Vitamin C to Decrease the Effects of Smoking in Pregnancy on Infant Lung Function (VCSIP): Rationale, design, and methods of a randomized, controlled trial of vitamin C supplementation in pregnancy for the primary prevention of effects of in utero tobacco smoke exposure on infant lung function and respiratory health

Cindy T. McEvoy, Kristin F. Milner, Ashley J. Scherman, Diane G. Schilling, Christina J. Tiller, Brittany Vuylsteke, Lyndsey E. Shorey-Kendrick, Eliot R. Spindel, Robert Schuff, Julie Mitchell, Dawn Peters, Jill Metz, David Haas, Keith Jackson, Robert Tepper, Cynthia D. Morris

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Despite strong anti-smoking efforts, at least 12% of American women cannot quit smoking when pregnant resulting in > 450,000 smoke-exposed infants born yearly. Smoking during pregnancy is the largest preventable cause of childhood respiratory illness including wheezing and asthma. Recent studies have shown a protective effect of vitamin C supplementation on the lung function of offspring exposed to in utero smoke in a non-human primate model and an initial human trial. Vitamin C to Decrease the Effects of Smoking in Pregnancy on Infant Lung Function (VCSIP) is a randomized, double-blind, placebo-controlled trial to evaluate pulmonary function at 3 months of age in infants delivered to pregnant smokers randomized to 500 mg/day of vitamin C versus placebo during pregnancy. Secondary aims evaluate the incidence of wheezing through 12 months and pulmonary function testing at 12 months of age. Women are randomized between 13 and 23 weeks gestation from clinical sites in Portland, Oregon at Oregon Health & Science University and PeaceHealth Southwest Medical Center and in Indianapolis, Indiana at Indiana University and Wishard Hospital. Vitamin C supplementation occurs from randomization to delivery. Monthly contact with participants and monitoring of medical records is performed to document medication adherence, changes in smoking and medical history, and adverse events. Pulmonary function testing of offspring occurs at 3 and 12 months of age and incidence of wheezing and respiratory illness through 12 months is captured via at least quarterly questionnaires. Ancillary studies are investigating the impact of vitamin C on placental blood flow and DNA methylation.

Original languageEnglish (US)
Pages (from-to)66-77
Number of pages12
JournalContemporary Clinical Trials
Volume58
DOIs
StatePublished - Jul 1 2017

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Primary Prevention
Smoke
Ascorbic Acid
Tobacco
Randomized Controlled Trials
Smoking
Respiratory Sounds
Pregnancy
Lung
Health
Placebos
Medication Adherence
Incidence
DNA Methylation
Random Allocation
Primates
Medical Records
Asthma

Keywords

  • Asthma
  • Forced expiratory flows
  • In utero smoke
  • Lung development
  • Pulmonary function test
  • Vitamin C
  • Wheeze

ASJC Scopus subject areas

  • Medicine(all)
  • Pharmacology (medical)

Cite this

Vitamin C to Decrease the Effects of Smoking in Pregnancy on Infant Lung Function (VCSIP) : Rationale, design, and methods of a randomized, controlled trial of vitamin C supplementation in pregnancy for the primary prevention of effects of in utero tobacco smoke exposure on infant lung function and respiratory health. / McEvoy, Cindy T.; Milner, Kristin F.; Scherman, Ashley J.; Schilling, Diane G.; Tiller, Christina J.; Vuylsteke, Brittany; Shorey-Kendrick, Lyndsey E.; Spindel, Eliot R.; Schuff, Robert; Mitchell, Julie; Peters, Dawn; Metz, Jill; Haas, David; Jackson, Keith; Tepper, Robert; Morris, Cynthia D.

In: Contemporary Clinical Trials, Vol. 58, 01.07.2017, p. 66-77.

Research output: Contribution to journalArticle

McEvoy, Cindy T. ; Milner, Kristin F. ; Scherman, Ashley J. ; Schilling, Diane G. ; Tiller, Christina J. ; Vuylsteke, Brittany ; Shorey-Kendrick, Lyndsey E. ; Spindel, Eliot R. ; Schuff, Robert ; Mitchell, Julie ; Peters, Dawn ; Metz, Jill ; Haas, David ; Jackson, Keith ; Tepper, Robert ; Morris, Cynthia D. / Vitamin C to Decrease the Effects of Smoking in Pregnancy on Infant Lung Function (VCSIP) : Rationale, design, and methods of a randomized, controlled trial of vitamin C supplementation in pregnancy for the primary prevention of effects of in utero tobacco smoke exposure on infant lung function and respiratory health. In: Contemporary Clinical Trials. 2017 ; Vol. 58. pp. 66-77.
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abstract = "Despite strong anti-smoking efforts, at least 12{\%} of American women cannot quit smoking when pregnant resulting in > 450,000 smoke-exposed infants born yearly. Smoking during pregnancy is the largest preventable cause of childhood respiratory illness including wheezing and asthma. Recent studies have shown a protective effect of vitamin C supplementation on the lung function of offspring exposed to in utero smoke in a non-human primate model and an initial human trial. Vitamin C to Decrease the Effects of Smoking in Pregnancy on Infant Lung Function (VCSIP) is a randomized, double-blind, placebo-controlled trial to evaluate pulmonary function at 3 months of age in infants delivered to pregnant smokers randomized to 500 mg/day of vitamin C versus placebo during pregnancy. Secondary aims evaluate the incidence of wheezing through 12 months and pulmonary function testing at 12 months of age. Women are randomized between 13 and 23 weeks gestation from clinical sites in Portland, Oregon at Oregon Health & Science University and PeaceHealth Southwest Medical Center and in Indianapolis, Indiana at Indiana University and Wishard Hospital. Vitamin C supplementation occurs from randomization to delivery. Monthly contact with participants and monitoring of medical records is performed to document medication adherence, changes in smoking and medical history, and adverse events. Pulmonary function testing of offspring occurs at 3 and 12 months of age and incidence of wheezing and respiratory illness through 12 months is captured via at least quarterly questionnaires. Ancillary studies are investigating the impact of vitamin C on placental blood flow and DNA methylation.",
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