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| |  Vitamin Supplements Do Not Prevent Pre-eclampsia in Pregnant Women With Type 1 Diabetes NEW YORK -- July 1, 2010 -- Taking vitamins C and E during pregnancy does not lower the risk of pre-eclampsia in women with type 1 diabetes. However, vitamin supplementation could be beneficial in women with a low antioxidant status and needs further investigation, according to an article published online first in The Lancet and presented at the 70th Annual Scientific Sessions of the American Diabetes Association (ADA). Interestingly, contrary to previous research, the report shows no evidence of vitamin C and E supplements causing any harm to mothers or babies. The Diabetes and Pre-Eclampsia Intervention Trial (DAPIT) study group examined the benefits of 1000mg vitamin C and 400 IU vitamin E in 762 pregnant women with type 1 diabetes, recruited from 25 antenatal clinics in the UK. Women were randomly assigned to vitamins (n = 379) or placebo (n = 383) daily from between 8 and 22 weeks' gestation until delivery. Overall, findings showed that the rate of pre-eclampsia was similar in both groups (15% vs 19%). However, in women with low antioxidant status at the start of the study, 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% vs 11%) and appeared to reduce the risk of having a low birthweight baby (6% vs 10%). Additionally, fewer babies were born preterm to women taking vitamin C. These findings, said the authors, suggest that: "Dietary intervention rich in various antioxidants might have benefits that cannot be replicated by individual supplements. Alternatively, prescription of antioxidant vitamins at 8 to 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 pathogenesis of pre-eclampsia remains plausible, but the benefit of vitamin supplementation might be limited to women with vitamin depletion; however, this idea needs confirmation," they said. In an accompanying comment, Baha M Sibai, MD, University of Cincinnati, Cincinnati, Ohio, cautioned that "the placebo group in DAPIT contained more women with previous pre-eclampsia, chronic hypertension, and nephropathy than did the supplementation group…because the DAPIT investigators did not adjust for all the above factors in women with low antioxidant status, the conclusions for this group might not be valid." "The aetiology of pre-eclampsia might be multi-factorial," he said. "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." SOURCE: The Lancet
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