Ana V Pejcic, Nemanja Z Petrovic, Milan D Djordjic, Milos N Milosavljevic
{"title":"孕妇的维生素 C 水平和维生素 C 补充剂对预防胎膜早破的功效：系统回顾与元分析》。","authors":"Ana V Pejcic, Nemanja Z Petrovic, Milan D Djordjic, Milos N Milosavljevic","doi":"10.4274/balkanmedj.galenos.2024.2024-2-79","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Premature rupture of membranes (PROM) is defined as the leakage of amniotic fluid before the onset of labor and delivery contractions. Some studies found that women who experienced PROM had significantly lower vitamin C blood levels than those who did not, while others found no significant differences. Previous systematic reviews and meta-analyses on the efficacy of vitamin C in the prevention of PROM had conflicting results.</p><p><strong>Aims: </strong>Conduct a systematic review and meta-analysis to determine if there was a significant difference in vitamin C blood levels in women who had PROM versus the control group who did not and to determine if vitamin C supplements could help prevent it.</p><p><strong>Study design: </strong>Systematic review and meta-analysis.</p><p><strong>Methods: </strong>We registered our protocol with PROSPERO (CRD42022371644). We searched PubMed/MEDLINE, Web of Science, and Scopus through February 15, 2024. Additionally, backward and forward citation searches were conducted. Studies were selected based on predetermined inclusion and exclusion criteria. Meta-Essentials: Workbooks for Meta-Analysis (version 1.5) was used for analysis.</p><p><strong>Results: </strong>Twenty-five studies (26 reports) met all eligibility criteria, with 18 studies (18 reports) assessing vitamin C levels and seven studies (eight reports) evaluating efficacy. Women with PROM, whether preterm or term, had significantly lower vitamin C levels [Hedges’ g, -1.48; 95% confidence interval (CI): -2.82, -0.14; <i>p</i> = 0.020; <i>I<sup>2</sup></i> = 94.08%) and specifically preterm PROM after removing the outlying study [Hedges’ g, -1.29; 95% CI: -1.85, -0.73; <i>p</i> < 0.001; <i>I<sup>2</sup></i> = 87.35%). Vitamin C supplementation significantly reduced the risk of preterm or term PROM [risk ratio (RR), 0.57; 95% CI: 0.39, 0.81; <i>p</i> < 0.001; <i>I<sup>2</sup></i> = 12.17%), particularly for preterm PROM (RR, 0.67; 95% CI: 0.45, 0.99; <i>p</i> = 0.001; <i>I<sup>2</sup></i> = 0.00%). There were no significant differences in vitamin C levels between women with term PROM and controls, and there were no differences in the risk of developing term PROM between women taking vitamin C supplements and controls. Results were not robust in all sensitivity analyses.</p><p><strong>Conclusion: </strong>Women with PROM, particularly those who developed it preterm, appear to have significantly lower vitamin C levels, and vitamin C supplementation appears to be effective in reducing the risk of PROM, particularly preterm PROM. More high-quality studies with low risk of bias, more homogenous, and larger samples are needed to confirm these findings.</p>","PeriodicalId":8690,"journal":{"name":"Balkan Medical Journal","volume":" ","pages":"248-260"},"PeriodicalIF":1.9000,"publicationDate":"2024-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11588900/pdf/","citationCount":"0","resultStr":"{\"title\":\"Vitamin C Levels in Pregnant Women and the Efficacy of Vitamin C Supplements in Preventing Premature Rupture of Membranes: A Systematic Review and Meta-Analysis\",\"authors\":\"Ana V Pejcic, Nemanja Z Petrovic, Milan D Djordjic, Milos N Milosavljevic\",\"doi\":\"10.4274/balkanmedj.galenos.2024.2024-2-79\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Premature rupture of membranes (PROM) is defined as the leakage of amniotic fluid before the onset of labor and delivery contractions. Some studies found that women who experienced PROM had significantly lower vitamin C blood levels than those who did not, while others found no significant differences. Previous systematic reviews and meta-analyses on the efficacy of vitamin C in the prevention of PROM had conflicting results.</p><p><strong>Aims: </strong>Conduct a systematic review and meta-analysis to determine if there was a significant difference in vitamin C blood levels in women who had PROM versus the control group who did not and to determine if vitamin C supplements could help prevent it.</p><p><strong>Study design: </strong>Systematic review and meta-analysis.</p><p><strong>Methods: </strong>We registered our protocol with PROSPERO (CRD42022371644). We searched PubMed/MEDLINE, Web of Science, and Scopus through February 15, 2024. Additionally, backward and forward citation searches were conducted. Studies were selected based on predetermined inclusion and exclusion criteria. Meta-Essentials: Workbooks for Meta-Analysis (version 1.5) was used for analysis.</p><p><strong>Results: </strong>Twenty-five studies (26 reports) met all eligibility criteria, with 18 studies (18 reports) assessing vitamin C levels and seven studies (eight reports) evaluating efficacy. Women with PROM, whether preterm or term, had significantly lower vitamin C levels [Hedges’ g, -1.48; 95% confidence interval (CI): -2.82, -0.14; <i>p</i> = 0.020; <i>I<sup>2</sup></i> = 94.08%) and specifically preterm PROM after removing the outlying study [Hedges’ g, -1.29; 95% CI: -1.85, -0.73; <i>p</i> < 0.001; <i>I<sup>2</sup></i> = 87.35%). Vitamin C supplementation significantly reduced the risk of preterm or term PROM [risk ratio (RR), 0.57; 95% CI: 0.39, 0.81; <i>p</i> < 0.001; <i>I<sup>2</sup></i> = 12.17%), particularly for preterm PROM (RR, 0.67; 95% CI: 0.45, 0.99; <i>p</i> = 0.001; <i>I<sup>2</sup></i> = 0.00%). There were no significant differences in vitamin C levels between women with term PROM and controls, and there were no differences in the risk of developing term PROM between women taking vitamin C supplements and controls. Results were not robust in all sensitivity analyses.</p><p><strong>Conclusion: </strong>Women with PROM, particularly those who developed it preterm, appear to have significantly lower vitamin C levels, and vitamin C supplementation appears to be effective in reducing the risk of PROM, particularly preterm PROM. More high-quality studies with low risk of bias, more homogenous, and larger samples are needed to confirm these findings.</p>\",\"PeriodicalId\":8690,\"journal\":{\"name\":\"Balkan Medical Journal\",\"volume\":\" \",\"pages\":\"248-260\"},\"PeriodicalIF\":1.9000,\"publicationDate\":\"2024-07-05\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11588900/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Balkan Medical Journal\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.4274/balkanmedj.galenos.2024.2024-2-79\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/5/22 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q2\",\"JCRName\":\"MEDICINE, GENERAL & INTERNAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Balkan Medical Journal","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.4274/balkanmedj.galenos.2024.2024-2-79","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/5/22 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
引用次数: 0
摘要
背景：胎膜早破（PROM）是指在分娩和宫缩开始之前羊水流出。一些研究发现，经历过胎膜早破的妇女血液中的维生素 C 含量明显低于未经历过的妇女，而另一些研究则发现两者之间没有明显差异。目的：我们旨在进行一项系统回顾和荟萃分析，以确定发生过PROM的产妇与未发生PROM的对照组相比，维生素C血液水平是否存在显著差异，并确定维生素C补充剂是否有助于预防PROM：研究设计：系统综述和荟萃分析：我们在 PROSPERO（CRD42022371644）上注册了我们的方案。我们检索了 PubMed/MEDLINE、Web of Science 和 Scopus，检索期至 2024 年 2 月 15 日。此外，我们还进行了前向和后向引文检索。研究根据预先确定的纳入和排除标准进行筛选。Meta-Essentials：使用《Meta-Essentials：Meta 分析工作手册》（1.5 版）进行分析：25项研究（26份报告）符合所有资格标准，其中18项研究（18份报告）评估了维生素C水平，7项研究（8份报告）评估了疗效。无论是早产儿还是足月儿，PROM 妇女的维生素 C 水平都明显较低[Hedges' g，-1.48；95% 置信区间（CI）：-2.82，-0.14；p = 0.020；I2 = 94.08%]，剔除离群研究后，PROM 妇女的维生素 C 水平尤其较低[Hedges' g，-1.29；95% CI：-1.85，-0.73；p < 0.001；I2 = 87.35%]。补充维生素 C 可显著降低早产或足月 PROM 的风险[风险比 (RR)，0.57；95% CI：0.39，0.81；p < 0.001；I2 = 12.17%]，尤其是早产 PROM（RR，0.67；95% CI：0.45，0.99；p = 0.001；I2 = 0.00%）。足月 PROM 妇女与对照组妇女的维生素 C 水平无明显差异，服用维生素 C 补充剂的妇女与对照组妇女发生足月 PROM 的风险也无差异。所有敏感性分析的结果均不可靠：结论：患有 PROM（尤其是早产 PROM）的妇女的维生素 C 水平似乎明显较低，补充维生素 C 似乎能有效降低 PROM（尤其是早产 PROM）的风险。要证实这些发现，还需要进行更多高质量、低偏倚风险、同质性更强、样本更大的研究。
Vitamin C Levels in Pregnant Women and the Efficacy of Vitamin C Supplements in Preventing Premature Rupture of Membranes: A Systematic Review and Meta-Analysis
Background: Premature rupture of membranes (PROM) is defined as the leakage of amniotic fluid before the onset of labor and delivery contractions. Some studies found that women who experienced PROM had significantly lower vitamin C blood levels than those who did not, while others found no significant differences. Previous systematic reviews and meta-analyses on the efficacy of vitamin C in the prevention of PROM had conflicting results.
Aims: Conduct a systematic review and meta-analysis to determine if there was a significant difference in vitamin C blood levels in women who had PROM versus the control group who did not and to determine if vitamin C supplements could help prevent it.
Study design: Systematic review and meta-analysis.
Methods: We registered our protocol with PROSPERO (CRD42022371644). We searched PubMed/MEDLINE, Web of Science, and Scopus through February 15, 2024. Additionally, backward and forward citation searches were conducted. Studies were selected based on predetermined inclusion and exclusion criteria. Meta-Essentials: Workbooks for Meta-Analysis (version 1.5) was used for analysis.
Results: Twenty-five studies (26 reports) met all eligibility criteria, with 18 studies (18 reports) assessing vitamin C levels and seven studies (eight reports) evaluating efficacy. Women with PROM, whether preterm or term, had significantly lower vitamin C levels [Hedges’ g, -1.48; 95% confidence interval (CI): -2.82, -0.14; p = 0.020; I2 = 94.08%) and specifically preterm PROM after removing the outlying study [Hedges’ g, -1.29; 95% CI: -1.85, -0.73; p < 0.001; I2 = 87.35%). Vitamin C supplementation significantly reduced the risk of preterm or term PROM [risk ratio (RR), 0.57; 95% CI: 0.39, 0.81; p < 0.001; I2 = 12.17%), particularly for preterm PROM (RR, 0.67; 95% CI: 0.45, 0.99; p = 0.001; I2 = 0.00%). There were no significant differences in vitamin C levels between women with term PROM and controls, and there were no differences in the risk of developing term PROM between women taking vitamin C supplements and controls. Results were not robust in all sensitivity analyses.
Conclusion: Women with PROM, particularly those who developed it preterm, appear to have significantly lower vitamin C levels, and vitamin C supplementation appears to be effective in reducing the risk of PROM, particularly preterm PROM. More high-quality studies with low risk of bias, more homogenous, and larger samples are needed to confirm these findings.
期刊介绍：
The Balkan Medical Journal (Balkan Med J) is a peer-reviewed open-access international journal that publishes interesting clinical and experimental research conducted in all fields of medicine, interesting case reports and clinical images, invited reviews, editorials, letters, comments and letters to the Editor including reports on publication and research ethics. The journal is the official scientific publication of the Trakya University Faculty of Medicine, Edirne, Turkey and is printed six times a year, in January, March, May, July, September and November. The language of the journal is English.
The journal is based on independent and unbiased double-blinded peer-reviewed principles. Only unpublished papers that are not under review for publication elsewhere can be submitted. Balkan Medical Journal does not accept multiple submission and duplicate submission even though the previous one was published in a different language. The authors are responsible for the scientific content of the material to be published. The Balkan Medical Journal reserves the right to request any research materials on which the paper is based.
The Balkan Medical Journal encourages and enables academicians, researchers, specialists and primary care physicians of Balkan countries to publish their valuable research in all branches of medicine. The primary aim of the journal is to publish original articles with high scientific and ethical quality and serve as a good example of medical publications in the Balkans as well as in the World.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
