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Research
Pre-eclampsia Risk for Women with Type 1 Diabetes Unaffected by Vitamin C & E Supplements
The report also suggest that vitamin supplementation could
be beneficial in those women with low levels of dietary antioxidants in their
blood
A new report published by medical journal The Lancet, reveals
women with type 1 diabetes, who are at high risk of pre-eclampsia and preterm
delivery, will not have their risk lowered by taking vitamin supplements C and
E. The report, involving researchers from the Centre for Public Health and the
School of Nursing and Midwifery at Queen's University Belfast and the Belfast
Health and Social Care Trust also found, however, that vitamin supplementation
could be beneficial in those women with low levels of dietary antioxidants in
their blood and that this possibility needs further investigation.
The causes of pre-eclampsia are not known, but it has been
suggested that oxidative stress, (where free radicals harm cells), might play
a key role in the development of the condition. In 1999, a small trial suggested
that vitamin C and E might reduce pre-eclampsia in all pregnant women, not just
those with type 1 diabetes. Since then, however, subsequent larger trials found
no benefit of vitamin C and E supplementation during regular pregnancies.
Several previous research studies had also previously suggested
that because type 1 diabetes is associated with both increased oxidative stress
(and a reduction in antioxidants), antioxidant vitamin supplements could improve
outcomes for these women. To investigate further, the Diabetes and Pre-Eclampsia
Intervention Trial (DAPIT) study group examined the benefits of 1000 mg vitamin
C and 400 IU (international units) vitamin E in 762 pregnant women with type
1 diabetes, recruited from 25 UK antenatal clinics in the UK. Women were randomly
assigned to vitamins (379) or placebo (383) daily from between 8 and 22 weeks
until delivery.
Overall, findings showed that the rate of pre-eclampsia was
similar in both groups (15 per cent vs 19 per cent). In women with low antioxidant
status at the start of the study however, taking vitamins was associated with
a significantly lower risk of pre-eclampsia.
There was no evidence of harm from vitamin supplementation
to either mothers or babies. Antioxidant vitamins did not increase the likelihood
of developing high blood pressure during pregnancy (11 per cent vs 11 per cent)
and actually tended to reduce the risk of having a low birthweight baby (six
per cent vs 10 per cent). Additionally, fewer babies were born preterm to women
taking vitamin C.
Professor Ian Young from the Centre for Public Health, Queen's
School of Medicine, Dentistry and Biomedical Sciences, said, "Dietary intervention
rich in various antioxidants might have benefits that cannot be replicated by
individual supplements. Alternatively, prescription of antioxidant vitamins
at 8-22 weeks' gestation might be too late to affect the pathological process
for most patients with diabetes.
"In principle, the notion that oxidative stress is implicated
in the cause and development of pre-eclampsia remains plausible, but the benefit
of vitamin supplementation might be limited to women with vitamin depletion;
however, this idea needs confirmation."
Baha M Sibai from the University of Cincinnati, Ohio, USA,
said, "The causes of pre-eclampsia might be multi-factorial. Some cases
might be caused by immunological factors, others by dietary factors, and others
because of pre-existing medical conditions, or by a combination of these factors.
Therefore any single intervention is unlikely to be effective in prevention."
EH News Bureau
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