Nath Banashree, Gaikwad Harsha, Roy Hirok, Paul Sayanti, Kanti Vaibhav
Obstetrics and Gynaecology, All India Institute of Medical Sciences, Raebareli, Raebareli, IND.
Obstetrics and Gynaecology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, IND.
Cureus. 2024 Jun 15;16(6):e62445. doi: 10.7759/cureus.62445. eCollection 2024 Jun.
Vitamin C is a micronutrient assumed to have effects on the occurrence of "preterm premature rupture of membranes" (PPROM) and "premature rupture of membranes" (PROM). The objective of this review was to find the pooled incidence of PROM and/or PPROM between subgroups in relation to dose, mode of therapy (monotherapy vs. combination therapy) and history of PROM/PPROM in previous pregnancies. A search was conducted in the electronic databases (PubMed, Google Scholar, Scopus) from inception to November 2022, using the search terms "Vitamin C", "Ascorbic acid", "preterm premature rupture of membrane" and "premature rupture of membrane". The lists of references of all the selected eligible articles were also searched to find studies of interest. A total of nine randomized controlled trials (published in English) with 16,076 participants involving the supplementation of vitamin C during pregnancy were picked up for analysis. Data management was done using the Review Manager (RevMan 5.3). A statistical test for publication bias was done in jamovi, version 2.3.18. In comparison to placebo, vitamin C supplementation was not found to be significantly effective in preventing the occurrence of PPROM/PROM. However, a low dose of vitamin C and the monotherapy mode of administration significantly decreased the occurrence of PPROM/PROM. Vitamin C has significant beneficial effects in women with a history of PROM in a previous pregnancy. Hence, we conclude that vitamin C administered as monotherapy in low doses (preferably 100 mg/day) has definite benefits in preventing the occurrence of PROM/PPROM with greater advantages seen in those with a history of similar complications in a previous pregnancy.
维生素C是一种微量营养素，被认为对“早产胎膜早破”（PPROM）和“胎膜早破”（PROM）的发生有影响。本综述的目的是找出与剂量、治疗方式（单一疗法与联合疗法）以及既往妊娠中PROM/PPROM病史相关的亚组中PROM和/或PPROM的合并发生率。从数据库建立至2022年11月，在电子数据库（PubMed、谷歌学术、Scopus）中进行了检索，使用的检索词为“维生素C”“抗坏血酸”“早产胎膜早破”和“胎膜早破”。还检索了所有选定合格文章的参考文献列表，以查找感兴趣的研究。共选取了9项涉及孕期补充维生素C的随机对照试验（英文发表），16076名参与者进行分析。使用Review Manager（RevMan 5.3）进行数据管理。在jamovi 2.3.18版本中进行了发表偏倚的统计检验。与安慰剂相比，未发现补充维生素C在预防PPROM/PROM发生方面有显著效果。然而，低剂量维生素C和单一疗法给药方式显著降低了PPROM/PROM的发生率。维生素C对既往有PROM病史的女性有显著有益作用。因此，我们得出结论，低剂量（最好为100毫克/天）单一疗法使用维生素C在预防PROM/PPROM发生方面有明确益处，在既往有类似并发症病史的女性中优势更明显。
