Antioxidants for preventing pre-eclampsia.

The Cochrane database of systematic reviews

Jan 2008

DOI: 10.1002/14651858.CD004227.pub3

Citations:136

Influential Citations:2

Systematic Reviews / Meta-Analyses

COI

Enhanced Details

Methods

Ten trials with a total of 6533 women were analyzed, focusing on randomized comparisons of antioxidant supplementation versus placebo or no treatment, primarily assessing the incidence of pre-eclampsia and its complications.

Intervention

Antioxidants were evaluated to determine their effectiveness in preventing pre-eclampsia during pregnancy.

Results

No significant difference was found between the antioxidant groups and controls regarding pre-eclampsia risk. Some secondary outcomes indicated potential issues, such as increased abdominal pain and a higher likelihood of antihypertensive use in antioxidant-supplemented women.

Limitations

The heterogeneity across studies and the lack of clear definitions or consistency in outcomes affected the findings. Additionally, potential reporting biases may have influenced the results.

Abstract

BACKGROUND Oxidative stress has been proposed as a key factor involved in the development of pre-eclampsia. Supplementing women with antioxidants during pregnancy may help to counteract oxidative stress and thereby prevent or delay the onset of pre-eclampsia. OBJECTIVES To determine the effectiveness and safety of any antioxidant supplementation during pregnancy and the risk of developing pre-eclampsia and its related complications. SEARCH STRATEGY We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (May 2007), the Cochrane Central Register of Controlled Trials (The Cochrane Library 2006, Issue 3), MEDLINE (1950 to October 2007) and Current Contents (1998 to August 2004). SELECTION CRITERIA All randomised trials comparing one or more antioxidants with either placebo or no antioxidants during pregnancy for the prevention of pre-eclampsia, and trials comparing one or more antioxidants with another, or with other interventions. DATA COLLECTION AND ANALYSIS Two review authors independently assessed trials for inclusion and trial quality and extracted data. MAIN RESULTS Ten trials, involving 6533 women, were included in this review, five trials were rated high quality. For the majority of trials, the antioxidant assessed was combined vitamin C and E therapy. There was no significant difference between antioxidant and control groups for the relative risk (RR) of pre-eclampsia (RR 0.73, 95% confidence intervals (CI) 0.51 to 1.06; nine trials, 5446 women) or any other primary outcome: severe pre-eclampsia (RR 1.25, 95% CI 0.89 to 1.76; two trials, 2495 women), preterm birth (before 37 weeks) (RR 1.10, 95% CI 0.99 to 1.22; five trials, 5198 women), small-for-gestational-age infants (RR 0.83, 95% CI 0.62 to 1.11; five trials, 5271 babies) or any baby death (RR 1.12, 95% CI 0.81 to 1.53; four trials, 5144 babies). Women allocated antioxidants were more likely to self-report abdominal pain late in pregnancy (RR 1.61, 95% CI 1.11 to 2.34; one trial, 1745 women), require antihypertensive therapy (RR 1.77, 95% CI 1.22 to 2.57; two trials, 4272 women) and require an antenatal hospital admission for hypertension (RR 1.54, 95% CI 1.00 to 2.39; one trial, 1877 women). However, for the latter two outcomes, this was not clearly reflected in an increase in any other hypertensive complications. AUTHORS' CONCLUSIONS Evidence from this review does not support routine antioxidant supplementation during pregnancy to reduce the risk of pre-eclampsia and other serious complications in pregnancy. show less