Effect of Antioxidants on the Occurrence of Pre-Eclampsia in Women at Increased Risk: A Randomised Trial

Chappell, Lucy C; Seed, Paul; Briley, Annette; Kelly, Frank J.; Lee, Rosalind; Hunt, Beverley J.; Parmar, Kiran; Bewley, Susan; Shennan, Andrew; Steer, Philip; Poston, Lucilla

doi:10.1097/00006254-200003000-00003

Cited by 62 publications

(75 citation statements)

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“…infections or dietary deficiencies in spring could predispose to the more frequent occurrence of pre-eclampsia in late autumn and winter). Calcium 13 , fish oil 14 , antioxidants 15 and homocysteine 16 have been thought to possibly play causal roles in pre-eclampsia. Seasonal variability in dietary intake may be relevant for understanding the seasonal variation in occurrence of pre-eclampsia.…”

Section: Discussionmentioning

confidence: 99%

Seasonal variation in the occurrence of pre‐eclampsia

Magnus¹,

Eskild

2001

BJOG

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Objective To obtain evidence for seasonal variability in pre‐eclampsia using the assumption that environmental factors may have a role in the causal mechanisms. Design Cross sectional population‐based study. Population All 1,869,388 deliveries in Norway in the years 1967 to 1998. Method For each month, the percentage of births complicated by pre‐eclampsia was calculated. The relative risks of pre‐eclampsia by month of delivery were estimated as odds ratios using the month with lowest risk as the reference category. Results Mothers of children born in August had the lowest risk of pre‐eclampsia, and the risk was highest in the winter months (for December adjusted OR: 1.26, 95% CI 1.20–1.31). This pattern was independent of parity, maternal age, year and place of living. Conclusion The finding may provide a new clue for understanding the causes of pre‐eclampsia. Environmental factors that show a similar seasonal variation should be investigated as possible causes.

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Section: Discussionmentioning

confidence: 99%

Seasonal variation in the occurrence of pre‐eclampsia

Magnus¹,

Eskild

2001

BJOG

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“…Women were recruited prospectively at St Thomas' Hospital and the Chelsea and Westminster Hospital, London, for a separate study relating to the prevention of pre-eclampsia. 22 In that study, women were identified as being at increased risk of pre-eclampsia on the basis of (i) abnormal uterine artery Doppler waveform (defined as a resistance index 95th centile for gestation and/or the presence of an early diastolic notch) or (ii) previous history of pre-eclampsia requiring delivery before 37 weeks of gestation. The risk of pre-eclampsia in a subsequent pregnancy for this group is approximately 10%, that is several fold higher than other parous women.…”

Section: Methodsmentioning

confidence: 99%

Association of raised titres of antibodies to Chlamydia pneumoniae with a history of pre‐eclampsia

Goulis

Chappell

Gibbs

et al. 2005

BJOG

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Objective To establish the prevalence of Chlamydia pneumoniae (C. pneumoniae) infection in a pregnant UK population and to investigate whether C. pneumoniae infection is more common in women with a previous history of pre-eclampsia. Design Prospective study.Setting Academic Hospital.Population Ninety-one pregnant women (54 parous and 37 nulliparous) at 16 -22 weeks of gestation were studied. Of the parous women, 32 had a previous history of pre-eclampsia. Methods Peripheral blood was drawn for C. pneumoniae antibodies between 16-22 and 28-40 weeks of gestation. C. pneumoniae antibodies were measured using a solid-phase enzyme immunoassay. According to pregnancy outcome, women were categorised into normal, gestational hypertension and pre-eclampsia groups. Main outcome measures Serum levels of IgG, IgA and IgM C. pneumoniae antibodies.Results Prevalence of seropositivity to C. pneumoniae was 77%. Parous women had significantly higher levels of IgA and IgM C. pneumoniae antibodies than nulliparous women (P < 0.04). Parous women with previous pre-eclampsia were found to have higher levels of antibodies than parous women with a normal obstetric history (P 0.003). There was no difference in the antibody levels in women with different pregnancy outcomes. Conclusions The longitudinal data do not indicate an association between C. pneumoniae infection and preeclampsia. However, the subgroup analysis of parous women demonstrated raised C. pneumoniae antibodies in the women with previous pre-eclampsia, and therefore suggests that there may be an association between C. pneumoniae and the disease in this group.

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“…The women gave written consent and were interviewed by telephone twice antenatally (overall response rate 92 and 86% respectively) and again 6 and 18 months after delivery (overall response rate 70 and 62% respectively). The median (2.5th percentile, 97.5th percentile) gestational age at the interview was 16 (10,27) completed weeks for the first antenatal interview and 31 (26,37) completed weeks for the second antenatal interview. The questions covered a broad variety of topics including data on elevated blood pressure and pre-eclampsia.…”

Section: Methodsmentioning

confidence: 99%

“…[5][6][7] Whether intake of antioxidants can protect against pre-eclampsia 8,9 is less certain. Although a small randomised controlled trial showed a lower occurrence of pre-eclampsia in high-risk women who were supplemented with high doses of the antioxidative vitamins C and E, 10 recently, two large randomised studies combining high doses of vitamin C and E showed no difference in the incidence of pre-eclampsia in the treated women compared to the controls. 11,12 There was also an increase in the rates of low birthweight in the intervention group in the first of these trials.…”

Section: Introductionmentioning

confidence: 97%

Intake of vitamin C and E in pregnancy and risk of pre‐eclampsia: prospective study among 57 346 women

Klemmensen

Tabor

Østerdal

et al. 2009

BJOG

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Objective It has been suggested that vitamin C, alone or in combination with vitamin E, may protect against pre-eclampsia, whereas the safety of high-dose vitamin E supplements has been questioned. We investigated dietary intakes of vitamins C and E to see if they correlated with the incidence of pre-eclampsia.Design Prospective cohort study.Setting The Danish National Birth Cohort; a population-based pregnancy cohort; analyses were based on 57 346 pregnancies.Methods Vitamin intake was estimated from a food frequency questionnaire completed in gestational week 25, recording intake from diet and supplements during the previous four weeks. Pre-eclampsia diagnoses were obtained from the Danish National Patient Registry; we worked with two entities, 'pre-eclampsia (all types)' and 'severe pre-eclampsia/eclampsia/ HELLP'. We adjusted for confounding factors by logistic regression.Main outcome measures A small increase in the incidence of severe disease was also seen in the group of women (64, n = 49 373) with a high intake of vitamin E from supplements and dietary sources. ResultsThe incidence of 'pre-eclampsia (all types)' did not correlate with dietary vitamin C and E intake. There was a decreasing trend (P = 0.01) in the incidence of 'severe preeclampsia/eclampsia/HELLP' with increasing dietary vitamin C intake; with an intake of 130-170 mg/day as reference, odds ratios ranged from 1.21 (95% confidence interval 0.83 to 1.75) for an intake below 70 mg/day to 0.70 (0.40 to 1.23) for an intake exceeding 275 mg/day (total n = 57 346). For vitamin E intake aggregated from diet and supplements (n = 49 373), with an intake of 10.5-13.5 mg/day as reference, the 'severe pre-eclampsia/ eclampsia/HELLP' odds ratio was 1.46 (1.02 to 2.09) for an intake exceeding 18 mg/day.Conclusions Low dietary intake of vitamin C was associated with a trend towards an increased incidence of either severe pre-eclampsia, eclampsia or HELLP. A small increase in the incidence of severe disease was also seen in the group of women with a high intake of vitamin E from supplements and dietary sources.

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Effect of Antioxidants on the Occurrence of Pre-Eclampsia in Women at Increased Risk: A Randomised Trial

Cited by 62 publications

References 0 publications

Seasonal variation in the occurrence of pre‐eclampsia

Seasonal variation in the occurrence of pre‐eclampsia

Association of raised titres of antibodies to Chlamydia pneumoniae with a history of pre‐eclampsia

Intake of vitamin C and E in pregnancy and risk of pre‐eclampsia: prospective study among 57 346 women

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