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孕期补充维生素C预防早产的疗效：系统评价与荟萃分析

Efficacy of vitamin C supplementation during pregnancy in the prevention of preterm birth: a systematic review and meta-analysis.

作者信息

Pereira Ana Gabriela Alves, Molino Gabriela Oliveira Gonçalves, Santos Ana Clara Felix de Farias, Dias Maírla Marina Ferreira, Pimenta Nicole Dos Santos, da Silva Pedro Henrique Costa Matos

机构信息

Universidade Estadual Paulista "Júlio de Mesquita Filho" São PauloSP Brazil Universidade Estadual Paulista "Júlio de Mesquita Filho", São Paulo, SP, Brazil.

Universidade Federal de Ciências da Saúde de Porto Alegre Porto AlegreRS Brazil Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS, Brazil.

出版信息

Rev Bras Ginecol Obstet. 2025 Mar 17;47. doi: 10.61622/rbgo/2025rbgo1. eCollection 2025.

DOI:10.61622/rbgo/2025rbgo1
PMID:40584396
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12204115/
Abstract

OBJECTIVE

Preterm birth is a leading global cause of neonatal mortality and morbidity, with oxidative stress playing a role in its pathogenesis. Vitamin C, a powerful antioxidant, may help reduce this risk. This study assessed the effectiveness of vitamin C supplementation, both alone and with vitamin E, in preventing preterm birth compared to a placebo.

DATA SOURCE

Databases were systematically searched in PubMed, Cochrane and Embase in December 2023 and updated in May 2024.

STUDY SELECTION

Included RCTs evaluated vitamin C's effect on preterm birth and related neonatal outcomes.

DATA COLLECT

Statistical analyses used a random-effects model for pooled risk ratios (RR) and 95% confidence intervals (CI). Heterogeneity was assessed with the I² statistic.

DATA SYNTHESIS

Seventeen RCTs (21,567 patients) were analyzed. Vitamin C supplementation showed no significant difference compared to placebo for preterm birth (RR 1.04; 95% CI 0.96, 1.14). No significant differences were observed for neonatal death (RR 0.77; 95% CI 0.55, 1.08), NICU admission (RR 1.03; 95% CI 0.95, 1.13), preterm PROM (RR 1.04; 95% CI 0.63, 1.71), or birth weight (MD 52.41; 95% CI -19.65, 124.47). A slight decrease in gestational age was observed (MD 0.26; 95% CI -0.02, 0.55).

CONCLUSION

Vitamin C supplementation alone or in combination with vitamin E does not significantly prevent preterm birth or improve related neonatal outcomes.

摘要

目的

早产是全球新生儿死亡和发病的主要原因，氧化应激在其发病机制中起作用。维生素C是一种强大的抗氧化剂，可能有助于降低这种风险。本研究评估了单独补充维生素C以及与维生素E联合补充相比安慰剂在预防早产方面的有效性。

数据来源

2023年12月在PubMed、Cochrane和Embase中系统检索数据库，并于2024年5月更新。

研究选择

纳入的随机对照试验评估了维生素C对早产及相关新生儿结局的影响。

数据收集

统计分析采用随机效应模型计算合并风险比（RR）和95%置信区间（CI）。用I²统计量评估异质性。

数据综合

分析了17项随机对照试验（21567例患者）。补充维生素C与安慰剂相比，在早产方面无显著差异（RR 1.04；95% CI 0.96，1.14）。在新生儿死亡（RR 0.77；95% CI 0.55，1.08）、新生儿重症监护病房（NICU）入院（RR 1.03；95% CI 0.95，1.13）、早产胎膜早破（RR 1.04；95% CI 0.63，1.71）或出生体重（MD 52.41；95% CI -19.65，124.47）方面未观察到显著差异。观察到孕周略有下降（MD 0.26；95% CI -0.02，0.55）。

结论

单独补充维生素C或与维生素E联合补充并不能显著预防早产或改善相关新生儿结局。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fb9e/12204115/b0933d3ce84a/1806-9339-rbgo-47-e-rbgo1-gf04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fb9e/12204115/c78cbe36740b/1806-9339-rbgo-47-e-rbgo1-gf01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fb9e/12204115/ff581692b1c2/1806-9339-rbgo-47-e-rbgo1-gf02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fb9e/12204115/81f5688a1a28/1806-9339-rbgo-47-e-rbgo1-gfS01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fb9e/12204115/315153052a07/1806-9339-rbgo-47-e-rbgo1-gfS02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fb9e/12204115/7e438c208031/1806-9339-rbgo-47-e-rbgo1-gf03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fb9e/12204115/57d39d215a75/1806-9339-rbgo-47-e-rbgo1-gfS03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fb9e/12204115/a3c47358709c/1806-9339-rbgo-47-e-rbgo1-gfS04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fb9e/12204115/b0933d3ce84a/1806-9339-rbgo-47-e-rbgo1-gf04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fb9e/12204115/c78cbe36740b/1806-9339-rbgo-47-e-rbgo1-gf01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fb9e/12204115/ff581692b1c2/1806-9339-rbgo-47-e-rbgo1-gf02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fb9e/12204115/81f5688a1a28/1806-9339-rbgo-47-e-rbgo1-gfS01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fb9e/12204115/315153052a07/1806-9339-rbgo-47-e-rbgo1-gfS02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fb9e/12204115/7e438c208031/1806-9339-rbgo-47-e-rbgo1-gf03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fb9e/12204115/57d39d215a75/1806-9339-rbgo-47-e-rbgo1-gfS03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fb9e/12204115/a3c47358709c/1806-9339-rbgo-47-e-rbgo1-gfS04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fb9e/12204115/b0933d3ce84a/1806-9339-rbgo-47-e-rbgo1-gf04.jpg

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The efficacy and safety of vitamin C administration to women with history of premature preterm rupture of membrane in prevention of such event in current pregnancy: Randomized controlled clinical trial.对有胎膜早破病史的女性给予维生素C预防本次妊娠中胎膜早破事件的疗效及安全性：随机对照临床试验
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