The plasma antioxidant vitamin status of the INTAPP cohort examined: The unsuspected importance of ß-carotene and γ-tocopherol in preeclampsia.

OBJECTIVE: Examine the levels of plasma antioxidant vitamins before and during a treatment with placebo or vitamin E + C supplement to prevent preeclampsia (PE). STUDY DESIGN: Per-protocol analysis of a subset group of pregnant women (n = 295) from the International Trial of Antioxidants for the Prevention of PE (INTAPP) randomized case-control study. Normotensive receiving placebo or vitamins (n = 115 and 87 respectively) were compared to gestational hypertension (GH) without proteinuria (n = 30 and 27) and PE (n = 21 and 15). Vitamin quantification was performed at 12-18, 24-26 and 32-34 weeks of gestation. MAIN OUTCOME MEASURES: Coenzyme (Co) Q10, ß-carotene and vitamins E (α and γ forms) plasma levels. RESULTS: Vitamin E + C supplementation was found to increase the α-tocopherol levels by 40% but was associated with a 57% decrease in the γ-tocopherol isoform for all study groups (p < 0.001). The ß -carotene was lower in the PE than in the normotensive and GH groups (p < 0.001) while the level of CoQ10 remained unaffected. CONCLUSIONS: A more personalized approach that target the suboptimal levels of specific antioxidants without disturbing the α/γ-tocopherol ratio could be a more successful approach to counteract oxidative stress in PE.

Absorption, transport, and bioavailability of vitamin e and its role in pregnant women.

Vitamin E is an important lipophilic antioxidant. The term refers to eight essential naturally occurring fat-soluble nutrients called tocopherols or tocotrienols. Among these isomers, alpha-tocopherol has the highest biologically active form and is found in all lipoprotein fractions. Vitamin E deficiency during pregnancy may cause miscarriage, preterm birth, preeclampsia, and intrauterine growth restriction. This review highlights recent findings that have led to a better understanding of vitamin E absorption, transport, bioavailability, and its role in pregnancy, and that underline the need for re-evaluation of the potential benefits of vitamin E supplementation in pregnant women.