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Originally at
Friday January 18 10:28 AM ET
NEW YORK (Reuters Health) - Women who get little vitamin C both before
and during their pregnancies have an increased risk of suffering a ruptured
membrane and subsequently delivering prematurely, according to research
presented this week at the Society for Maternal-Fetal Medicine's annual
meeting in New Orleans, Louisiana.
``Vitamin C plays a role in the structure of collagen in the fetal membrane,
and when it's not there, it makes the membrane weaker,'' lead author Dr.
Anna Siega-Riz, an assistant professor of maternal and child health and
nutrition at the University of North Carolina at Chapel Hill, told Reuters
Health.
Women with a low vitamin C intake have been found to be more susceptible
to premature rupture of the membrane attached to the placenta, leading
to an increased risk of premature delivery.
To further investigate the relationship between intake of the vitamin
and membrane rupture, the researchers studied 2,247 pregnant women enrolled
in a study funded by the National Institute of Child Health and Human Development.
The women were given a questionnaire asking them to detail their intake
of various foods before their pregnancy as well as during their second
trimester of pregnancy.
The investigators found a strong relationship between a lack of vitamin
C in a woman's diet and a tendency toward rupturing the placental membrane.
For example, the women who were in the bottom 10th percentile of vitamin
C consumers before pregnancy, meaning they took in less than 21 milligrams
(mg) of vitamin C daily, had twice the risk of suffering a premature ruptured
membrane during their pregnancy.
Similarly, women who were in the bottom 10th percentile of vitamin C
users during their second trimester of pregnancy, consuming less than 65
mg of vitamin C daily, were at 70% increased risk of suffering a premature
ruptured membrane.
The researchers controlled for other factors that could contribute to
membrane rupture, such as cigarette smoking, age and race. But other factors
the researchers didn't account for could be responsible for the association
seen in the study, Siega-Riz noted. For example, women with high vitamin
C intake tend to be in better health and have better overall nutritional
habits.
``We can't say causality, because you can't base anything on observational
studies,'' she said. ``This is another study that shows there is a potential
for a causal pathway for vitamin C leading to rupture of membranes, which
needs to be verified with randomized, clinical trials.''
The researchers found that only 28% of the women said they had taken
vitamin C supplements before pregnancy, while 80% reported taking a multivitamin
by the 30th week of pregnancy. The study's results suggest that starting
vitamins after becoming pregnant is not enough to ward off rupture risk.
``The best advice we can give is for women to take a multivitamin preconceptually
and throughout pregnancy,'' Siega-Riz said. ``You can't ignore the preconceptual
period--women have to be in good physical well-being when they become pregnant.''
NEW YORK (Reuters Health) - Women who add extra vitamin C to their diet
during pregnancy may lower their risk of premature delivery, a team of
Mexican researchers reports.
In Mexico, premature rupture of the membrane surrounding the fetus has
become relatively common among pregnant women, lead researcher Veronica
Gutierrez at the National Institute of Perinatology in Mexico City told
Reuters Health. This rupture can increase a woman's risk of premature delivery.
Vitamin C is known to play an important role in the structure of the
collagen-composed membrane. In fact, women who don't get enough vitamin
C both before and during pregnancy may be more susceptible to premature
membrane rupture, according to previous research.
Yet, the water-soluble vitamin does not last long in the body; whatever
is not used is excreted on a daily basis. And, during pregnancy, levels
of vitamin C and everything else that circulates in blood plasma drop due
to the various processes required to ensure proper fetal development.
Gutierrez and her colleagues speculated that supplementing pregnant
women's diets with vitamin C would prevent levels from the nutrient in
white blood cells, where it is stored, from dropping.
Their findings were presented during the American Society for Parenteral
and Enteral Nutrition's recent annual meeting in San Antonio, Texas.
For the study, 52 women in their fifth month of pregnancy were given
either an inactive "placebo" treatment or 100 milligrams of vitamin C each
day for three months.
As is typical during normal pregnancy, vitamin C levels in blood plasma
decreased for all the women, study findings indicate. Yet the white blood
cell concentration of the vitamin decreased only among women given placebo.
In fact, women who took vitamin C supplements experienced an increase
in their white blood cell concentration of the vitamin, Gutierrez and her
colleagues note.
Further, at delivery, less than 5% of the women who received vitamin
C supplements experienced premature membrane rupture, in comparison to
nearly 25% of women taking placebo, study findings indicate.
The researchers conclude that vitamin C supplementation maintains stores
of the nutrient in white blood cells and "may have value in preventing
(premature rupture>)."
Commenting on the study, Dr. Anna Siega-Riz of the University of North
Carolina at Chapel Hill said it "contributes another piece of evidence
that vitamin C is important in the events that lead to premature rupture
of the membranes." Siega-Riz was not involved in the current study but
she has performed research linking vitamin C deficiency with premature
rupture.
The difference in membrane rupture rates between the two study groups
"suggests that more studies with ample power to detect a difference are
needed to confirm the role of vitamin C in preventing (premature rupture),"
Siega-Riz told Reuters Health.
Still, in light of Gutierrez's findings, and her own research, Siega-Riz
said, "it is only prudent to develop vitamin C recommendations for pregnant
women."
Gutierrez noted that the extra vitamin C should not just come in the
form of pills. Pregnant women should also be sure to eat lots of vitamin
C-containing fruits and vegetables, she said, such as citrus fruits and
broccoli.
The US Institute of Medicine currently recommends that all women consume
75 milligrams of vitamin C per day. A single eight-ounce serving of orange
juice from frozen concentrate contains 100 milligrams of the vitamin.
http:
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By Charnicia E. Huggins
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