human
***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 OBJECTIVE To assess the relationship between glycemic control , pre-eclampsia , and gestational hypertension in women with type 1 diabetes . RESEARCH DESIGN AND METHODS Pregnancy outcome ( pre-eclampsia or gestational hypertension ) was assessed prospect ively in 749 women from the r and omized controlled Diabetes and Pre-eclampsia Intervention Trial ( DAPIT ) . HbA1c  ( A1C )  values were available up to 6 months before pregnancy ( n = 542 ) , at the first antenatal visit ( median 9 weeks ) ( n = 721 ) , at 26 weeks ’ gestation ( n = 592 ) , and at 34 weeks ’ gestation ( n = 519 ) and were categorized as optimal ( < 6.1 % : referent ) , good ( 6.1–6.9 % ) , moderate ( 7.0–7.9 % ) , and poor ( ≥8.0 % ) glycemic control , respectively . RESULTS Pre-eclampsia and gestational hypertension developed in 17 and 11 % of pregnancies , respectively . Women who developed pre-eclampsia had significantly higher A1C values before and during pregnancy compared with women who did not develop pre-eclampsia ( P < 0.05 , respectively ) . In early pregnancy , A1C ≥8.0 % was associated with a significantly increased risk of pre-eclampsia ( odds ratio 3.68 [ 95 % CI 1.17–11.6 ] ) compared with optimal control . At 26 weeks ’ gestation , A1C values ≥6.1 % ( good : 2.09 [ 1.03–4.21 ] ; moderate : 3.20 [ 1.47–7.00 ] ; and poor : 3.81 [ 1.30–11.1 ] ) and at 34 weeks ’ gestation A1C values ≥7.0 % ( moderate : 3.27 [ 1.31–8.20 ] and poor : 8.01 [ 2.04–31.5 ] ) significantly increased the risk of pre-eclampsia compared with optimal control . The adjusted odds ratios for pre-eclampsia for each 1 % decrement in A1C before pregnancy , at the first antenatal visit , at 26 weeks ’ gestation , and at 34 weeks ’ gestation were 0.88 ( 0.75–1.03 ) , 0.75 ( 0.64–0.88 ) , 0.57 ( 0.42–0.78 ) , and 0.47 ( 0.31–0.70 ) , respectively . Glycemic control was not significantly associated with gestational hypertension . CONCLUSIONS Women who developed pre-eclampsia had significantly higher A1C values before and during pregnancy . These data suggest that optimal glycemic control both early and throughout pregnancy may reduce the risk of pre-eclampsia in women with type 1 diabetes BACKGROUND Conflicting results have been reported on the ability of dietary carotenoids to improve vitamin A status in lactating women .  Red palm oil is one of the richest dietary sources of beta-carotene . OBJECTIVE We aim ed to determine the efficacy of red palm oil in increasing retinol and provitamin A status in pregnant and lactating women . DESIGN Ninety rural , pregnant Tanzanian women from 3 r and omly selected villages were recruited during their third trimester to participate in 3 dietary intervention groups : a control group , who were encouraged to maintain the traditional practice of eating staples with dark-green leafy vegetables , and 2 study groups , who were given either sunflower or red palm oil for use in household food preparations . The intervention lasted 6 mo . Plasma sample s were collected at the third trimester and 1 and 3 mo postpartum , and breast-milk sample s were collected 1 and 3 mo postpartum . RESULTS Supplementation with red palm oil , which is rich in provitamin A , increased alpha- and beta-carotene concentrations significantly ( P < 0.001 ) in both plasma and breast milk . Plasma retinol concentrations were similar in all dietary groups . Breast-milk retinol concentrations tended to decrease from 1 to 3 mo postpartum in the control group , but were maintained in both oil groups . The difference in change in breast-milk retinol concentration between the red palm oil group and the control group was significant ( P = 0.041 ) . CONCLUSIONS Consumption of red palm oil increases concentrations of alpha- and beta-carotene in both breast milk and serum and maintains breast-milk retinol concentrations . Sunflower oil consumption seems to conserve breast-milk retinol similarly to consumption of red palm oil . Breast-milk retinol might be maintained through increased dietary intake of these vegetable oils and use of mild cooking preparation methods ( such as the addition of oil at the end of cooking and avoidance of frying ) Summary Background Results of several trials of antioxidant use during pregnancy have not shown a reduction in pre-eclampsia , but the effect in women with diabetes is unknown . We aim ed to assess whether supplementation with vitamins C and E reduced incidence of pre-eclampsia in women with type 1 diabetes . Methods We enrolled women from 25 UK antenatal metabolic clinics in a multicentre r and omised placebo-controlled trial . Eligibility criteria were type 1 diabetes preceding pregnancy , presentation between 8 weeks ' and 22 weeks ' gestation , singleton pregnancy , and age 16 years or older . Women were r and omly allocated in a 1:1 ratio to receive 1000 mg vitamin C and 400 IU vitamin E ( α-tocopherol ) or matched placebo daily until delivery . The r and omisation sequence was stratified by centre with balanced blocks of eight patients . All trial personnel and participants were masked to treatment allocation . The primary endpoint was pre-eclampsia , which we defined as gestational hypertension with proteinuria . Analysis was by modified intention to treat . This study is registered , IS RCT N27214045 . Findings Between April , 2003 , and June , 2008 , 762 women were r and omly allocated to treatment groups ( 379 vitamin supplementation , 383 placebo ) . The primary endpoint was assessed for 375 women allocated to receive vitamins , and 374 allocated to placebo . Rates of pre-eclampsia did not differ between vitamin ( 15 % , n=57 ) and placebo ( 19 % , 70 ) groups ( risk ratio 0·81 , 95 % CI 0·59–1·12 ) . No adverse maternal or neonatal outcomes were reported . Interpretation Supplementation with vitamins C and E did not reduce risk of pre-eclampsia in women with type 1 diabetes . However , the possibility that vitamin supplementation might be beneficial in women with a low antioxidant status at baseline needs further testing . Funding The Wellcome Trust Background Prenatal antioxidant supplementation might influence fetal lung growth and development and reduce infant respiratory morbidity . The aim of this study was to test the hypothesis that infants of mothers at risk of pre-eclampsia who were r and omised to receive high-dose vitamins C and E ( 1000 mg vitamin C and 400 IU RRR α-tocopherol daily ) during pregnancy would have better respiratory outcomes than infants whose mothers were r and omised to receive placebo . Methods Respiratory outcomes to 2 years of age were documented using question naires and , in a subset , by recording their healthcare utilisation and calculating the cost of care data . Results 330 women who had taken vitamin supplementation and 313 who had taken placebo completed the respiratory question naire ( 386 and 366 infants , respectively ) . There were no significant differences between the two groups in the proportions diagnosed with asthma . 54 women who had taken vitamin supplementation and 45 who had taken placebo  took part in the healthcare utilisation study ( 65 and 53 infants , respectively ) . On average , infants of mothers receiving vitamin supplementation had 2.6 ( 99 % CI 0.8 to 5.1 ) times more A&E/outpatient visits and 3.2 ( 99 % CI 0.2 to 6.9 ) times more GP visits than infants of mothers receiving placebo , and their costs of care were £ 226 ( 99 % CI £ 27 to £ 488 ) more for outpatient admissions , £ 57 ( 99 % CI £ 3 to £ 123 ) more for GP visits and £ 22 ( 99 % CI £ 3 to £ 50 ) more for medications . Conclusions High-dose antenatal vitamin C and E supplementation  does not improve infant respiratory outcome and is associated with increased healthcare utilisation and cost of care OBJECTIVE We sought to compare the rates of superimposed preeclampsia and adverse outcomes in women with chronic hypertension with or without prior preeclampsia . STUDY DESIGN We conducted secondary analysis of 369 women with chronic hypertension ( 104 with prior preeclampsia ) enrolled at 12 - 19 weeks as part of a multisite trial of antioxidants  to prevent preeclampsia ( no reduction was found ) . Outcome measures were rates of superimposed preeclampsia and other adverse perinatal outcomes . RESULTS Prepregnancy body mass index , blood pressure , and smoking status at enrollment were similar between groups . The rates of superimposed preeclampsia ( 17.3 % vs 17.7 % ) , abruptio placentae ( 1.0 % vs 3.1 % ) , perinatal death ( 6.7 % vs 8.7 % ) , and small for gestational age ( 18.4 % vs 14.3 % ) were similar between groups , but preterm delivery < 37 weeks was higher in the prior preeclampsia group ( 36.9 % vs 27.1 % ; adjusted risk ratio , 1.46 ; 95 % confidence interval , 1.05 - 2.03 ; P = .032 ) . CONCLUSION In women with chronic hypertension , a history of preeclampsia does not increase the rate of superimposed preeclampsia , but is associated with an increased rate of delivery at < 37 weeks 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 OBJECTIVE : To estimate whether maternally administered vitamins C and E lower the risk of spontaneous preterm birth . METHODS : This is a secondary analysis of a r and omized , double-masked , placebo-controlled trial in nulliparous women at low-risk administered 1,000 mg vitamin C and 400 international units vitamin E or placebo daily from 9 to 16 weeks of gestation until delivery . Outcomes include preterm birth attributable to premature rupture of membranes ( PROM ) and total spontaneous preterm births ( spontaneous preterm birth attributable to PROM or spontaneous labor ) . RESULTS : Of the 10,154 women r and omized , outcome data were available for 9,968 ( 4,992 vitamin group and 4,976 placebo group ) . A total of 1,038 women ( 10.4 % ) delivered preterm , of whom 698 ( 7.0 % ) had  spontaneous preterm birth . A spontaneous preterm birth occurred in 356 women ( 7.1 % ) assigned to daily vitamin C and E supplementation and in 342 ( 6.9 % ) assigned to placebo . There were 253 women ( 2.5 % ) who delivered after preterm PROM and 445 ( 4.5 % ) after a spontaneous preterm labor . In women supplemented with vitamins C and E , births attributed to preterm PROM were similar at less than 37 and 35 weeks of gestation , but births were less frequent before 3 
    Output:
    
agent
***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 OBJECTIVE To assess the relationship between glycemic control , pre-eclampsia , and gestational hypertension in women with type 1 diabetes . RESEARCH DESIGN AND METHODS Pregnancy outcome ( pre-eclampsia or gestational hypertension ) was assessed prospect ively in 749 women from the r and omized controlled Diabetes and Pre-eclampsia Intervention Trial ( DAPIT ) . HbA1c  ( A1C )  values were available up to 6 months before pregnancy ( n = 542 ) , at the first antenatal visit ( median 9 weeks ) ( n = 721 ) , at 26 weeks ’ gestation ( n = 592 ) , and at 34 weeks ’ gestation ( n = 519 ) and were categorized as optimal ( < 6.1 % : referent ) , good ( 6.1–6.9 % ) , moderate ( 7.0–7.9 % ) , and poor ( ≥8.0 % ) glycemic control , respectively . RESULTS Pre-eclampsia and gestational hypertension developed in 17 and 11 % of pregnancies , respectively . Women who developed pre-eclampsia had significantly higher A1C values before and during pregnancy compared with women who did not develop pre-eclampsia ( P < 0.05 , respectively ) . In early pregnancy , A1C ≥8.0 % was associated with a significantly increased risk of pre-eclampsia ( odds ratio 3.68 [ 95 % CI 1.17–11.6 ] ) compared with optimal control . At 26 weeks ’ gestation , A1C values ≥6.1 % ( good : 2.09 [ 1.03–4.21 ] ; moderate : 3.20 [ 1.47–7.00 ] ; and poor : 3.81 [ 1.30–11.1 ] ) and at 34 weeks ’ gestation A1C values ≥7.0 % ( moderate : 3.27 [ 1.31–8.20 ] and poor : 8.01 [ 2.04–31.5 ] ) significantly increased the risk of pre-eclampsia compared with optimal control . The adjusted odds ratios for pre-eclampsia for each 1 % decrement in A1C before pregnancy , at the first antenatal visit , at 26 weeks ’ gestation , and at 34 weeks ’ gestation were 0.88 ( 0.75–1.03 ) , 0.75 ( 0.64–0.88 ) , 0.57 ( 0.42–0.78 ) , and 0.47 ( 0.31–0.70 ) , respectively . Glycemic control was not significantly associated with gestational hypertension . CONCLUSIONS Women who developed pre-eclampsia had significantly higher A1C values before and during pregnancy . These data suggest that optimal glycemic control both early and throughout pregnancy may reduce the risk of pre-eclampsia in women with type 1 diabetes BACKGROUND Conflicting results have been reported on the ability of dietary carotenoids to improve vitamin A status in lactating women .  Red palm oil is one of the richest dietary sources of beta-carotene . OBJECTIVE We aim ed to determine the efficacy of red palm oil in increasing retinol and provitamin A status in pregnant and lactating women . DESIGN Ninety rural , pregnant Tanzanian women from 3 r and omly selected villages were recruited during their third trimester to participate in 3 dietary intervention groups : a control group , who were encouraged to maintain the traditional practice of eating staples with dark-green leafy vegetables , and 2 study groups , who were given either sunflower or red palm oil for use in household food preparations . The intervention lasted 6 mo . Plasma sample s were collected at the third trimester and 1 and 3 mo postpartum , and breast-milk sample s were collected 1 and 3 mo postpartum . RESULTS Supplementation with red palm oil , which is rich in provitamin A , increased alpha- and beta-carotene concentrations significantly ( P < 0.001 ) in both plasma and breast milk . Plasma retinol concentrations were similar in all dietary groups . Breast-milk retinol concentrations tended to decrease from 1 to 3 mo postpartum in the control group , but were maintained in both oil groups . The difference in change in breast-milk retinol concentration between the red palm oil group and the control group was significant ( P = 0.041 ) . CONCLUSIONS Consumption of red palm oil increases concentrations of alpha- and beta-carotene in both breast milk and serum and maintains breast-milk retinol concentrations . Sunflower oil consumption seems to conserve breast-milk retinol similarly to consumption of red palm oil . Breast-milk retinol might be maintained through increased dietary intake of these vegetable oils and use of mild cooking preparation methods ( such as the addition of oil at the end of cooking and avoidance of frying ) Summary Background Results of several trials of antioxidant use during pregnancy have not shown a reduction in pre-eclampsia , but the effect in women with diabetes is unknown . We aim ed to assess whether supplementation with vitamins C and E reduced incidence of pre-eclampsia in women with type 1 diabetes . Methods We enrolled women from 25 UK antenatal metabolic clinics in a multicentre r and omised placebo-controlled trial . Eligibility criteria were type 1 diabetes preceding pregnancy , presentation between 8 weeks ' and 22 weeks ' gestation , singleton pregnancy , and age 16 years or older . Women were r and omly allocated in a 1:1 ratio to receive 1000 mg vitamin C and 400 IU vitamin E ( α-tocopherol ) or matched placebo daily until delivery . The r and omisation sequence was stratified by centre with balanced blocks of eight patients . All trial personnel and participants were masked to treatment allocation . The primary endpoint was pre-eclampsia , which we defined as gestational hypertension with proteinuria . Analysis was by modified intention to treat . This study is registered , IS RCT N27214045 . Findings Between April , 2003 , and June , 2008 , 762 women were r and omly allocated to treatment groups ( 379 vitamin supplementation , 383 placebo ) . The primary endpoint was assessed for 375 women allocated to receive vitamins , and 374 allocated to placebo . Rates of pre-eclampsia did not differ between vitamin ( 15 % , n=57 ) and placebo ( 19 % , 70 ) groups ( risk ratio 0·81 , 95 % CI 0·59–1·12 ) . No adverse maternal or neonatal outcomes were reported . Interpretation Supplementation with vitamins C and E did not reduce risk of pre-eclampsia in women with type 1 diabetes . However , the possibility that vitamin supplementation might be beneficial in women with a low antioxidant status at baseline needs further testing . Funding The Wellcome Trust Background Prenatal antioxidant supplementation might influence fetal lung growth and development and reduce infant respiratory morbidity . The aim of this study was to test the hypothesis that infants of mothers at risk of pre-eclampsia who were r and omised to receive high-dose vitamins C and E ( 1000 mg vitamin C and 400 IU RRR α-tocopherol daily ) during pregnancy would have better respiratory outcomes than infants whose mothers were r and omised to receive placebo . Methods Respiratory outcomes to 2 years of age were documented using question naires and , in a subset , by recording their healthcare utilisation and calculating the cost of care data . Results 330 women who had taken vitamin supplementation and 313 who had taken placebo completed the respiratory question naire ( 386 and 366 infants , respectively ) . There were no significant differences between the two groups in the proportions diagnosed with asthma . 54 women who had taken vitamin supplementation and 45 who had taken placebo  took part in the healthcare utilisation study ( 65 and 53 infants , respectively ) . On average , infants of mothers receiving vitamin supplementation had 2.6 ( 99 % CI 0.8 to 5.1 ) times more A&E/outpatient visits and 3.2 ( 99 % CI 0.2 to 6.9 ) times more GP visits than infants of mothers receiving placebo , and their costs of care were £ 226 ( 99 % CI £ 27 to £ 488 ) more for outpatient admissions , £ 57 ( 99 % CI £ 3 to £ 123 ) more for GP visits and £ 22 ( 99 % CI £ 3 to £ 50 ) more for medications . Conclusions High-dose antenatal vitamin C and E supplementation  does not improve infant respiratory outcome and is associated with increased healthcare utilisation and cost of care OBJECTIVE We sought to compare the rates of superimposed preeclampsia and adverse outcomes in women with chronic hypertension with or without prior preeclampsia . STUDY DESIGN We conducted secondary analysis of 369 women with chronic hypertension ( 104 with prior preeclampsia ) enrolled at 12 - 19 weeks as part of a multisite trial of antioxidants  to prevent preeclampsia ( no reduction was found ) . Outcome measures were rates of superimposed preeclampsia and other adverse perinatal outcomes . RESULTS Prepregnancy body mass index , blood pressure , and smoking status at enrollment were similar between groups . The rates of superimposed preeclampsia ( 17.3 % vs 17.7 % ) , abruptio placentae ( 1.0 % vs 3.1 % ) , perinatal death ( 6.7 % vs 8.7 % ) , and small for gestational age ( 18.4 % vs 14.3 % ) were similar between groups , but preterm delivery < 37 weeks was higher in the prior preeclampsia group ( 36.9 % vs 27.1 % ; adjusted risk ratio , 1.46 ; 95 % confidence interval , 1.05 - 2.03 ; P = .032 ) . CONCLUSION In women with chronic hypertension , a history of preeclampsia does not increase the rate of superimposed preeclampsia , but is associated with an increased rate of delivery at < 37 weeks 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 OBJECTIVE : To estimate whether maternally administered vitamins C and E lower the risk of spontaneous preterm birth . METHODS : This is a secondary analysis of a r and omized , double-masked , placebo-controlled trial in nulliparous women at low-risk administered 1,000 mg vitamin C and 400 international units vitamin E or placebo daily from 9 to 16 weeks of gestation until delivery . Outcomes include preterm birth attributable to premature rupture of membranes ( PROM ) and total spontaneous preterm births ( spontaneous preterm birth attributable to PROM or spontaneous labor ) . RESULTS : Of the 10,154 women r and omized , outcome data were available for 9,968 ( 4,992 vitamin group and 4,976 placebo group ) . A total of 1,038 women ( 10.4 % ) delivered preterm , of whom 698 ( 7.0 % ) had  spontaneous preterm birth . A spontaneous preterm birth occurred in 356 women ( 7.1 % ) assigned to daily vitamin C and E supplementation and in 342 ( 6.9 % ) assigned to placebo . There were 253 women ( 2.5 % ) who delivered after preterm PROM and 445 ( 4.5 % ) after a spontaneous preterm labor . In women supplemented with vitamins C and E , births attributed to preterm PROM were similar at less than 37 and 35 weeks of gestation , but births were less frequent before 3 
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