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  • Title: Antioxidant vitamins, long-chain fatty acids, and spontaneous preterm birth.
    Author: Kramer MS, Kahn SR, Platt RW, Genest J, Rozen R, Chen MF, Goulet L, Séguin L, Dassa C, Lydon J, McNamara H, Dahhou M, Lamoureux J, Evans RW.
    Journal: Epidemiology; 2009 Sep; 20(5):707-13. PubMed ID: 19568173.
    Abstract:
    BACKGROUND: Neither macro- nor micronutrient supplements have been clearly demonstrated to reduce the risk of preterm birth. However, there has been little attention to carotenoids, tocopherols, and long-chain fatty acids other than n-3 polyunsaturates. METHODS: We conducted a case-control study nested in a large (n = 5337) prospective, multicenter cohort. All cohort women had an interview, examination, and venipuncture at 24-26 weeks' gestation. Frozen plasma samples in spontaneous preterm births (n = 207) and approximately 2-term controls per case (n = 443) were analyzed for carotenoids, retinol, tocopherols, and long-chain fatty acids. Fresh placentas were fixed, stained, and assessed (without knowledge of pregnancy outcome) for histologic evidence of infection or inflammation, decidual vasculopathy, and infarction. RESULTS: High (above the median) plasma concentrations of alpha- and beta-carotene, alpha- and beta-cryptoxanthin, and lycopene were all associated with reductions in risk of spontaneous preterm birth, with evidence of dose-response effects across quartiles. Modest increases in risk were observed with elevated total monounsaturated, total polyunsaturated, and total n-6 polyunsaturated long-chain fatty acids concentrations. Paradoxically, a high gamma-tocopherol concentration was associated with increased preterm birth risk (adjusted odds ratio = 1.8 [95% confidence interval = 1.2-2.6]). Only one of the studied micronutrients (lutein) was independently associated with a reduced risk of decidual vasculopathy (0.5 [0.3-0.9]). CONCLUSIONS: Carotenoids and long-chain fatty acids warrant further investigation in in vitro, animal, and human studies of preterm birth.
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