Association of Ascorbic Acid Concentration and Preterm Premature Rupture of Membrane

Background: Premature rupture of membranes (PROM) is the rupture of amniotic membranes before labor begins, and when membranes rupture occurs before 37 weeks of gestation, it is known as preterm PROM (PPROM). It is known to complicate around 3% of preterm pregnancies and is responsible for 40% to 75% of neonatal deaths. It is suggested that vitamin C status plays a role in reducing the incidence of PPROM. The study aims to establish the association between maternal plasma vitamin C concentration among women with PPROM and women without PPROM. Subjects and Methods: A prospective cohort study was done at Al Basrah Teaching Hospital for maternity and children over the period from January 1st, 2023, to December 31st, 2023. The study included 34 cases of PPROM, which were matched for gestational age with 28 controls. The data were collected from women who were included in the study through a well-formed questionnaire. Then 5 cc of blood was drawn from each woman to measure the Hb, WBC, and vitamin C levels. Results: The vitamin C level was lower among cases (7.22 ± 4.66) than controls (14.23±5.29) with a P-value of 0.001. Urinary tract infection was also higher among cases (p –value=0.001). Women with caesarean sections had a lower level of vitamin C (6.23 ± 2.8) in comparison to women with vaginal delivery (11.63 ± 6.05), and those with postpartum haemorrhage had a lower level of vitamin C (7.25 ± 4.91). however, only the mode of delivery had a statistically significant level (p-value of 0.001). Conclusion:  A lower level of vitamin C was noticed among women with PPROM in comparison to healthy women. A higher incidence of postpartum haemorrhage (PPH) and neonatal complications was noticed among those with PROM and vitamin C deficiency.