Clinical Opinion
Is vitamin E a safe prophylaxis for preeclampsia?

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The prophylactic use of vitamins E and C for the prevention of preeclampsia is currently being evaluated in multiple clinical trials in Canada, Mexico, the United Kingdom, the United States, and other developing countries. In addition to its antioxidant capacity, exogenous vitamin E may prevent an immunologic switch (Th1 to Th2) that is vital for early-to late transition in normal pregnancies. Moreover, vitamin E could be a potential interferon-gamma (IFN-γ) mimic facilitating persistent proinflammatory reactions at the fetal-maternal interface. These untoward effects of dietary intake of vitamin E may be more pronounced in those treated cases that fail to develop preeclampsia. A critical test of this hypothesis would be to establish whether, under variable O2 tension, vitamin E is capable of affecting cytokine signaling in placental trophoblasts and maternal immune effector cells, both in early and late human pregnancies.

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      The explanation for why supplementation with vitamins C and E increases the risk of gestational hypertension and PROM is unknown. Banerjee et al27 have hypothesized that nonantioxidant effects of exogenous vitamin E could have detrimental effects on human pregnancy. Vitamin E therapy could prevent an immunologic switch from T-helper cell 1 to T-helper cell 2 that is vital for early-to-late transition in normal pregnancies.

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