Oral Vitamin C (500 mg/d) to pregnant smokers improves infant airway function at 3 months (VCSIP) a randomized trial

Cindy T. McEvoy, Lyndsey E. Shorey-Kendrick, Kristin Milner, Diane Schilling, Christina Tiller, Brittany Vuylsteke, Ashley Scherman, Keith Jackson, David M. Haas, Julia Harris, Robert Schuff, Byung S. Park, Annette Vu, Dale F. Kraemer, Julie Mitchell, Jill Metz, David Gonzales, Carol Bunten, Eliot R. Spindel, Robert S. TepperCynthia D. Morris

Research output: Contribution to journalArticle

6 Scopus citations

Abstract

Rationale: We reported a randomized trial demonstrating daily supplemental vitamin C to pregnant smokers significantly improved newborn pulmonary function tests. The current study tests these results in a new cohort using infant pulmonary function tests. Objectives: To determine if infants of pregnant smokers randomized to daily supplemental vitamin C would have improved forced expiratory flows (FEFs) at 3 months of age compared with those randomized to placebo, and to investigate the association of the a5 nicotinic acetylcholine receptor. Methods: A randomized, double-blind, placebo-controlled trial was conducted at three centers. Two hundred fifty-one pregnant smokers were randomized at 13–23 weeks of gestation: 125 randomized to vitamin C (500 mg/d) and 126 to placebo. Measurements and Main Results: The primary outcome was FEF75 at 3 months of age performed with the raised volume rapid thoracic compression technique (Jaeger/Viasys). FEF50 and FEF2575 obtained from the same expiratory curves were prespecified secondary outcomes. The infants of pregnant smokers randomized to vitamin C (n = 113) had the following FEFs at 3 months of age compared with those randomized to placebo (n = 109) as measured by FEF75 (200.7 vs. 188.7 ml/s; adjusted 95% confidence interval [CI] for difference, 23.33 to 35.64; P = 0.10), FEF50 (436.7 vs. 408.5 ml/s; adjusted 95% CI for difference, 6.10–61.30; P = 0.02), and FEF2575 (387.4 vs. 365.8 ml/s; adjusted 95% CI for difference, 0.92–55.34; P = 0.04). Infant FEFs seemed to be negatively associated with the maternal risk alleles for the a5 nicotinic acetylcholine receptor (rs16969968). Conclusions: Although the primary outcome of FEF75 was not improved after vitamin C supplementation to pregnant smokers, the predetermined secondary outcomes FEF50 and FEF2575 were significantly improved. These results extend our previous findings and demonstrate improved airway function (FEF50 and FEF2575) at 3 months of age in infants after vitamin C supplementation to pregnant smokers.

Original languageEnglish (US)
Pages (from-to)1139-1147
Number of pages9
JournalAmerican journal of respiratory and critical care medicine
Volume199
Issue number9
DOIs
StatePublished - May 1 2019

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Keywords

  • Forced expiratory flows
  • Infant pulmonary function
  • Smoking in pregnancy
  • Vitamin C
  • Wheezing

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine

Cite this

McEvoy, C. T., Shorey-Kendrick, L. E., Milner, K., Schilling, D., Tiller, C., Vuylsteke, B., Scherman, A., Jackson, K., Haas, D. M., Harris, J., Schuff, R., Park, B. S., Vu, A., Kraemer, D. F., Mitchell, J., Metz, J., Gonzales, D., Bunten, C., Spindel, E. R., ... Morris, C. D. (2019). Oral Vitamin C (500 mg/d) to pregnant smokers improves infant airway function at 3 months (VCSIP) a randomized trial. American journal of respiratory and critical care medicine, 199(9), 1139-1147. https://doi.org/10.1164/rccm.201805-1011OC