***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Objective To determine whether antioxidant therapy alters the disease process in severe early onset pre‐eclampsia , in support of the hypothesis that increased lipid peroxides and reactive oxygen species production play an important role in the pathogenesis of the disease To study the effect of calcium and vitamin D supplementation on the incidence of toxaemia of pregnancy , 200 r and omly selected pregnant women ( supplemented group ) , were put on calcium ( 375 mg/day ) and vitamin D ( 1,200 IU/day ) supplements at 20 - 24 weeks of pregnancy onwards . Another 200 pregnant women constituted the non-supplemented group . At 32 and 36 weeks of pregnancy the systolic and diastolic blood pressure of non-toxemic women was significantly lower in the supplemented group than in the non-supplemented group . However , the incidence of toxaemia in the supplemented group ( 6 % ) was not significantly different from that in the non-supplemented group ( 9 % ) Hypertension during pregnancy increases fetal growth retardation , preterm deliveries , and perinatal deaths , and yet its causes remain unclear . In HIV-infected women , preterm birth additionally increases the risk of HIV transmission to the infant . Oxidative stress and endothelial cell dysfunction of the placenta have been implicated in the development of hypertension during pregnancy . Vitamin intake can reduce oxidative stress and improve endothelial function . We therefore evaluated the effect of multivitamin ( 20 mg thiamine , 20 mg riboflavin , 25 mg B-6 , 50 microg B-12 , 500 mg C , 30 mg E , and 0.8 mg folic acid ) and vitamin A supplements ( 30 mg beta-carotene plus 5000 IU preformed vitamin A ) in relation to hypertension during pregnancy ( systolic blood pressure > or = 140 mm Hg or diastolic blood pressure > or = 90 mm Hg at any time during pregnancy ) . In a double-blind , placebo-controlled , r and omized , clinical trial , conducted among 1078 HIV-positive pregnant Tanzanian women , those who received multivitamins were 38 % less likely to develop hypertension during pregnancy than those who did not [ relative risk ( RR ) = 0.62 , 95 % CI 0.40 - 0.94 , P = 0.03 ] . There was no overall effect of vitamin A on hypertension during pregnancy ( RR = 1.00 , 95 % CI 0.66 - 1.51 , P = 0.98 ) . Hypertension during pregnancy was more likely in women with high baseline systolic blood pressure ( > 120 vs. < or = 120 mm Hg ) ( RR = 6.02 , 95%CI 2.59 - 13.97 , P < 0.001 ) , and those with higher mid-upper arm circumference ( RR = 1.12 , 95 % CI 1.04 - 1.19 , P = 0.002 ) . Taking multivitamins containing vitamins B , C , and E during pregnancy may be an inexpensive and effective strategy to improve the health of the mother and baby BACKGROUND Vitamin C is involved in the synthesis and degradation of collagen and is important for maintenance of the chorioamniotic membranes . Inadequate availability of ascorbic acid during pregnancy has been proposed as a risk factor for premature rupture of the chorioamniotic membranes ( PROM ) . OBJECTIVE The objective of the study was to evaluate the effectiveness of 100 mg vitamin C/d in preventing PROM . DESIGN A controlled double-blind trial was performed . Pregnant women ( n = 126 ) in their 20th wk of gestation were invited ; 120 accepted and were r and omly assigned to 2 groups  ( 100 mg vitamin C/d or placebo ) . Every 4 wk , plasma and leukocyte vitamin C concentrations were measured , and each subject was evaluated for cervicovaginal infection . The incidence of PROM was recorded for each group as an indicator of the protective effect of vitamin C supplementation . RESULTS One hundred nine patients finished the study .  Mean plasma vitamin C concentrations decreased significantly throughout the pregnancy in both groups ( P = 0.001 ) , and there were no significant differences between groups . Between weeks 20 and 36 , mean leukocyte vitamin C concentrations decreased from 17.5 to 15.23 microg/10(8 ) cells in the placebo group and increased from 17.26 to 22.17 microg/10(8 ) cells in the supplemented group ( within- and between-group differences : P = 0.001 ) . The incidence of PROM was 14 per 57 pregnancies ( 24.5 % ) in the placebo group and 4 per 52 pregnancies ( 7.69 % ) in the supplemented group ( relative risk : 0.26 ; 95 % CI : 0.078 , 0.837 ) . CONCLUSION Daily supplementation with 100 mg vitamin C after 20 wk of gestation effectively lessens the incidence of PROM CONTEXT Pregnant women who are positive for thyroid peroxidase antibodies [ TPOAb(+ ) ] are prone to develop  postpartum thyroid dysfunction ( PPTD ) and permanent hypothyroidism .  Selenium ( Se ) decreases thyroid inflammatory activity in patients with autoimmune thyroiditis . OBJECTIVE We examined whether Se supplementation , during and after pregnancy , influences the thyroidal autoimmune pattern and function . DESIGN This was a prospect i ve , r and omized , placebo-controlled study . SETTING The study was conducted in the Department of Obstetrics and Gynecology and Department of Endocrinology . PATIENTS A total of 2143 euthyroid pregnant women participated in the study ; 7.9 % were TPOAb(+ ) . INTERVENTIONS During pregnancy and the postpartum period , 77 TPOAb(+ ) women received selenomethionine 200 microg/d ( group S1 ) , 74 TPOAb(+ ) women received placebo ( group S0 ) , and 81 TPOAb(- ) age-matched women were the control group ( group C ) . MAIN OUTCOME MEASURES We measured the prevalence of PPTD and hypothyroidism . RESULTS PPTD and permanent hypothyroidism were significantly lower in group S1 compared with S0 ( 28.6 vs. 48.6 % , P<0.01 ; and 11.7 vs. 20.3 % , P<0.01 ) . CONCLUSION Se supplementation during pregnancy and in the postpartum period reduced thyroid inflammatory activity and the incidence of hypothyroidism OBJECTIVE Rates of  pre-eclampsia  in women with type 1 diabetes are two to four times higher than in normal pregnancies . Diabetes is associated with antioxidant depletion and increased free radical production , and an increasing body of evidence suggests that oxidative stress and endothelial cell activation may be relevant to disease pathogenesis in pre-eclampsia . The Diabetes and Pre-eclampsia Intervention Trial ( DAPIT ) aims to establish if pregnant women with type 1 diabetes supplemented with vitamins C and E have lower rates of pre-eclampsia and endothelial activation compared with placebo treatment . METHODS DAPIT is a r and omised multicentre double-blind placebo-controlled trial that will recruit 756 pregnant women with type 1 diabetes from 20 metabolic-antenatal clinics in the UK over 4 years . Women are r and omised to daily vitamin C ( 1000 mg ) and vitamin E ( 400 IU ) or placebo at 8 - 22 weeks of gestation until delivery . Maternal venous blood is obtained at r and omisation , 26 and 34 weeks , for markers of endothelial activation and oxidative stress and to assess glycaemic control . The primary outcome of DAPIT is pre-eclampsia . Secondary outcomes include endothelial activation ( PAI-1/PAI-2 ) and birthweight centile In a previous study from this institution , patients at high risk for preterm labour were screened for the presence of bacterial vaginosis ( BV ) . When BV was present , they were r and omised to receive either treatment ( metronidazole ) or placebo ( vitamin C ) . There were significantly more patients with preterm labour in the metronidazole group . The aim of this double-blind r and omised placebo-controlled trial study was to determine whether vitamin C could indeed reduce the recurrence risk of preterm labour .  Patients with a history of preterm labour in a preceding pregnancy were r and omised to receive 250 mg vitamin C or a matching placebo twice daily until 34 weeks ' gestation . They attended a dedicated premature labour clinic . Significantly more women delivered before term in the group that received vitamin C , but there was no difference in the outcome of the babies between the two groups . Supplementation with vitamin C did not prevent premature labour We studied the effect of VIBOVITmama ( Polfa Kutno S.A. ) supplementation on the course of pregnancy duration , delivery and puerperium and also the status of zinc , copper and selenium in the blood of matched maternal-cord pairs . Healthy pregnant women ( n=138 ) were divided by a double blinded trial into a test group taking vitamin and mineral supplementation containing 15 mg of zinc , 2 mg of copper and 20 microg of selenium and a control group taking placebo .  Course of pregnancy , delivery and puerperium were analyzed , as well as concentration of bioelements in the blood serum of pregnant women in the I , II , and II trimester and in umbilical cord blood of their children . In the study group we noted fewer by 1.45 % cases of pregnancy induced hypertension and a much higher rate of natural deliveries ( 75 % ) in comparison to the control group ( 53 % ) . During pregnancy in the supplemented group a 1 % increase of zinc serum concentration was found . In the control group zinc concentration decreased by 7 % ( p < 0.005 ) . Insignificant differences in serum concentration of copper and selenium was observed between the study group and controls . In umbilical cord blood the differences in the concentration of the above microelements were also insignificant . The results allow for the statement that VIBOVITmama supplementation stabilizes the zinc , copper and selenium levels in blood of pregnant women without the risk of overdosing , especially with reference to selenium OBJECTIVE To determine whether supplementation with vitamins C and E  after preterm premature rupture of membranes ( PPROM ) is associated with an increased latency period . METHODS In this double-blind , r and omized , controlled trial , 60 women with singleton pregnancies of 26 to 34 weeks ' duration and PPROM were r and omly assigned to vitamin C ( 500 mg/day ) and vitamin E ( 400 IU/day ) or placebo until delivery . All women received 2 doses of betamethasone in the first 24 h after admission as well as broad-spectrum antibiotic prophylaxis . RESULTS Important demographic , as well as clinical characteristics such as number of cases of chorioamnionitis , early neonatal sepsis , and respiratory distress syndrome , were similar in the 2 groups . A statically significant difference in the mean+/-S.D. number of days of latency was found between the groups ( 10.5+/-5.2 days vs. 3.5+/-4.0 days ( P = 0.03 ) . CONCLUSION Vitamins C and E supplementation of after PPROM is associated with a longer latency before delivery BACKGROUND Oxidative stress could play a part in pre-eclampsia , and there is some evidence to suggest that vitamin C and vitamin E supplements could reduce the risk of the disorder . Our aim was to investigate the potential benefit of these antioxidants in a cohort of women with a range of clinical risk factors . METHODS We did a r and omised , placebo-controlled trial to which we enrolled 2410 women identified as at increased risk of pre-eclampsia from 25 hospitals . We assigned the women 1000 mg vitamin C and 400 IU vitamin E ( RRR alpha tocopherol ; n=1199 ) or matched placebo ( n=1205 ) daily from the second trimester of pregnancy until delivery . Our primary endpoint was pre-eclampsia , and our main secondary endpoints were low birthweight ( < 2.5 kg ) and small size for gestational age ( < 5th customised birthweight centile ) . Analyses were by intention to treat . This study is registered as an International St and ard R and omised Controlled Trial , number IS RCT N 62368611 . FINDINGS Of 2404 patients treated , we analysed 2395 ( 99.6 % ) . The incidence of pre-eclampsia was similar in treatment placebo groups ( 15 % [ n=181 ] vs 16 % [ n=187 ] , RR 0.97 [ 95 % CI 0.80 - 1.17 ] ) . More low birthweight babies were born to women who took antioxidants than to controls ( 28 % [ n=387 ] vs 24 % [ 
    Output:
    
However , for the latter two outcomes , this was not clearly reflected in an increase in any other hypertensive complications .
AUTHORS ' CONCLUSIONS Evidence from this review does not support routine antioxidant supplementation during pregnancy to reduce the risk of pre-eclampsia and other serious complications in pregnancy