Preeclampsia Clinical Trial
Official title:
A Randomized Clinical Trial of Antioxidants to Prevent Preeclampsia and An Observational Cohort Study to Predict Preeclampsia
Preeclampsia is one of the most common complications of pregnancy and is characterized by
high blood pressure and protein in the urine. This can cause problems in the second half of
pregnancy for both the mother and fetus. This study of preeclampsia consists of two parts: 1)
a randomized, placebo controlled, multicenter clinical trial of 10,000 low-risk nulliparous
women between 9 and 16 weeks gestation and 2) an observational, cohort study of 4,000
patients between 9 and 12 weeks gestation who are also enrolled in the trial.
Subjects in both parts will receive either 1000 mg of vitamin C and 400 IU of vitamin E or
matching placebo daily. The purpose of the randomized, clinical trial is to find out if high
doses of vitamin C and E will reduce the risk of preeclampsia and other problems associated
with the disease. The study will also evaluate the safety of antioxidant therapy for mother
and infant. Patients will be seen monthly to receive their supply of study drug, to have
weight and blood pressure recorded, to have urine protein measured, and to assess any side
effects. At two visits, blood and urine will be collected.
The observational, cohort study will prospectively measure potential biochemical and
biophysical markers that might predict preeclampsia. These patients will have additional
procedures including uterine artery Doppler and blood drawn for a complete blood count (CBC).
A Randomized, Clinical Trial of Antioxidants to Prevent Preeclampsia:
Preeclampsia is the leading cause of maternal morbidity, as well as perinatal morbidity and
mortality. Once the diagnosis has been established, therapy other than delivery has not been
successful except to prolong pregnancy minimally (at some risk to mother and infant).
Prevention efforts to reduce or eliminate preeclampsia are directed at the pathophysiology of
the disorder prior to clinically evident preeclampsia and before irreversible changes have
occurred.
This double-masked, placebo-controlled trial of 10,000 subjects is designed to evaluate the
effects of antioxidant therapy in preventing serious complications associated with
pregnancy-related hypertension in low risk, nulliparous women who begin treatment at 9-16
weeks gestation. The hypothesis being tested is that antioxidant therapy initiated prior to
16 weeks gestation will reduce the frequency of serious maternal and infant complications
associated with pregnancy-related hypertension.
After randomization, subjects will receive either 1000 mg of vitamin C and 400 IU of vitamin
E or matching placebo daily. They will be seen for monthly pill counts and to assess side
effects, weight, blood pressure, and urine for protein. Blood and urine are collected at 24
and 32 weeks' gestation.
An Observational Cohort Study to Predict Preeclampsia:
A prospective, cohort study has been designed to complement the randomized, controlled, trial
(RCT) and will test various biochemical and biophysical markers for ability to predict
preeclampsia in 4,000 of the women who are enrolled in the RCT and are between 9 and 12 weeks
gestation. These subjects will have additional procedures including a CBC and uterine artery
Doppler.
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