Cindy T McEvoy1, Lyndsey E Shorey-Kendrick2, Kristin Milner3, Diane Schilling3, Christina Tiller4, Brittany Vuylsteke3, Ashley Scherman3, Keith Jackson5, David M Haas6, Julia Harris3, Byung S Park7, Annette Vu8, Dale F Kraemer8, David Gonzales9, Carol Bunten10, Eliot R Spindel2, Cynthia D Morris8,11, Robert S Tepper4. 1. Department of Pediatrics, Oregon Health & Science University, Portland, OR, USA mcevoyc@ohsu.edu. 2. Division of Neuroscience, Oregon National Primate Research Center, Beaverton, OR, USA. 3. Department of Pediatrics, Oregon Health & Science University, Portland, OR, USA. 4. Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA. 5. PeaceHealth Southwest Medical Center, Vancouver, WA, USA. 6. Department of Obstetrics and Gynecology, Indiana University School of Medicine, Indianapolis, IN, USA. 7. Oregon Health & Science University-Portland State University, School of Public Health and Knight Cancer Institute, Portland, OR, USA. 8. Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland, OR, USA. 9. Division of Pulmonary & Critical Care Medicine, Oregon Health & Science University, Portland, OR, USA. 10. Vancouver Clinic, Vancouver, WA, USA. 11. Oregon Clinical & Translational Research Institute, Oregon Health & Science University, Portland, OR, USA.
Abstract
BACKGROUND: Vitamin C (500 mg·day-1) supplementation for pregnant smokers has been reported to increase newborn pulmonary function and infant forced expiratory flows (FEFs) at 3 months of age. Its effect on airway function through 12 months of age has not been reported. OBJECTIVE: To assess whether vitamin C supplementation to pregnant smokers is associated with a sustained increased airway function in their infants through 12 months of age. METHODS: This is a prespecified secondary outcome of a randomised, double-blind, placebo-controlled trial that randomised 251 pregnant smokers between 13 and 23 weeks of gestation: 125 to 500 mg·day-1 vitamin C and 126 to placebo. Smoking cessation counselling was provided. FEFs performed at 3 and 12 months of age were analysed by repeated measures analysis of covariance. RESULTS: FEFs were performed in 222 infants at 3 months and 202 infants at 12 months of age. The infants allocated to vitamin C had significantly increased FEFs over the first year of life compared to those allocated to placebo. The overall increased flows were: 40.2 mL·sec-1 for FEF75 (adjusted 95% CI for difference 6.6 to 73.8; p=0.025); 58.3 mL·sec-1 for FEF50 (95% CI 10.9 to 105.8; p=0.0081); and 55.1 mL·sec-1 for FEF25-75 (95% CI, 9.7 to 100.5; p=0.013). CONCLUSIONS: In offspring of pregnant smokers randomised to vitamin C versus placebo, vitamin C during pregnancy was associated with a small but significantly increased airway function at 3 and 12 months of age, suggesting a potential shift to a higher airway function trajectory curve. Continued follow-up is underway.
BACKGROUND: Vitamin C (500 mg·day-1) supplementation for pregnant smokers has been reported to increase newborn pulmonary function and infant forced expiratory flows (FEFs) at 3 months of age. Its effect on airway function through 12 months of age has not been reported. OBJECTIVE: To assess whether vitamin C supplementation to pregnant smokers is associated with a sustained increased airway function in their infants through 12 months of age. METHODS: This is a prespecified secondary outcome of a randomised, double-blind, placebo-controlled trial that randomised 251 pregnant smokers between 13 and 23 weeks of gestation: 125 to 500 mg·day-1 vitamin C and 126 to placebo. Smoking cessation counselling was provided. FEFs performed at 3 and 12 months of age were analysed by repeated measures analysis of covariance. RESULTS: FEFs were performed in 222 infants at 3 months and 202 infants at 12 months of age. The infants allocated to vitamin C had significantly increased FEFs over the first year of life compared to those allocated to placebo. The overall increased flows were: 40.2 mL·sec-1 for FEF75 (adjusted 95% CI for difference 6.6 to 73.8; p=0.025); 58.3 mL·sec-1 for FEF50 (95% CI 10.9 to 105.8; p=0.0081); and 55.1 mL·sec-1 for FEF25-75 (95% CI, 9.7 to 100.5; p=0.013). CONCLUSIONS: In offspring of pregnant smokers randomised to vitamin C versus placebo, vitamin C during pregnancy was associated with a small but significantly increased airway function at 3 and 12 months of age, suggesting a potential shift to a higher airway function trajectory curve. Continued follow-up is underway.
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