ascorbic-acid and Fetal-Membranes--Premature-Rupture

To assess the evidence available on the use of vitamin C supplementation greater than recommended dietary intake to reduce preterm birth rates.. Systematic review of randomized controlled trials using vitamin C alone or with one other supplement other than iron. Trials must report preterm birth rates but can have other primary outcomes. Preterm birth is defined as birth at less than 37 weeks' gestational age for this review. Review focused on studies with populations representative of Organization for Economic Co-operation and Development countries.. Inadequate level of evidence on the use of vitamin C alone to prevent preterm birth rates in low-risk populations based on one study. Three studies provided convincing evidence of no benefit in low-risk groups of use of vitamins C and E combined. Three studies provided adequate evidence of no benefit in high-risk groups of use of vitamins C and E combined.. The available evidence supports no benefit gained from using vitamin C to prevent preterm birth. Evidence does not support limiting use of vitamin C supplementation for other indications.

Topics: Antioxidants; Ascorbic Acid; Dietary Supplements; Drug Therapy, Combination; Female; Fetal Membranes, Premature Rupture; Humans; Pregnancy; Premature Birth; Randomized Controlled Trials as Topic; Vitamin E

The aim of this review was to evaluate recently published review articles which examine the use of nutritional supplements to prevent preterm birth (PTB) by modifying vaginal bacteria.. Probiotics, vitamin D and vitamin C were all identified as nutritional supplements that have the potential to alter bacterial flora and consequently reduce PTB and treat or prevent genital infections. Evidence shows that probiotics may reduce the incidence of PTB as well as being effective at treating bacterial vaginosis, a known cause for PTB. Low vitamin D levels may be associated with bacterial vaginosis, although no evidence was identified which demonstrated that vitamin D supplementation reduced the risk of having bacterial vaginosis or PTB.There is little evidence regarding vitamin C supplementation, although it does suggest a possible benefit with regard to preterm rupture of membranes; however, this did not appear to reduce rates of PTB.. Although there is evidence that taking probiotics in pregnancy may reduce the incidence of PTB, it is mainly derived from small, poor quality studies. Vitamin D and vitamin C may have potential benefits, but these remain to be proven. Large randomized controlled trials are needed to more accurately evaluate the potential benefits of these low-cost interventions for reducing PTB and its consequences.

Topics: Ascorbic Acid; Ascorbic Acid Deficiency; Dietary Supplements; Evidence-Based Medicine; Female; Fetal Membranes, Premature Rupture; Humans; Obstetric Labor, Premature; Pregnancy; Prenatal Nutritional Physiological Phenomena; Probiotics; Risk; Vagina; Vaginosis, Bacterial; Vitamin D; Vitamin D Deficiency

Preterm premature rupture of membranes (PPROM) results initially from damage to collagen in the chorioamnion leading to a tear in the membrane. Tissue-damaging molecules called reactive oxygen species (ROS) are capable of damaging collagen in the chorioamnion that could lead to PPROM. This hypothesis is supported by epidemiological studies linking clinical conditions known to produce ROS or reduce antioxidant protection to PPROM, by in-vitro studies in which membrane segments exposed to ROS exhibited tissue alterations consistent with PPROM, and by clinical studies showing that chorioamnion and amniotic fluid samples obtained from PPROM patients exhibit excessive collagen degradation. The role of antioxidants to protect the chorioamnion from ROS damage has been demonstrated in one in-vitro study. A prospective, randomized blinded trial of antioxidant therapy during pregnancy is needed to evaluate this approach for the prevention of PPROM.

Topics: Adult; Amnion; Antioxidants; Ascorbic Acid; Chorioamnionitis; Chorion; Collagen; Female; Fetal Membranes, Premature Rupture; Humans; In Vitro Techniques; Oxidative Stress; Pregnancy; Pregnancy Complications, Infectious; Reactive Oxygen Species; Vitamin E

We propose that generation of reactive oxygen species may be a potentially reversible pathophysiologic pathway leading to preterm premature rupture of the membranes. Reactive oxygen species generated by the body's response to diverse insults such as infection, cigarette smoking, bleeding, or cocaine use can activate collagenolytic enzymes and impair fetal membrane integrity. Vitamin E, a lipid-soluble antioxidant, inhibits membrane-damaging effects of reactive oxygen species-induced lipid peroxidation. Vitamin C, a water-soluble antioxidant in plasma, stimulates and protects collagen synthesis while recycling vitamin E. Prior evidence shows that (1) damage by reactive oxygen species can impair fetal membrane integrity, (2) reduced midgestation levels of vitamin C are associated with preterm premature rupture of membranes, and (3) these vitamins can be safely and effectively absorbed and delivered to gestational tissues. Current prenatal vitamin preparations contain vitamins C and E in concentrations that are less than 1/3 and 1/10, respectively; these levels have been suggested for effective antioxidant protection. We hypothesize that increased dietary consumption or supplementation of vitamins C and E during pregnancy may reduce physiologically the risks of that portion of preterm premature rupture of membranes that is mediated by excessive or undamped peroxidation of fetal membranes. This hypothesis, if confirmed, should stimulate initiation of therapeutic trials to test the efficacy of enhanced supplementation with vitamins C and E during pregnancy to prevent preterm premature rupture of membranes.

Topics: Amnion; Ascorbic Acid; Chorion; Diet; Drug Synergism; Female; Fetal Membranes, Premature Rupture; Humans; Hypochlorous Acid; Pregnancy; Reactive Oxygen Species; Vitamin E

To determine whether maternal vitamin C and vitamin E supplementation after the premature rupture of membranes is associated with an increase in the latency period before delivery.. In the present prospective open randomized trial, 229 pregnant women with preterm premature rupture of membranes (PPROM) at ≥ 24.0 and < 34.0 weeks' gestation were randomly assigned to receive either 1,000 mg of vitamin C and 400 IU of vitamin E (n = 126) or a placebo (n = 123). The primary outcome was the latency period until delivery. Analysis was performed on an intention-to-treat basis.. No significant differences in demographic or clinical characteristics were observed between the groups. Latency period until delivery was significantly higher in the group that received vitamins compared with the control group (11.2 ± 6.3 days versus 6.2 ± 4.0 days; p < 0.001). Gestational age at delivery was also significantly higher in the vitamin group compared with the control group (31.9 ± 2.6 weeks versus 31.0 ± 2.6 weeks; p = 0.01). No significant differences in adverse maternal outcome (i.e., chorioamnionitis or endometritis) or neonatal outcome (i.e., neonatal sepsis, neonatal death, necrotizing enterocolitis, or grade 3 to 4 intraventricular hemorrhage) were noted between groups.. The findings of the present study suggest that the use of vitamins C and E in women with PPROM is associated with a longer latency period before delivery. Moreover, adverse neonatal and maternal outcomes, which are often associated with prolonged latency periods, were similar between the groups.

Topics: Adult; Ascorbic Acid; Delivery, Obstetric; Dietary Supplements; Female; Fetal Death; Fetal Membranes, Premature Rupture; Humans; Male; Pregnancy; Time Factors; Vitamin E; Vitamins; Young Adult

We sought to investigate whether prenatal vitamin C and E supplementation reduces the incidence of gestational hypertension (GH) and its adverse conditions among high- and low-risk women.. In a multicenter randomized controlled trial, women were stratified by the risk status and assigned to daily treatment (1 g vitamin C and 400 IU vitamin E) or placebo. The primary outcome was GH and its adverse conditions.. Of the 2647 women randomized, 2363 were included in the analysis. There was no difference in the risk of GH and its adverse conditions between groups (relative risk, 0.99; 95% confidence interval, 0.78-1.26). However, vitamins C and E increased the risk of fetal loss or perinatal death (nonprespecified) as well as preterm prelabor rupture of membranes.. Vitamin C and E supplementation did not reduce the rate of preeclampsia or GH, but increased the risk of fetal loss or perinatal death and preterm prelabor rupture of membranes.

Topics: Adult; Antioxidants; Ascorbic Acid; Dietary Supplements; Double-Blind Method; Female; Fetal Death; Fetal Membranes, Premature Rupture; Humans; Hypertension, Pregnancy-Induced; Pre-Eclampsia; Pregnancy; Prenatal Care; Risk; Risk Factors; Vitamin E

Generation of reactive oxygen species (ROS) has been suggested as a mechanism of fetal membrane (FM) weakening leading to rupture, particularly with preterm premature rupture of the fetal membranes (PROM). In vitro, FM incubation with tumor necrosis factor (TNF) mimics physiological FM weakening, concomitant with generation of ROS and collagen remodeling. Proinflammatory cytokines are also postulated to have a role in the development of the FM physiological weak zone where rupture normally initiates in-term gestations. We hypothesized that antioxidant treatment may block ROS development and resultant FM weakening. Two studies examining antioxidant effects upon FM strength were conducted, one in vivo and the other in vitro. Fetal membrane of patients enrolled in a multicenter placebo-controlled trial to determine the effect of vitamin C (1 g/day) and vitamin E (400 IU/day) upon complications of pre-eclampsia were examined for FM biomechanical properties and biochemical remodeling at birth. Separately, biomechanics and biochemical markers of remodeling were determined in FM fragments incubated with TNF with or without vitamin C preincubation. Supplemental dietary vitamin C in combination with vitamin E did not modify rupture strength, work to rupture, or matrix metalloproteinase-9 (MMP9; protein or activity) either within or outside the term FM physiological weak zone. In vitro, TNF decreased FM rupture strength by 50% while increasing MMP9 protein. Vitamin C did not inhibit these TNF-induced effects. Vitamin C alone had a weakening effect on FM in vitro. We speculate that vitamin C supplementation during pregnancy will not be useful in the prevention of preterm PROM.

Topics: Adult; Ascorbic Acid; Dietary Supplements; Extraembryonic Membranes; Female; Fetal Membranes, Premature Rupture; Humans; Matrix Metalloproteinase 9; Organ Culture Techniques; Pregnancy; Young Adult

To estimate whether maternally administered vitamins C and E lower the risk of spontaneous preterm birth.. This is a secondary analysis of a randomized, double-masked, placebo-controlled trial in nulliparous women at low-risk administered 1,000 mg vitamin C and 400 international units vitamin E or placebo daily from 9 to 16 weeks of gestation until delivery. Outcomes include preterm birth attributable to premature rupture of membranes (PROM) and total spontaneous preterm births (spontaneous preterm birth attributable to PROM or spontaneous labor).. Of the 10,154 women randomized, outcome data were available for 9,968 (4,992 vitamin group and 4,976 placebo group). A total of 1,038 women (10.4%) delivered preterm, of whom 698 (7.0%) had spontaneous preterm birth. A spontaneous preterm birth occurred in 356 women (7.1%) assigned to daily vitamin C and E supplementation and in 342 (6.9%) assigned to placebo. There were 253 women (2.5%) who delivered after preterm PROM and 445 (4.5%) after a spontaneous preterm labor. In women supplemented with vitamins C and E, births attributed to preterm PROM were similar at less than 37 and 35 weeks of gestation, but births were less frequent before 32 weeks of gestation (0.3% compared with 0.6%, adjusted odds ratio 0.3-0.9). However, total spontaneous preterm births across gestation in women supplemented with vitamins C and E or a placebo were similar.. Maternal supplementation with vitamins C and E beginning at 9 to 16 weeks of gestation in nulliparous women at low risk did not reduce spontaneous preterm births.. ClinicalTrials.gov, www.clinicaltrials.gov, NCT00135707.. I.

Topics: Adolescent; Adult; Antioxidants; Ascorbic Acid; Dietary Supplements; Female; Fetal Membranes, Premature Rupture; Humans; Pregnancy; Premature Birth; Vitamin E; Young Adult

The purpose of this study was to determine if antioxidant supplementation during pregnancy reduces the incidence of premature rupture of the membranes (PROM).. A placebo-controlled, double-blind trial was conducted. PROM and preterm PROM (PPROM) were planned secondary outcomes of the trial. Women between 12(0/7) and 19(6/7) 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.. 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.. Contrary to expectations, vitamins C and E supplementation in this dose combination may be associated with an increased risk of PROM and PPROM.

Topics: Adult; Antioxidants; Ascorbic Acid; Dietary Supplements; Double-Blind Method; Drug Therapy, Combination; Female; Fetal Membranes, Premature Rupture; Humans; Pregnancy; Pregnancy Outcome; Prospective Studies; Vitamin E

Vitamin C is involved in the synthesis and degradation of collagen and is important for maintenance of the chorioamniotic membranes. Inadequate availability of ascorbic acid during pregnancy has been proposed as a risk factor for premature rupture of the chorioamniotic membranes (PROM).. The objective of the study was to evaluate the effectiveness of 100 mg vitamin C/d in preventing PROM.. A controlled double-blind trial was performed. Pregnant women (n = 126) in their 20th wk of gestation were invited; 120 accepted and were randomly assigned to 2 groups (100 mg vitamin C/d or placebo). Every 4 wk, plasma and leukocyte vitamin C concentrations were measured, and each subject was evaluated for cervicovaginal infection. The incidence of PROM was recorded for each group as an indicator of the protective effect of vitamin C supplementation.. One hundred nine patients finished the study. Mean plasma vitamin C concentrations decreased significantly throughout the pregnancy in both groups (P = 0.001), and there were no significant differences between groups. Between weeks 20 and 36, mean leukocyte vitamin C concentrations decreased from 17.5 to 15.23 microg/10(8) cells in the placebo group and increased from 17.26 to 22.17 microg/10(8) cells in the supplemented group (within- and between-group differences: P = 0.001). The incidence of PROM was 14 per 57 pregnancies (24.5%) in the placebo group and 4 per 52 pregnancies (7.69%) in the supplemented group (relative risk: 0.26; 95% CI: 0.078, 0.837).. Daily supplementation with 100 mg vitamin C after 20 wk of gestation effectively lessens the incidence of PROM.

Topics: Adult; Antioxidants; Ascorbic Acid; Double-Blind Method; Female; Fetal Membranes, Premature Rupture; Humans; Mexico; Pregnancy

To determine whether supplementation with vitamins C and E after preterm premature rupture of membranes (PPROM) is associated with an increased latency period.. In this double-blind, randomized, controlled trial, 60 women with singleton pregnancies of 26 to 34 weeks' duration and PPROM were randomly assigned to vitamin C (500 mg/day) and vitamin E (400 IU/day) or placebo until delivery. All women received 2 doses of betamethasone in the first 24 h after admission as well as broad-spectrum antibiotic prophylaxis.. Important demographic, as well as clinical characteristics such as number of cases of chorioamnionitis, early neonatal sepsis, and respiratory distress syndrome, were similar in the 2 groups. A statically significant difference in the mean+/-S.D. number of days of latency was found between the groups (10.5+/-5.2 days vs. 3.5+/-4.0 days (P = 0.03).. Vitamins C and E supplementation of after PPROM is associated with a longer latency before delivery.

Topics: Adult; Ascorbic Acid; Chorioamnionitis; Dietary Supplements; Double-Blind Method; Female; Fetal Membranes, Premature Rupture; Gestational Age; Humans; Infant, Newborn; Pregnancy; Pregnancy Trimester, Third; Time Factors; Treatment Outcome; Vitamin E

The study assessed the relationship of plasma ascorbic acid (vitamin C) level and IL-6 with preterm premature rupture of membranes (PPROM) in pregnant women.. A case-control study was carried out in University Hospital, Baghdad from July 2019 to July 2020. Two groups of pregnant women with a gestational age between 28-36+6 weeks were included. There were 50 PPROM cases, and 50 healthy controls showing uncomplicated pregnancy and intact amniotic membrane. Both groups matched with their body mass index and gestational age. Plasma vitamin C and interleukin-6 (IL-6) were assessed at the time of admission and 48 hours later in the study group while it was measured at the onset of labour in healthy controls. In addition, the culture and sensitivity of the placental membranes after delivery were assessed in both groups.. The mean serum vitamin C value was 2.016±0.15 mg/dl in the PPROM group while it was 5.04±0.22 mg/dl for controls at the time of enrollment. Therefore, women with low vitamin C levels were at a higher risk to have PPROM. The plasma IL-6 mean values were higher in the PPROM group versus healthy controls (18.88±0.31pg/ml vs 5.99±0.12 pg/ml ), P <0.0001.. This study highlighted the ability of vitamin C deficiency with the elevated level of IL-6 in pregnant women in the third trimester to predict preterm premature rupture of the membrane.

Topics: Ascorbic Acid; Case-Control Studies; Female; Fetal Membranes, Premature Rupture; Gestational Age; Humans; Infant; Infant, Newborn; Interleukin-6; Placenta; Pregnancy; Pregnant Women

Preterm premature rupture of membranes (PPROM) is associated with significant maternal and perinatal morbidity. This study examined maternal oxidative stress in PPROM.. This was a prospective cross-sectional study conducted in a university hospital. A total of 72 pregnant women were recruited into two groups, those with PPROM (38 cases) and those without PPROM (34 controls) matched for gestational age. Plasma interleukin-6, C-reactive protein, vitamins C, E and A, 8-isoprostane, total oxidant status (TOS) and antioxidant status (TAS) were determined for all study participants and the data were compared between the PPROM and control groups.. Both case and control groups were comparably matched in age, parity, gestational age and smoking status. There was a significant association between low 8-isoprostane, low vitamin C and high total oxidant status and the occurrence of PPROM (p < 0.001).. Plasma vitamin C and 8-isoprostane levels were lower and TOS higher in women with PPROM. Further research is needed to identify robust biological markers for the prevention and also prognosis of PPROM.

Topics: Ascorbic Acid; C-Reactive Protein; Cross-Sectional Studies; Dinoprost; Female; Fetal Membranes, Premature Rupture; Humans; Interleukin-6; Oxidants; Pregnancy; Prospective Studies; Vasoconstrictor Agents; Vitamin A; Vitamin E; Vitamins

Preterm prelabour rupture of membranes (PPROM) is a leading cause of preterm births. Its attendant contribution to maternal and perinatal morbidity and mortality makes it imperative to identify factors that may help prevent this condition. This study examined the association between plasma vitamin C concentration and the risk of (PPROM) amongst pregnant women in a tertiary hospital setting.. This was a prospective cross sectional study conducted at the Obstetric and Gynaecology Department of University of Benin Teaching Hospital (UBTH), Benin City. The study was in two phases, first a pilot study to determine baseline plasma vitamin C concentration amongst pregnant women in UBTH was conducted. In the main study 80 pregnant women were recruited into two groups of those with PPROM (40 cases) and those without PPROM (40 controls) matched for gestational age. Plasma vitamin C concentration was determined for all study participants and their sociodemographic characters were used to generate a database for analysis.. In the pilot study, plasma vitamin C concentration decreased with increasing gestational age of pregnancy. In the main study plasma vitamin C concentration was significantly lower in women with PPROM than controls without PPROM, 0.53 ± 0.05 vs. 0.58 ± 0.05 mg/dl; P = 0.0001. Both groups (case and control) were comparably matched in age, parity and social class. There was a significant association between low vitamin C levels and the occurrence of PPROM (95% CI 1.53-11.88; P = 0.008).. Plasma vitamin C was found to be lower in women with PPROM. Low plasma vitamin C concentration may thus be an associated risk factor for PPROM. Hence improved dietary or drug supplements may be a useful adjunctive strategy to reducing the incidence of PPROM and its attendant adverse sequelae. While this intervention is advocated, further multicentre investigation of the effects of vitamin C on risk of preterm PROM is suggested.

Topics: Adult; Analysis of Variance; Ascorbic Acid; Cross-Sectional Studies; Female; Fetal Membranes, Premature Rupture; Gestational Age; Humans; Nigeria; Pregnancy; Prospective Studies; Young Adult

Prelabor rupture of the fetal membranes affects approximately 10% of women at term, resulting in an increased risk of maternal and neonatal infection. Evidence suggests that membrane rupture is related to biochemical processes involving the extracellular matrix of the membranes. We tested the hypothesis that prelabor ruptured membranes are characterized by reduced collagen concentrations, altered collagen cross-link profiles, and increased concentrations of biomarkers of oxidative damage. We also set out to determine whether these effects are modulated by ascorbic acid status. In a case-control study, we explored the role that ascorbic acid, oxidative stress, collagen, and collagen cross-links play in determining membrane integrity and developed a functional assay to assess membrane proteolytic susceptibility. Prelabor ruptured membrane had a reduced ascorbic acid concentration in comparison with controls while protein carbonyl and malondialdehyde concentrations were increased. Collagen concentrations were also reduced in prelabor ruptured membrane, and while the concentration of collagen cross-links was not significantly different between prelabor and timely ruptured membrane, there was a regional variation in cross-link ratio within the amniotic sac. Proteolytic resistance in vitro was reduced in prelabor ruptured membrane and also exhibited regional variation within the amniotic sac. Our findings are strongly supportive of a role for the enhanced degradation of membrane collagen in the determination of prelabor rupture of fetal membranes. The formation of the rupture initiation site is a function of a regional variation in collagen cross-link ratio. Tissue ascorbic acid status may be an important mediator of these processes.

Topics: Adult; Amino Acids; Ascorbic Acid; Case-Control Studies; Collagen; Disease Susceptibility; Extraembryonic Membranes; Female; Fetal Membranes, Premature Rupture; Humans; Hydroxyproline; Infant, Newborn; Malondialdehyde; Oxidative Stress; Pregnancy; Proteins; Reference Values

To examine the relationship between plasma and leukocyte concentration of ascorbic acid and collagen type I propeptide C during pregnancy and subsequent premature rupture of membranes (PROM).. Fifteen women with PROM and 26 controls were compared for plasma and leukocyte concentration of vitamin C and for Pro-C during pregnancy.. A statistically significant difference in maternal leukocyte ascorbic acid concentration was found between the two groups at week 28 of gestation (P50 was 16.90 for PROM group vs. 21.46 for control group; P>0.05). Increased risk for PROM (odds ratio, 10.99; 95% confidence interval, 2.40-49.91) was found with elevated concentrations of Pro-C at week 16 of gestation.. A higher rate of collagen synthesis early in pregnancy was demonstrated in PROM cases. However, no correlation with ascorbic acid availability was found. This study supports the findings of others that collagen metabolism disturbances are associated with PROM.

Topics: Ascorbic Acid; Case-Control Studies; Collagen; Female; Fetal Membranes, Premature Rupture; Gestational Age; Humans; Leukocytes; Phosphopeptides; Pregnancy; Procollagen; Protein C; Protein Precursors

Ascorbic acid deficiency may lead to premature rupture of the membranes.. The study included a prospective cohort of pregnant women, aged >/=16 years, with singleton gestations who received care at one of four prenatal clinics in central North Carolina from 1995 through 1998. Vitamin C intake preconceptionally and during the second trimester was examined for its association with preterm delivery and subsets of preterm labor, premature rupture of the membranes, and medical induction in 2064 women.. Women who had total vitamin C intakes of <10th percentile preconceptionally had twice the risk of preterm delivery because of premature rupture of the membranes (relative risk, 2.2; 95% CI, 1.1, 4.5). This risk was attenuated slightly for second-trimester intake (relative risk, 1.7; 95% CI, 0.8, 3.5). The elevated risk of preterm premature rupture of the membranes was greatest for women with a low vitamin C intake during both time periods.. Because diet and supplement use are modifiable behaviors, corroboration of these findings would suggest a possible intervention strategy.

Topics: Adolescent; Adult; Antioxidants; Ascorbic Acid; Cohort Studies; Dose-Response Relationship, Drug; Drug Administration Schedule; Female; Fetal Membranes, Premature Rupture; Humans; Incidence; Obstetric Labor, Premature; Pregnancy; Pregnancy Trimester, Second; Prospective Studies; Regression Analysis; Risk

Topics: Antioxidants; Ascorbic Acid; Controlled Clinical Trials as Topic; Female; Fetal Membranes, Premature Rupture; Humans; Midwifery; Obstetric Labor, Premature; Patient Education as Topic; Pregnancy; Risk Factors

Some studies have shown an association between vitamin C disposability (Vit C), and the development of premature rupture of membranes (RPM). However, vitamin C role in the metabolism of collagen upon chorioamnion tissue, has not been analyzed. In this study the effect of modulation with different vit C concentrations in culture cells derived from human amnion, was analyzed. Vit C concentrations were used in order to cover physiological range (29.0 micrograms/ml). After stimulation the cells media were analyzed for enzymatic activity of metalloproteinases with extracellular matrix (MMP), and relative quantity of MMP-1, MMP-2 and MMP-9, was quantified, by immune transference, using monospecific polyclonal antibodies. The activity, as well as protein decreased in amniotic cells media, in a direct way as to vit C concentration, so, at the highest used concentrations (100 micrograms/ml), the least MMP activity/quantity, was obtained. These results show a finding not described until now, which permits to establish a direct connection between vit C availability and increase in collagen degradation. According to results, the less availability of vit C, the greater degradation of collagen, which should lead to a mechanical support loss and eventual fetal membranes rupture.

Topics: Amnion; Ascorbic Acid; Blotting, Western; Cells, Cultured; Chorion; Collagen; Collagenases; Diet; Female; Fetal Membranes, Premature Rupture; Gelatinases; Humans; Matrix Metalloproteinase 1; Matrix Metalloproteinase 2; Matrix Metalloproteinase 9; Metalloendopeptidases; Pregnancy

The association of antioxidant vitamins in serum and amniotic fluid with preterm rupture of fetal membrane (PROM) was examined. Amniotic fluid and venous blood specimens from 80 pregnant women with or without PROM were analyzed for ascorbic acid (ASA), alpha-tocopherol, retinol and beta-carotene concentrations. No differences in retinol and alpha-tocopherol in amniotic fluid or serum concentrations were found between the PROM and control groups. PROM and control subjects had similar serum ASA concentrations. However, PROM subjects had lower amniotic fluid ASA concentrations (p < 0.0001) and lower ratios of amniotic fluid ASA to serum ASA concentration than those of controls. Serum beta-carotene levels were lower in PROM group than control group (p = 0.025). The findings suggest that a low level of ASA in amniotic fluid but not serum appears to be an important determinant of PROM. beta-Carotene and ASA may act synergistically to prevent PROM in smokers.

Topics: Adult; Amniotic Fluid; Antioxidants; Ascorbic Acid; beta Carotene; Carotenoids; Female; Fetal Membranes, Premature Rupture; Humans; Parity; Pregnancy; Vitamin A; Vitamin E

Using a prospective comparative design, African American gravidae with and without genital tract infection were assessed with respect to dietary intakes, serum nutrient values, hematologic values, and pregnancy outcomes. Intakes of ascorbic acid, vitamin A, protein, and iron were the dietary variables while levels of ascorbic acid, protein, albumin, globulin, and ferritin were the variables measured in serum. The hematologic variables included hemoglobin, hematocrit, and red and white blood cell counts. Pregnancy outcome was defined on the basis of premature rupture of the membranes (PROM), and infant birth weight, birth length, gestational age, and head circumference. The sample consisted of 335 nulliparous women who were between 16-35 years of age, 96 of whom had genital tract infection based on laboratory reports. Findings indicated no significant differences between the mean dietary intakes as well as serum values of the infected and non-infected women, and no difference in the incidence of PROM. However, non-infected women had a better mean hematologic profile than the infected gravidae during pregnancy. Also, for the non-infected group, there were significant relationships between head circumference and protein consumption (P = .015) and serum ferritin (P = .05). For the infected women, the relationship between the hemoglobin and hematocrit measurements obtained at the first prenatal visit and infant birth weight, birth length and head circumference were statistically significant.

Topics: Adolescent; Adult; Ascorbic Acid; Birth Weight; Black or African American; Candidiasis, Vulvovaginal; Diet; Dietary Proteins; District of Columbia; Female; Fetal Membranes, Premature Rupture; Gestational Age; Hematocrit; Humans; Infant, Newborn; Iron; Labor, Obstetric; Pregnancy; Pregnancy Complications, Infectious; Pregnancy Outcome; Prospective Studies; Vaginitis; Vaginosis, Bacterial; Vitamin A

The present study was undertaken to explore the association between vitamin C nutritional status in pregnant women with premature rupture of the chorioamniotic membranes (PRM). A case-control cross-sectional study was carried out in 10 women with PRM and 19 women without PRM. The women were evaluated in the first hours postpartum while hospitalized: 10 ml of blood were obtained from each woman to determine vitamin C expressed as micrograms/10(8) leucocytes or microgram/mg of leucocyte protein. Data on fruit and vegetable consumption was collected by a frequency dietary survey and the hospital clinical records were reviewed to obtain their obstetric history and data on the presence of infection during pregnancy, in placenta and/or in fetal membranes. Low vitamin C levels were considered at a cut-off point equal or less than 26.33 micrograms/10(8) leucocytic cells and 3.15 micrograms/mg leucocyte protein. An association was found between low vitamin C levels and cases with PRM. No difference was found in the frequency of consumption of fruit and vegetables between the two groups. Infections were more frequently found in the PRM group, when the women had low levels of vitamin C, and when both risk factors were present simultaneously the proportion of PRM cases identified was greater than 0.75.

Topics: Adult; Ascorbic Acid; Ascorbic Acid Deficiency; Case-Control Studies; Cross-Sectional Studies; Female; Fetal Membranes, Premature Rupture; Humans; Incidence; Leukocytes; Pregnancy; Risk Factors