An international trial of antioxidants in the prevention of preeclampsia (INTAPP).
OBJECTIVE
We sought to investigate whether prenatal vitamin C and E supplementation reduces the incidence of gestational hypertension (GH) and its adverse conditions among high- and low-risk women.


METHODS
In a multicenter randomized controlled trial, women were stratified by the risk status and assigned to daily treatment (1 g vitamin C and 400 IU vitamin E) or placebo. The primary outcome was GH and its adverse conditions.


RESULTS
Of the 2647 women randomized, 2363 were included in the analysis. There was no difference in the risk of GH and its adverse conditions between groups (relative risk, 0.99; 95% confidence interval, 0.78-1.26). However, vitamins C and E increased the risk of fetal loss or perinatal death (nonprespecified) as well as preterm prelabor rupture of membranes.


CONCLUSIONS
Vitamin C and E supplementation did not reduce the rate of preeclampsia or GH, but increased the risk of fetal loss or perinatal death and preterm prelabor rupture of membranes.
Xu
Hairong
H
Department of Obstetrics and Gynecology, Hôpital Ste-Justine, Université de Montréal, Montreal, QC, Canada.
Perez-Cuevas
Ricardo
R
Xiong
Xu
X
Reyes
Hortensia
H
Roy
Chantal
C
Julien
Pierre
P
Smith
Graeme
G
von Dadelszen
Peter
P
Leduc
Line
L
Audibert
François
F
Moutquin
Jean-Marie
JM
Piedboeuf
Bruno
B
Shatenstein
Bryna
B
Parra-Cabrera
Socorro
S
Choquette
Pierre
P
Winsor
Stephanie
S
Wood
Stephen
S
Benjamin
Alice
A
Walker
Mark
M
Helewa
Michael
M
Dubé
Johanne
J
Tawagi
Georges
G
Seaward
Gareth
G
Ohlsson
Arne
A
Magee
Laura A
LA
Olatunbosun
Femi
F
Gratton
Robert
R
Shear
Roberta
R
Demianczuk
Nestor
N
Collet
Jean-Paul
JP
Wei
Shuqin
S
Fraser
William D
WD
D000328:Adult; D000975:Antioxidants / Q000627:therapeutic use*; D001205:Ascorbic Acid / Q000627:therapeutic use*; D019587:Dietary Supplements; D004311:Double-Blind Method; D005260:Female; D005313:Fetal Death / Q000453:epidemiology; D005322:Premature Rupture of Fetal Membranes / Q000453:epidemiology; D006801:Humans; D046110:Hypertension, Pregnancy-Induced / Q000453:epidemiology / Q000517:prevention & control; D011225:Pre-Eclampsia / Q000453:epidemiology / Q000517:prevention & control*; D011247:Pregnancy; D011295:Prenatal Care; D012306:Risk; D012307:Risk Factors; D014810:Vitamin E / Q000627:therapeutic use*
D000975:Antioxidants; D014810:Vitamin E; D001205:Ascorbic Acid