cellulose) until delivery. Primary outcomes were the risks of maternal preeclampsia, death or serious outcomes in the infants (on the basis of definitions used by the Australian and New Zealand Neonatal Network), and delivering an infant whose birth weight was below the 10th percentile for gestational age.

Results Of the 1877 women enrolled in the study, 935 were randomly assigned to the vitamin group and 942 to the placebo group. Baseline characteristics of the two groups were similar. There were no significant differences between the vitamin and placebo groups in the risk of preeclampsia (6.0 percent and 5.0 percent, respectively; relative risk, 1.20; 95 percent confidence interval, 0.82 to 1.75), death or serious outcomes in the infant (9.5 percent and 12.1 percent; relative risk, 0.79; 95 percent confidence interval, 0.61 to 1.02), or having an infant with a birth weight below the 10th percentile for gestational age (8.7 percent and 9.9 percent; relative risk, 0.87; 95 percent confidence interval, 0.66 to 1.16).

Conclusions Supplementation with vitamins C and E during pregnancy does not reduce the risk of preeclampsia in nulliparous women, the risk of intrauterine growth restriction, or the risk of death or other serious outcomes in their infants. (Controlledtrials.com number, ISRCTN00416244 [controlled-trials.com] .)

Source Information

From the Discipline of Obstetrics and Gynaecology, University of Adelaide, Women's and Children's Hospital, North Adelaide (A.R.R., C.A.C., G.A.D., J.S.R.); and the Department of Perinatal Medicine, Women's and Children's Hospital, North Adelaide (R.R.H.) — both in Australia.

Address reprint requests to Dr. Crowther at the Discipline of Obstetrics and Gynaecology, University of Adelaide, Women's and Children's Hospital, 72 King William Rd., North Adelaide SA 5006, Australia, or at caroline.crowther{at}adelaide.edu.au.

Full Text of this Article

Related Letters:

Vitamins C and E and the Prevention of Preeclampsia
Padayatty S. J., Levine M., Briley A. L., Poston L., Shennan A. H., Crowther C. A., Rumbold A. R., Robinson J., the ACTS Study Group
Extract | Full Text | PDF  
N Engl J Med 2006; 355:1065-1066, Sep 7, 2006. Correspondence

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