Potential role of ascorbic acid and β-carotene in the prevention of preterm rupture of the fetal membranes

Abstract

Many conditions can predispose a pregnant women to premature rupture of the fetal membranes (PROM), but its etiology is unknown. The purpose of this study was to explore ascorbic acid (ASA) and other antioxidant vitamins in serum and amniotic fluid of women with PROM. Amniotic fluid and venous blood specimens were obtained simutaneously from 41 patients with PROm for ASA, vitamin E, retinol and β-carotene. Control specimens were obtained from 32 normal pregnant subjects who underwent amniocentesis in the third trimester. No statistical differences were found between the PROM and control group in regards to retinol and vitamin E concentrations in amniotic fluid and serum. Serum ASA concentration of PROM subjects were not different from controls, however the PROM subjects had a significantly lower amniotic fluid ASA concentrations. Serum β-carotene levels were significantly lower in the PROM group compared to the control group (p=.025). The ratio of amniotic fluid ASA concentration to ASA serum concentration was significantly lower in PROM patients than in controls. This study is the first to demonstrate significantly low levels of amniotic fluid ASA and serum beta carotene in patients with PROM. Our findings suggest that low levels of ASA in the amniotic fluid, but not in serum, is a determinant of PROM. β-carotene may play an important role in preventing PROM in smokers. In smokers β-carotene and ASA may act synergically to prevent PROM.