Vitamin C Supplementation and PROM

Document Type : Original Article

Authors

1 Midwife, Ms.c, Hazrat Fatemeh Nursing and Midwifery School, Shiraz University of Medical Sciences, Shiraz, Iran

2 Professor of Gynecology, Medical school, Shiraz University of Medical Sciences, Shiraz, Iran

3 Associate Professor of Statistics, Health Science School, Shiraz University of Medical Sciences, Shiraz, Iran

Abstract

Introduction: Premature rupture of membranes (PROM) affects 10-20% of all pregnancies, occuring in approximately 30% to 40% of preterm deliveries. Vitamin C has a role in collagen metabolism and increases resistance maintenance of the chorioamniotic membranes. The objective of this study was to evaluate the relationship between vitamin C supplementation with PROM and preterm delivery.
 
Methods and Materials: This clinical-trial study carried out from Jan to Jul 2006 at Hafez and Shoushtari Hospitals of Shiraz University of Medical Sciences. This study was approved by the local committee of medical ethics. Pregnant women (n=117) with 20 weeks gestational age, randomly divided into two groups 57 in the case group and 60 in the control group and evaluated every 4 weeks, from 20 to 36 weeks of pregnancy. At each evaluation, a vaginal examination was performed, to rule out bacterial vaginosis infection. The case group received a chewing tablet of 100 mg vitamin C daily. PROM and preterm delivery was recorded for each group as indicator of the protective effect of vitamin C supplementation.
 
Results: PROM occurred in 5 (8.77%) and 22 (36.67 %) pregnancies in the case and control group respectively (p<0/001). Four patients (7.41%) in the case group and 18 pregnant women (32.08 %( in the control group delivered at term with PROM (p=0.001). One woman (33.30%) in the case group and 4 women (57.10 %( in the control group delivered due to PROM at term (p> 0.5).
 
Conclusion: Supplementation of vitamin C after 20 weeks of gestation prevents PROM.

Keywords


1. Cunningham FG, Gant NF, Leveno KJ, Gilstrap LC + William,
s obstetrics. Newyork: Mc Graw-Hill;
2005. 856-860.
2. Casanueva E, Ripoll C, Tolentino M. Vitamin C supplementation to prevent premature rupture of
membranes: a randomized trial+Am J Clin Nutr 2005; 81(4): 859-863+
3. Lowdermilk Perry. Maternity & Women,
s Health Care. 9th ed. Mosby; 2007. unit 4, section 18.
4. Khashoggi TY+Outcome of pregnancies with preterm premature rupture of membranes. Saudi Med J
2004; 25(12):1957-1961.
5. Shi Wu Wen+ Epidemiology of preterm birth and neonatal outcome. Seminars in Fetal and Neonatal
Medicine 2004 9_ 6] a 429-435.
6. Siega-Riz AM, Promislow JH, Savitz DA.Vitamin C intake and the risk of preterm dlivery. Am J
Obstet Gynecol 2003; 189(2): 519-525+
7. James R WoodsN Judith L CavanaughN Edward P Norkus. The effect of labor on maternal and fetal
Vitamin C and E. Am J Obstet Gynecol 2002; 187:1179-1183.
8. Hydroxylation.http://answers.com.
9. Casanueva E, Vadillo-Ortega F, Pfeffer F. Vitamin C and premature rupture of chorioamniotic
membranes. Nutr Res 1998; 18: 241-245+
10. Institute of Medicine. Food and Nutrition Board. Dietary reference intake for vitamin C, vitamin E,
selenium and carotenoids. Washington. DC. National Academy Press 2000: 95-185.
11. Parry S, Strauss JF. Premature rupture of the fetal membranes. N Engl J Med .1998; 338: 663-8+
12. Wideman GL,Baird GH,Bolding OT. Ascorbic acid deficiency and premature rupture of fetal
membranes. Am J Obstet Gynecol 1964; 88:592-595.
13. Tejero E, Perichart O, Pfeffer F,Collagen synthesis during pregnancy, vitamin C availability, and risk of
premature rupture of fetal membranes. Int J Gynaecol Obstet 2003; 81:29-34.
14. Casanueva E, Magana L, Pfeffer F+ Incidence of premature rupture of membranes in pregnant women
with low leukocyte levels of vitamin C. Eur J Clin Nutr 1991; 45(8): 401-406.
15. Barrett BM, Sowell A, Gunter E,Wang M. Potential role of ascorbic acid and beta-carotene in the
prevention of preterm rupture of fetal membranes. Int J Vitam Nutr Res 1994; 64(3):192-197.