American Journal of Obstetrics & Gynecology
Volume 199, Issue 4 , Pages 433.e1-433.e8, October 2008

Antioxidant supplementation and premature rupture of the membranes: a planned secondary analysis

Presented at the 28th annual meeting of the Society for Maternal–Fetal Medicine, Dallas, TX, Jan. 28-Feb. 2, 2008.

  • Joseph A. Spinnato II, MD

      Affiliations

    • University of Cincinnati College of Medicine, Cincinnati, OH
    • ,
  • Salvio Freire, MD

      Affiliations

    • Universidade Federal de Pernambuco, Hospital das Clínicas, Recife, Brazil
    • ,
  • Joao Luiz Pinto e Silva, MD

      Affiliations

    • Universidade Estadual de Campinas, Campinas, Brazil
    • ,
  • Marilza Vieira Cunha Rudge, MD

      Affiliations

    • Universidade Estadual Paulista, Botucatu, Brazil
    • ,
  • Sérgio Martins-Costa, MD

      Affiliations

    • Universidade Federal do Rio Grande do Sul, Hospital de Clínicas, Porto Alegre, Brazil
    • ,
  • Matthew A. Koch, MD, PhD

      Affiliations

    • RTI International, Research Triangle Park, NC
    • ,
  • Norman Goco, MHS

      Affiliations

    • RTI International, Research Triangle Park, NC
    • ,
  • Cleide de Barros Santos, MD

      Affiliations

    • Universidade Federal de Pernambuco, Hospital das Clínicas, Recife, Brazil
    • ,
  • Jose Guilherme Cecatti, MD

      Affiliations

    • Universidade Estadual de Campinas, Campinas, Brazil
    • ,
  • Roberto Costa, MD

      Affiliations

    • Universidade Estadual Paulista, Botucatu, Brazil
    • ,
  • José Geraldo Ramos, MD

      Affiliations

    • Universidade Federal do Rio Grande do Sul, Hospital de Clínicas, Porto Alegre, Brazil
    • ,
  • Nancy Moss, PhD

      Affiliations

    • National Institute of Child Health and Human Development, Bethesda, MD
    • ,
  • Baha M. Sibai, MD

      Affiliations

    • University of Cincinnati College of Medicine, Cincinnati, OH

Received 28 February 2008; received in revised form 16 April 2008; accepted 7 July 2008.

Objective

The purpose of this study was to determine if antioxidant supplementation during pregnancy reduces the incidence of premature rupture of the membranes (PROM).

Study Design

A placebo-controlled, double-blind trial was conducted. PROM and preterm PROM (PPROM) were planned secondary outcomes of the trial. Women between 120/7 and 196/7 weeks of gestation and diagnosed to have chronic hypertension or a prior history of preeclampsia were randomized to daily treatment with both vitamin C (1000 mg) and E (400 IU) or placebo.

Results

Outcome data for PROM were available for 697 of 739 patients. The rates of PROM (37/349 [10.6%] vs 19/348 [5.5%]; adjusted risk ratio [RR] 1.89 [95.42% CI, 1.11-3.23]; P = .015), and PPROM (16/349 [4.6%] vs 6/348 [1.7%]; RR 2.68 [1.07-6.71]; P = .025) were increased in the antioxidant group.

Conclusion

Contrary to expectations, vitamins C and E supplementation in this dose combination may be associated with an increased risk of PROM and PPROM.

Key words: antioxidants, premature rupture of the membranes, prematurity, prevention, vitamin C, vitamin E

To access this article, please choose from the options below

Login to an existing account or Register a new account.

  • Purchase this article for 30.00 USD (You must login/register to purchase this article)

    Online access for 24 hours. The PDF version can be downloaded as your permanent record.

  • Subscribe to this title

    Get unlimited online access to this article and all other articles in this title 24/7 for one year.

  • Claim access now

    For current subscribers with Society Membership or Account Number.

  • Visit SciVerse ScienceDirect to see if you have access via your institution.
 

 Cite this article as: Spinnato JA II, Freire S, Pinto e Silva JL, et al. Antioxidant supplementation and premature rupture of the membranes: a planned secondary analysis. Am J Obstet Gynecol 2008;199:433.e1-433.e8.

 Reprints not available from the authors.

 This effort was supported by Grant Number 1 U01 HD40565 cosponsored by the National Institute of Child Health and Human Development and the Bill and Melinda Gates Foundation.

 ClinicalTrials.gov Identifier: NCT00097110.

PII: S0002-9378(08)00800-4

doi:10.1016/j.ajog.2008.07.011

American Journal of Obstetrics & Gynecology
Volume 199, Issue 4 , Pages 433.e1-433.e8, October 2008

Article Tools

* Image Usage & Resolution