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

Cynthia (Cindy) 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 Park, Annette Vu, Dale Kraemer, Julie Mitchell, Jill Metz, David Gonzales, Carol Bunten, Eliot Spindel, Robert S. Tepper & 1 others Cynthia Morris

Research output: Contribution to journalArticle

3 Citations (Scopus)

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 FEF 75 at 3 months of age performed with the raised volume rapid thoracic compression technique (Jaeger/Viasys). FEF 50 and FEF 2575 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 FEF 75 (200.7 vs. 188.7 ml/s; adjusted 95% confidence interval [CI] for difference, 23.33 to 35.64; P = 0.10), FEF 50 (436.7 vs. 408.5 ml/s; adjusted 95% CI for difference, 6.10–61.30; P = 0.02), and FEF 2575 (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 FEF 75 was not improved after vitamin C supplementation to pregnant smokers, the predetermined secondary outcomes FEF 50 and FEF 2575 were significantly improved. These results extend our previous findings and demonstrate improved airway function (FEF 50 and FEF 2575 ) 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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Ascorbic Acid
Placebos
Respiratory Function Tests
Nicotinic Receptors
Confidence Intervals
Thorax
Alleles
Mothers
Newborn Infant
Pregnancy

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

Oral Vitamin C (500 mg/d) to pregnant smokers improves infant airway function at 3 months (VCSIP) a randomized trial. / McEvoy, Cynthia (Cindy); Shorey-Kendrick, Lyndsey E.; Milner, Kristin; Schilling, Diane; Tiller, Christina; Vuylsteke, Brittany; Scherman, Ashley; Jackson, Keith; Haas, David M.; Harris, Julia; Schuff, Robert; Park, Byung; Vu, Annette; Kraemer, Dale; Mitchell, Julie; Metz, Jill; Gonzales, David; Bunten, Carol; Spindel, Eliot; Tepper, Robert S.; Morris, Cynthia.

In: American journal of respiratory and critical care medicine, Vol. 199, No. 9, 01.05.2019, p. 1139-1147.

Research output: Contribution to journalArticle

McEvoy, CC, Shorey-Kendrick, LE, Milner, K, Schilling, D, Tiller, C, Vuylsteke, B, Scherman, A, Jackson, K, Haas, DM, Harris, J, Schuff, R, Park, B, Vu, A, Kraemer, D, Mitchell, J, Metz, J, Gonzales, D, Bunten, C, Spindel, E, Tepper, RS & Morris, C 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, vol. 199, no. 9, pp. 1139-1147. https://doi.org/10.1164/rccm.201805-1011OC
McEvoy, Cynthia (Cindy) ; Shorey-Kendrick, Lyndsey E. ; Milner, Kristin ; Schilling, Diane ; Tiller, Christina ; Vuylsteke, Brittany ; Scherman, Ashley ; Jackson, Keith ; Haas, David M. ; Harris, Julia ; Schuff, Robert ; Park, Byung ; Vu, Annette ; Kraemer, Dale ; Mitchell, Julie ; Metz, Jill ; Gonzales, David ; Bunten, Carol ; Spindel, Eliot ; Tepper, Robert S. ; Morris, Cynthia. / Oral Vitamin C (500 mg/d) to pregnant smokers improves infant airway function at 3 months (VCSIP) a randomized trial. In: American journal of respiratory and critical care medicine. 2019 ; Vol. 199, No. 9. pp. 1139-1147.
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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 FEF 75 at 3 months of age performed with the raised volume rapid thoracic compression technique (Jaeger/Viasys). FEF 50 and FEF 25 – 75 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 FEF 75 (200.7 vs. 188.7 ml/s; adjusted 95{\%} confidence interval [CI] for difference, 23.33 to 35.64; P = 0.10), FEF 50 (436.7 vs. 408.5 ml/s; adjusted 95{\%} CI for difference, 6.10–61.30; P = 0.02), and FEF 25 – 75 (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 FEF 75 was not improved after vitamin C supplementation to pregnant smokers, the predetermined secondary outcomes FEF 50 and FEF 25 – 75 were significantly improved. These results extend our previous findings and demonstrate improved airway function (FEF 50 and FEF 25 – 75 ) at 3 months of age in infants after vitamin C supplementation to pregnant smokers.",
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T1 - Oral Vitamin C (500 mg/d) to pregnant smokers improves infant airway function at 3 months (VCSIP) a randomized trial

AU - McEvoy, Cynthia (Cindy)

AU - Shorey-Kendrick, Lyndsey E.

AU - Milner, Kristin

AU - Schilling, Diane

AU - Tiller, Christina

AU - Vuylsteke, Brittany

AU - Scherman, Ashley

AU - Jackson, Keith

AU - Haas, David M.

AU - Harris, Julia

AU - Schuff, Robert

AU - Park, Byung

AU - Vu, Annette

AU - Kraemer, Dale

AU - Mitchell, Julie

AU - Metz, Jill

AU - Gonzales, David

AU - Bunten, Carol

AU - Spindel, Eliot

AU - Tepper, Robert S.

AU - Morris, Cynthia

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N2 - 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 FEF 75 at 3 months of age performed with the raised volume rapid thoracic compression technique (Jaeger/Viasys). FEF 50 and FEF 25 – 75 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 FEF 75 (200.7 vs. 188.7 ml/s; adjusted 95% confidence interval [CI] for difference, 23.33 to 35.64; P = 0.10), FEF 50 (436.7 vs. 408.5 ml/s; adjusted 95% CI for difference, 6.10–61.30; P = 0.02), and FEF 25 – 75 (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 FEF 75 was not improved after vitamin C supplementation to pregnant smokers, the predetermined secondary outcomes FEF 50 and FEF 25 – 75 were significantly improved. These results extend our previous findings and demonstrate improved airway function (FEF 50 and FEF 25 – 75 ) at 3 months of age in infants after vitamin C supplementation to pregnant smokers.

AB - 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 FEF 75 at 3 months of age performed with the raised volume rapid thoracic compression technique (Jaeger/Viasys). FEF 50 and FEF 25 – 75 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 FEF 75 (200.7 vs. 188.7 ml/s; adjusted 95% confidence interval [CI] for difference, 23.33 to 35.64; P = 0.10), FEF 50 (436.7 vs. 408.5 ml/s; adjusted 95% CI for difference, 6.10–61.30; P = 0.02), and FEF 25 – 75 (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 FEF 75 was not improved after vitamin C supplementation to pregnant smokers, the predetermined secondary outcomes FEF 50 and FEF 25 – 75 were significantly improved. These results extend our previous findings and demonstrate improved airway function (FEF 50 and FEF 25 – 75 ) at 3 months of age in infants after vitamin C supplementation to pregnant smokers.

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KW - Smoking in pregnancy

KW - Vitamin C

KW - Wheezing

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