Research: CHAPPELL and colleagues,

Listed in Issue 28


CHAPPELL and colleagues, Department of Obstetrics and Gynaecology, Guys, Kings, and St Thomas School of Medicine, St Thomas Hospital, London conducted a randomised controlled trial to study the effect of supplementation with vitamins C and E in women at increased risk of pre-eclampsia.



283 women, identified as being at increased risk of pre-eclampsia or having a prior history were at 16-22 weeks gestation randomly assigned vitamin C (1000 mg/day) and vitamin E (400 IU/day) or placebo. Plasma markers of endothelial activation (plasminogen-activator inhibitor 1 (PAI-1)) and placental dysfunction (PAI-2) were measured each month until delivery. Pre-eclampsia was assessed by the development of proteinuric hypertension.


Supplementation with vitamins C and E was associated with a 21% decrease in the PAI-1/PAI-2 ratio during gestation. In the intention-to-treat cohort, pre-eclampsia occurred in 24 (17%) of 142 women in the placebo group and in only 11 (8%) of 141 in the vitamin group (adjusted Odds Ratio (RR) = 0.39). In the cohort who completed the study (81 placebo group, 79 vitamin group), the OR for pre-eclampsia was 0.24.


Supplementation with vitamins C and E may be beneficial in the prevention of pre-eclampsia in women at increased risk of the disease. Multicentre trials are required in order to demonstrate whether vitamin supplementation affects the occurrence of pre-eclampsia in low-risk women and to confirm these results in larger groups of high-risk women from different populations.


Chappell LC et al. Effect of antioxidants on the occurrence of pre-eclampsia in women at increased risk: a randomised trial. Lancet 354 (9181): 810-6. 4 Sep 1999. @i:49

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