Evaluation of maternal plasma ascorbic acid concentrations among women with and without preterm prelabour rupture of membranes: A case-control analysis
Year: 2026
Type: article
Study design: Observational Study
Abstract: Background: Preterm prelabour rupture of membranes (PPROM) refers to the unprompted breakage of the amniotic sac occurring prior to 37 completed weeks of gestation and before the initiation of active labour. It ranks among the foremost causes of adverse neonatal outcomes globally. Roughly 1% to 5% of all pregnancies are affected by this condition, and it accounts for nearly one-third of premature deliveries. Once the fetal membranes are compromised, susceptibility to ascending intrauterine infection rises sharply. At the molecular level, derangement of collagen turnover is regarded as the principal biochemical event precipitating such rupture. Objectives: The present investigation was designed to determine whether a meaningful relationship exists between maternal plasma ascorbic acid levels and the occurrence of PPROM, by comparing affected women against those with uncomplicated term pregnancies. Methods: A hospital-based case-control investigation was carried out in the Obstetrics and Gynaecology Department of a tertiary care teaching institute in Karnataka. A total sample of 120 antenatal women was enrolled, distributed equally into two arms: the study arm consisted of 60 women admitted to the labour room with a documented history of PPROM, whereas the control arm comprised an equal number of 60 women admitted at term for a normal delivery. Results: Within the study arm of 60 participants, exactly half (30 cases; 50%) exhibited plasma ascorbic acid values below 0.6 mg/dl, while the remaining 30 (50%) fell within the reference range of 0.6–2.0 mg/dl. The control arm, however, displayed a markedly different profile: only 10 women (16.7%) had levels below 0.6 mg/dl, 44 (73.3%) were within the reference range, and 6 (10%) exhibited values exceeding 2.0 mg/dl. The intergroup difference reached high statistical significance (p<0.001). Conclusion: The present findings clearly demonstrate that low maternal plasma vitamin C is associated with an elevated risk of PPROM, subsequent preterm delivery, increased neonatal intensive care admissions, poorer perinatal outcomes, and higher maternal anaemia rates. Given that habitual dietary vitamin C intake is typically modest (roughly 40–50 mg per day), and that gestational demand for the vitamin is heightened by increased oxidative stress, reduced dietary provision, and physiological haemodilution, nutritional intervention is warranted. Enhancing maternal nutritional status through improved dietary practices, coupled with routine vitamin C supplementation at 100 mg per day—administered alongside the standard iron and calcium prophylaxis during the second and third trimesters—should be considered essential to avert this largely preventable but potentially devastating obstetric complication.
Authors: Usha BN, Vytla Ananya, Vinutha Rani Malipatil
Language: English
Subfield: Obstetrics and Gynecology
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W7204474812