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Intake of vitamin C and E in pregnancy and risk of pre-eclampsia: prospective study among 57 346 women.
BJOG. 2009 Jun; 116(7):964-74.BJOG

Abstract

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.

RESULTS

The 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 pre-eclampsia/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.

Authors+Show Affiliations

Maternal Nutrition Group, Danish Epidemiology Science Centre, Statens Serum Institut, Copenhagen, Denmark. klem@dadlnet.dkNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19522799

Citation

Klemmensen, Ak, et al. "Intake of Vitamin C and E in Pregnancy and Risk of Pre-eclampsia: Prospective Study Among 57 346 Women." BJOG : an International Journal of Obstetrics and Gynaecology, vol. 116, no. 7, 2009, pp. 964-74.
Klemmensen A, Tabor A, Østerdal ML, et al. Intake of vitamin C and E in pregnancy and risk of pre-eclampsia: prospective study among 57 346 women. BJOG. 2009;116(7):964-74.
Klemmensen, A., Tabor, A., Østerdal, M. L., Knudsen, V. K., Halldorsson, T. I., Mikkelsen, T. B., & Olsen, S. F. (2009). Intake of vitamin C and E in pregnancy and risk of pre-eclampsia: prospective study among 57 346 women. BJOG : an International Journal of Obstetrics and Gynaecology, 116(7), 964-74. https://doi.org/10.1111/j.1471-0528.2009.02150.x
Klemmensen A, et al. Intake of Vitamin C and E in Pregnancy and Risk of Pre-eclampsia: Prospective Study Among 57 346 Women. BJOG. 2009;116(7):964-74. PubMed PMID: 19522799.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Intake of vitamin C and E in pregnancy and risk of pre-eclampsia: prospective study among 57 346 women. AU - Klemmensen,Ak, AU - Tabor,A, AU - Østerdal,M L, AU - Knudsen,V K, AU - Halldorsson,T I, AU - Mikkelsen,T B, AU - Olsen,S F, PY - 2009/6/16/entrez PY - 2009/6/16/pubmed PY - 2009/8/11/medline SP - 964 EP - 74 JF - BJOG : an international journal of obstetrics and gynaecology JO - BJOG VL - 116 IS - 7 N2 - 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. RESULTS: The 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 pre-eclampsia/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. SN - 1471-0528 UR - https://www.unboundmedicine.com/medline/citation/19522799/Intake_of_vitamin_C_and_E_in_pregnancy_and_risk_of_pre_eclampsia:_prospective_study_among_57_346_women_ L2 - https://doi.org/10.1111/j.1471-0528.2009.02150.x DB - PRIME DP - Unbound Medicine ER -