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Antioxidant supplementation in pre-eclampsia

2006; Elsevier BV; Volume: 367; Issue: 9517 Linguagem: Inglês

10.1016/s0140-6736(06)68434-1

1474-547X

Marshall D. Lindheimer, Baha M. Sibai,

Cardiovascular Issues in Pregnancy

Preventing pre-eclampsia or decreasing its severity would considerably reduce maternal-fetal morbidity worldwide, bringing as it would substantial decrements in maternal-fetal demise, premature births, and other serious immediate and long-term consequences of this multisystem disorder. Thus for over a decade now, many large and expensive multicentre randomised trials have failed to show significant reductions in the incidence of pre-eclampsia, or, when positive results occurred, the significance was small and the number to treat large. 1 Villar J Abalos E Nardin JM Meraldi M Carroli G Strategies to prevent and treat preeclampsia: evidence from randomized controlled trials. Semin Nephrol. 2004; 24: 707-715 Summary Full Text Full Text PDF Scopus (40) Google Scholar , 2 Villar J Abddel-Aleem H Meraldi M et al. World Health Organization randomized trial of calcium supplementation among low calcium intake women. Am J Obstet Gynecol. 2006; 194: 639-649 Summary Full Text Full Text PDF PubMed Scopus (250) Google Scholar All the trials were based on seemingly plausible hypotheses and/or promising results from small trials, or their likelihood of success was suggested in systematic reviews. First came the aspirin studies (more than 30 000 patients, randomised in over 30 trials 1 Villar J Abalos E Nardin JM Meraldi M Carroli G Strategies to prevent and treat preeclampsia: evidence from randomized controlled trials. Semin Nephrol. 2004; 24: 707-715 Summary Full Text Full Text PDF Scopus (40) Google Scholar ), and then the calcium supplementation trials (over 15 000 patients randomised in 12 studies 2 Villar J Abddel-Aleem H Meraldi M et al. World Health Organization randomized trial of calcium supplementation among low calcium intake women. Am J Obstet Gynecol. 2006; 194: 639-649 Summary Full Text Full Text PDF PubMed Scopus (250) Google Scholar ). Vitamin C and vitamin E in pregnant women at risk for pre-eclampsia (VIP trial): randomised placebo-controlled trialConcomitant supplementation with vitamin C and vitamin E does not prevent pre-eclampsia in women at risk, but does increase the rate of babies born with a low birthweight. As such, use of these high-dose antioxidants is not justified in pregnancy. Full-Text PDF Department of ErrorLindheimer MD, Sibai BM. Antioxidant supplementation in pre-eclampsia. Lancet 2006; 367: 1119. In this Comment, the final sentence of paragraph 2 should read: “Birthweight was significantly lower and there were significantly more unexplained deaths after gestational week 24 and higher rates of cord-blood acidosis in supplemented women.” The Comment authors were working from an earlier version of the Article, and the editors missed this point when checking against the final version. Full-Text PDF Compensation for vaccine injury in HungaryDaniel Salmon and colleagues (Feb 4, p 436)1 review vaccination legislation in the UK, Australia, and the USA. Experiences from several other countries (France, Sweden, Norway, Denmark) are mentioned, but we miss Hungary and other eastern European countries from the article. Full-Text PDF