Vitamin C Supplementation for Pregnant Smoking Women and Pulmonary Function in Their Newborn Infants: A Randomized Clinical Trial
Half of smoking women who become pregnant continue to smoke during pregnancy, with adverse effects on fetal lung development because of in utero exposure to tobacco products. Given the challenges of reducing smoking during pregnancy, this study sought to determine whether administration of vitamin C protects human lung development in utero. In this randomized trial, pregnant women in the active group received 500 mg daily of supplemental vitamin C. The primary outcome of interest was newborn infant pulmonary function tests of (PFTs), with secondary outcomes including incidence of wheezing during the first 12 months of life as well as PFT results at 1 year.
The women were enrolled at 3 different clinical sites in North America during 2007-2011. All were current smokers, defined as smoking at least 1 cigarette in 24 hours. The women were randomly assigned at ≤ 22 weeks of pregnancy to an intervention group (n = 89) or placebo (n = 90). All study mothers had declined smoking cessation efforts. A group of pregnant nonsmoking women were studied as a comparison group. Both smoking groups received brief counseling about cessation of smoking at each prenatal visit, and prenatal visits occurred at standard intervals. Newborn PFTs were obtained in the first 72 hours of life, when the infants were asleep. Follow-up PFTs at 1 year were obtained in 67% of the infants. Wheezing in the first 12 months of life was assessed by research personnel who administered a questionnaire to the family.
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