الفهرس 
L- ASCORBIC ACIDOnly 14 pages are availabe for public view
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Abstract
T
he aim of our study was to estimate the antenatal maternal plasma vitamin C level & to find its relation with cord blood levels of vitamin C of their off springs and to detect its influence on the placental growth, apoptosis as well as neonatal outcome in normal full term uncomplicated deliveries.
So this study was conducted on 30 pregnant women in labor room and their newborns at Maternity Hospital, Ain- Shams University. All selected cases were healthy, singleton pregnant women and their full term neonates.
Exclusion criteria:
o Any maternal disease that could affect either vitamin C level or feto-placental growth like preeclampsia, diabetes, sepsis, sickle cell disease and genital infections.
o Maternal habits like smoking, alcohol or drug abuse.
o Fetal disease or abnormalities like IUGR, preterm, congenital anomalies confirmed by antenatal ultrasound examination & Ballard score after delivery.
After explaining the nature of the study and taking verbal consents from all subjects of the study, Full history was taken from mothers laying stress on their antenatal care, vitamin and mineral supplementation, dietetic history with 24 hour recall of feeding, socio-economic status using Park & park score& drug history. All mothers were subjected to weight and height measurements with calculation of their BMI. Plasma blood samples were collected from the mothers, cord blood samples were collected immediately after delivery and placental samples were collected from the basal plate of the immediately delivered placentas. Blood samples were centrifuged within 30 mins and analyzed within 24 hours for vitamin C quantitative analysis. Placental samples were stored for pathological examination and quantitative analysis of apoptotic index.
Delivered neonates were subjected to full examination including Ballard scoring, Apgar scoring and full anthropometric measures; weight, length, OFC, left MAC, abdominal girth as well as calculation of neonatal BMI.
The results of our study revealed that 63.3% of mothers received antenatal vitamins and mineral supplementation by history taking. On comparing between them and those who did not receive we found no significant differences regarding neonatal & placental outcomes as well as vitamin C levels of them and their babies.
Further, 60% of the off springs were females and 40% were males & on comparing between them regarding anthropometry and placental outcome as well as vitamin C levels of them and their mothers, no significant differences were found.
In this work, 56.7% of the off springs were AGA, 23.3% were LGA while 20% were SGA. Multiple comparisons between the three groups showed significantly higher values in all maternal, neonatal and placental parameters as well as vitamin C levels among LGA followed by AGA then SGA groups.
Moreover, vitamin C levels of the cord blood were significantly higher than those of the mothers. Further, Significant higher values of neonatal anthropometry and placental weight while significant lower values of apoptotic index were detected among neonates with vitamin C level>12.3mg/l compared to those with vitamin C level<=12.3mg/l.
Correlations studies revealed that maternal age had no significant correlation with neonatal anthropometry, placental weight and apoptotic index or vitamin C levels of mothers and babies. While maternal BMI had significant positive correlations with neonatal weight, BMI, left mid arm circumference.
There were positive significant correlations between gestational age and neonatal length, head circumference as well as vitamin C level of mothers.
A positive significant correlation between Vitamin C level of mothers and vitamin C level of babies was detected. In addition, vitamin C level of mothers was the most sensitive discriminator for prediction of vitamin C level of the neonate by multiple regression analysis.
Moreover, positive significant correlations between either maternal or neonatal vitamin C levels with all neonatal anthropometry as well as placental weight. On the other hand a negative correlation between vitamin C levels and placental apoptotic index was found in our study.
Worth noting in the current study placental weight was the most sensitive discriminator for prediction of neonatal weight and BMI by multiple regression analysis followed by maternal vitamin C then maternal BMI, while negative significant correlations between placental apoptotic index and neonatal weight and BMI as well as placental weight were detected.
In conclusion, maternal vitamin C levels have a significant positive correlation with neonatal anthropometry and placental weight while a negative significant correlation with placental apoptosis is detected that made it prudent to hypothesize that maternal supplementation with vitamin C could be beneficial during pregnancy to support fetal growth and development