Vitamin C is Important for you and your child..4

Vitamin C is Important for you and your child..4





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7..  Poor Vitamin C may cause many Health problems to the Mother & child including Heart disease and develop Type1 Diabetes
Clinical data from the pregnant diabetic women are shown in Table 1 and are also presented in subgroups according to the median value (25%–75%) of maternal plasma vitC taken within four weeks of delivery. All comparisons of baseline data and diabetic characteristics in relation to the 50% percentile of vitC (26.6 (22.0–37.2) μmol/L) were non-significant (Table 1). The range (0%–100%) of plasma vitC in the cohort was 3.1–61.0 μmol/L.
Table 1
Clinical data and characteristics of the diabetic status by maternal vitamin C (vitC) within the last four weeks of pregnancy (n = 23/24) and of the whole cohort (n = 47).
Results regarding pregnancy and fetal related features are presented in Table 2. No relationship between maternal vitC level and birth weight or Apgar score was observed. Nor was the way of delivery (acute cesarean section, elective cesarean and induced delivery; 7/19/21) associated with vitC status. Moreover, no difference was observed in the level of HbA1c in relation of the median maternal vitC of 26.6 μmol/L, but a negative association of maternal vitC with HbA1c at delivery was found at regression analysis (r = −0.39, p = 0.006, n = 46). The vitC levels of the umbilical cord blood correlated positively with the obtained Apgar score of the newborn (r = 0.45, p = 0.011), also when corrected for maternal vitC, HbA1c and diabetes duration (r = 0.52, p = 0.025).
Table 2
Labor and fetus related features in relation to above or below the median level of maternal vitC in late pregnancy.
Hypovitaminosis C was found in 13 out of 47 diabetic women (28%) and was associated with a risk of complications of 69%, while the risk of complications was 29% in case of higher levels of vitC (Table 3). The relative risk of having complications of pregnancy was 2.4 times in case of maternal hypovitaminosis C compared to higher levels of maternal vitC (p = 0.02). In accordance, the diabetic women with complications of pregnancy had a significantly lower vitC status in late pregnancy compared to those without complications (mean (SD) 24.2 μmol/L (95% CI: 19.4–30) vs. 34.6 μmol/L (95% CI: 29.6–40); p= 0.011, n = 19 and 28, respectively). The type and distribution of complications are given in Table 4.
Table 3
Women with complications in subgroups according to vitC status in late pregnancy.
Table 4
The type and distribution of complications in T1DM women (n = 47). Recorded complications were prematurity, gestational hypertension, asphyxia, malformation, still birth, placental abruption, preeclampsia.


4. Discussion

The present cross-sectional study of T1DM pregnancy found an inverse relationship between vitC status and risks of complications in pregnancy. Thus, poor vitC status within four weeks of delivery was a positive predictor (69%) for complications of pregnancy, while a maternal vitC >23 μmol/L was a negative predictor (71%) for complications of pregnancy, respectively. In support of the observed relationship between maternal vitC status in late pregnancy and complications, we found a low maternal plasma vitC in case of complications of pregnancy (power of test > 80%).
The mean level of vitC was 24.2 μmol/L in the group with complications in pregnancy, thus in this normally distributed group nearly the half of the women had a level of vitC characterized as hypovitaminosis C. Much of the literature showing associations between vitC status and complications in pregnancy was conducted in pregnant experimental animals with or without induced diabetes and related to severe vitC deficiency (<11 μmol/L). This level increases the risk of developing outright scurvy, the ultimately mortal manifestation of prolonged severe vitC deficiency. However, only about 4% of the present cohort (2 patients out of 47) had severe vitC deficiency within four weeks of delivery and no clinical symptoms of scurvy were recorded in the case records of the pregnant women in this study. Therefore, it appears that the complications in diabetic pregnancy are already present at suboptimal vitC levels. In agreement, previous human studies identified a range of complications of pregnancy in non-diabetic women, the risks of which were inversely correlated with plasma vitC; this was, indeed, found over a wide concentration range above the level critical for development of scorbutic manifestations. Thus, although higher levels of vitC are not associated with scurvy, lack of scurvy does not preclude the presence of several other negative health effects of a suboptimal vitC status, and the optimal vitC intake in humans is still a matter of considerable debate 
In humans, a randomized placebo-controlled intervention study with vitamin C and E in T1DM pregnancies showed no overall effect of supplementation (1000 mg vitamin C and 400 IU vitamin E (α-tocopherol) daily until delivery) on the incidence of preeclampsia. However, subgroup analysis did reveal a significant positive effect of supplementation vs placebo on preeclampsia among patients who were vitC deficient at baseline (<10 μmol/L). Thus, the authors suggested that the significant benefit of supplementation on preeclampsia may be limited to women with severe vitC deficiency. VitC and E supplementation also resulted in fewer preterm deliveries compared to placebo in the cohort as a whole, but the potential correlation to vitC status at entry was not explored . Another study has also reported lack of effects of supplementation with vitC on the incidence of preeclampsia in high-risk T1DM women. The absence of effect of vitC supplementation on preeclampsia in humans with or without diabetes may arise from the variation in the degree of plasma saturation and subsequent differential outcomes of supplementation as discussed elsewhere .
Another interesting result of the present study is the difference in vitC level in umbilical cord blood of newborns reflects some of the difference in the mothers’ vitC level. Combined with the observation that the ratio of umbilical cord/maternal vitC favors babies born by mothers with vitC level below the median, our data collectively support the notion that the fetus is preferentially supplied with vitC at the expense of the mother. However, as the vitC level in these babies is significantly lower than that of those born by mothers with vitC level above the median, it also suggests that such a preferential supply cannot fully compensate for poor maternal vitC status. The maternal as well the umbilical vitC measurements were conducted with sufficient data to minimize a type 2 error on conclusions (power of t test > 80%). Thus in this study—in spite of the fetus acting as a “parasite” as described by Teel et al.—the newborns of mothers with low maternal vitC seem not to be able to obtain the same level of vitC in the umbilical cord as newborns of mothers with a higher vitC level, although their ratio is larger. This is in line with experimental data from guinea pigs showing that the preferential fetal transport may be overridden by increased needs of the mother during situations of deficiency, thereby potentially influencing the health of the offspring . In accordance, the vitC levels of the umbilical cord blood correlated positively with the obtained Apgar score of the newborn.
Finally, no correlation between diabetic characteristics of the pregnant women and vitC status was observed, although glycemic control measured as HbA1c showed an inverse correlation with maternal vitC level. VitC is thought to be actively transported by SVCT transporters in the placenta ; however, it also shares the same transporters as glucose via the GLUT-mediated transport of dehydroascorbic acid (DHA; the oxidized form of vitC) . Thus, it may be speculated that the degree of glycemic control and, consequently, the level of oxidative stress and ascorbate oxidation rate may affect the bioavailability of vitC in T1DM pregnant women through competitive inhibition of DHA transport as proposed by Mann and Newton already in 1975 and supported by the NHANES study 2003–2006 data ; here an inverse relationship between vitC and HbA1c was reported in 7697 non-diabetic participants. Moreover, Tu et al. have recently proposed that impaired red cell recycling of DHA may be a key link in diabetes.
Limitations of the present study include the small number of participants and that the registration of complications of pregnancy was done retrospectively on the case report forms, which in some cases may be imprecise. The included T1DM patients with diabetic complications, i.e., retino- and nephropathy, could potentially influence the outcome of pregnancy. However, we did not find any relationship of these variables with vitC probably due to the small number of participants. Finally, the samples for vitC were taken in a non-fasting state to avoid hypoglycemic episodes, which may have increased the SD of the vitC measurements and, thus, the risk of type 2 error.

Conclusions

In conclusion, the results from this small study of a pregnant T1DM cohort suggest that hypovitaminosis C in late pregnancy may be associated with an increased risk of developing complications in pregnancy and may also, to some extent, limit the obtainable level of vitC of the fetus as measured by umbilical values in the newborn. Further investigations are needed to disclose the possible clinical significance of vitC in the diabetic pregnancy and to confirm in larger studies that a benefit of vitC supplementation exists in pregnancies characterized by hypovitaminosis C.

I have seen many children suffering with skin problems, infections, heart problems etc. by birth.  I wish every couple should enjoy with Healthy child.  Take Vitamin C enriched in your food

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