Background: Oxidative stress is blamed in the pathogenesis of pre-eclampsia. However, it is
less clear what effect gestational antioxidants would have on pre-eclampsia associated
coagulopathy, and on neonatal outcome.
Aim of the study: To investigate the effect of antioxidants supplementation on coagulopathy
during pre-eclampsia and to evaluate maternal and neonatal outcome.
Patients and Methods: The study was performed as a randomized, controlled, blinded trial;
251 high risk pregnant women were randomized to receive either antioxidants (1000mg
vitamin C, 400IU vitamin E, 100µg Selenium and 1500IU vitamin A) or placebo. Primary
maternal outcome was pre-eclampsia or one of its complications. Newborns for both groups
were followed through the neonatal period. In each trimester, detailed blood chemistry
lipogram, and coagulation profile were done. Antioxidants blood levels (vitamins A, C, and
E) were measured immediately before delivery.
Results: Incidence of pre-eclampsia did not differ between the two groups. However, a
significant reduction in disease severity was noticed. Antioxidants reduced the levels of Ddimer, von Willibrand factor, and fibrinogen significantly. Platelets activity showed a
significant reduction in the supplemented group. Antioxidants were significantly higher in
blood of the supplemented group. Concerning neonatal outcome, low birth weight, need for
neonatal intensive care and neonatal hyperbilirubinaemia were significantly reduced in
newborns of the supplemented group.
Conclusion: Supplementing high risk women with antioxidants during pregnancy may help
to counteract the oxidative stress and control coagulopathy. However, it does not prevent the
disease. This study suggests potential benefits for gestational antioxidants as regards neonatal
outcome in pre-eclampsia.