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Antioxidants for preventing pre-eclampsia (Review)

Rumbold, Alice R., Duley, Lelia, Crowther, Caroline A. and Haslam, Ross R. (2008). Antioxidants for preventing pre-eclampsia (Review). Cochrane Database of Systematic Reviews,2008(1 - Article No. CD004227).

Document type: Journal Article
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Title Antioxidants for preventing pre-eclampsia (Review)
Author Rumbold, Alice R.
Duley, Lelia
Crowther, Caroline A.
Haslam, Ross R.
Journal Name Cochrane Database of Systematic Reviews
Publication Date 2008
Volume Number 2008
Issue Number 1 - Article No. CD004227
ISSN 1469-493X   (check CDU catalogue  open catalogue search in new window)
Total Pages 89
Place of Publication United Kingdom
Publisher John Wiley & Sons Ltd.
HERDC Category C1 - Journal Article (DEST)
Abstract Background
Oxidative stress has been proposed as a key factor involved in the development of pre-eclampsia. Supplementing women with antioxidants during pregnancy may help to counteract oxidative stress and thereby prevent or delay the onset of pre-eclampsia.

Objectives

To determine the effectiveness and safety of any antioxidant supplementation during pregnancy and the risk of developing pre-eclampsia and its related complications.

Search methods

We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (May 2007), the Cochrane Central Register of Controlled Trials (The Cochrane Library 2006, Issue 3), MEDLINE (1950 to October 2007) and Current Contents (1998 to August 2004).

Selection criteria

All randomised trials comparing one or more antioxidants with either placebo or no antioxidants during pregnancy for the prevention of pre-eclampsia, and trials comparing one or more antioxidants with another, or with other interventions.

Data collection and analysis
Two review authors independently assessed trials for inclusion and trial quality and extracted data.

Main results

Ten trials, involving 6533 women, were included in this review, five trials were rated high quality. For the majority of trials, the antioxidant assessed was combined vitamin C and E therapy. There was no significant difference between antioxidant and control groups for the relative risk (RR) of pre-eclampsia (RR 0.73, 95% confidence intervals (CI) 0.51 to 1.06; nine trials, 5446 women) or any other primary outcome: severe pre-eclampsia (RR 1.25, 95% CI 0.89 to 1.76; two trials, 2495 women), preterm birth (before 37 weeks) (RR 1.10, 95% CI 0.99 to 1.22; five trials, 5198 women), small-for-gestational-age infants (RR 0.83, 95% CI 0.62 to 1.11; five trials, 5271 babies) or any baby death (RR 1.12, 95% CI 0.81 to 1.53; four trials, 5144 babies). Women allocated antioxidants were more likely to self-report abdominal pain late in pregnancy (RR 1.61, 95% CI 1.11 to 2.34; one trial, 1745 women), require antihypertensive therapy (RR 1.77, 95% CI 1.22 to 2.57; two trials, 4272 women) and require an antenatal hospital admission for hypertension (RR 1.54, 95% CI 1.00 to 2.39; one trial, 1877 women). However, for the latter two outcomes, this was not clearly reflected in an increase in any other hypertensive complications.

Authors' conclusions
Evidence from this review does not support routine antioxidant supplementation during pregnancy to reduce the risk of pre-eclampsia and other serious complications in pregnancy.
Keywords Antioxidants
Pre-Eclampsia
DOI http://dx.doi.org/10.1002/14651858.CD004227.pub3   (check subscription with CDU E-Gateway service for CDU Staff and Students  check subscription with CDU E-Gateway in new window)


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