Can Maternal Vitamin C Supplements Increase Airway Function in Infants Born to Mothers Who Smoke?
BACKGROUND AND PURPOSE:
Daily vitamin C supplementation in pregnant smokers has been shown to increase newborn pulmonary function and infant forced expiratory flows (FEFs) at 3 months
McEvoy et al. (European Respiratory Journal, 2020) assessed whether vitamin C supplementation in pregnant smokers was associated with improved airway function in their infants through 12 months of age
Secondary outcome of a randomized, double-blind, placebo-controlled trial
Pregnant smokers between 13 and 23 weeks of gestation
Vitamin C: 125 to 500 mg/day
Participants were also provided with smoking cessation counseling
FEFs performed at 3 and 12 months of age
222 infants examined at 3 months | 202 infants examine at 12 months
While overall characteristics were similar between groups, women in the Vitamin C treatment group had significantly higher fasting ascorbic acid levels at mid (p<0.001) and late gestation (p<0.001)
Compared to placebo, infants born to mothers in the vitamin C group had significantly increased FEFs over the first year of life
Overall increased flows between 3 and 12 months
FEF75: 40.2 mL/sec (95% CI, 6.6 to 73.8; p = 0.025) | 16.1% effective increase
FEF50: 58.3 mL/sec (95% CI, 10.9 to 105.8; p = 0.0081) | 11.6% effective increase
FEF25 to 75: 55.1 mL/sec (95% CI, 9.7 to 100.5; p = 0.013) | 12% effective increase
Infants born to smokers who took a vitamin C supplement every day had small but significant increased airway function at 3 and 12 months of age, compared to infants born to smokers who did not supplement
The study was underpowered to assess clinical outcomes such as wheezing
The research team will be continuing the study to 5 years of age
The authors state that while the main goal should always be smoking cessation
This study demonstrates that the safe, inexpensive and simple intervention of vitamin C supplementation can persistently improve the airway function of infants exposed to in utero smoke
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