Women unable to quit smoking while pregnant should take vit C pills

Daily vitamin C pills could reduce damage done to unborn babies’ lungs by pregnant mothers who smoke

  • Researchers gave half of a group of pregnant women vitamin C pills and the other half placebo pills
  • The babies of mothers who took 500 mg of vitamin C had healthier airways at three months old 
  • Smoking can lead to preterm birth, low birth weight, birth defects such as cleft lip, and reduced lung capacity
  • Scientists say the primary goal of health professionals should remain helping mothers quit smoking  

Pregnant women who struggle to quit smoking should take vitamin C to better protect the lungs of their unborn child, a new study suggests.

Researchers say babies, whose mothers took 500mg of vitamin C daily, had healthier airways at three months old than those whose mothers did not.

The team, led by Oregon Health & Science University, says the nutrient found in citrus fruits could provide a safe and inexpensive intervention for pregnant women hooked on cigarettes.

However, they stress that helping mothers quit smoking should remain the primary goal of health professionals and public health officials.  

A new study has found that pregnant women who smoked, but took 500 mg of vitamin C daily, had babies with healthier airways at three months old than those whose mothers did not (file image)

It is well known that women who smoke while pregnant create several health problems for their children.

Smoking raises the risk of premature birth, vaginal bleeding and problems with the placenta. 

It also increases a baby’s risk of defects such as cleft lip and cleft palate or a low birth weight. 

Additionally, if women smoke while pregnant, it could damage unborn babies’ lungs at crucial points in their development – leading to reduced lung capacity in later life.

For the study, the team based their tests on forced expiratory flows (FEFs), which measures the speed at which air coming out of the lungs during the middle portion of a forced exhalation. 

Researchers say these tests are a good measure of function because they can detect airway obstruction.

The team looked at more than 250 pregnant smokers who began the study between 13 and 23 weeks into their term.

All of the women received counseling on quitting smoking throughout the course of the study, with about one in 10 doing so.

Half of the women received a vitamin C pill and the other half received a placebo pill.    

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The babies of the women who took vitamin C pills did better on FEFs than the babies of those who took placebo pills. 

‘Smoking during pregnancy reflects the highly addictive nature of nicotine that disproportionately affects the most vulnerable populations,’ said lead author Dr Cindy McEvoy, a professor of pediatrics at Oregon Health & Science University. 

‘Finding a way to help infants exposed to smoking and nicotine in the womb recognizes the unique dangers posed by a highly advertised, addictive product and the lifetime effects on offspring who did not choose to be exposed.’ 

Dr McEvoy says the study supports the hypothesis that cigarette smoking reduces the amount of vitamin C available in the body.

By taking a supplement, mothers can protect their cells from the damage caused by free radicals.  

In a previous study led by Dr McEvoy, her team found the babies of mothers born to smokers had better lung function 72 hours birth when their mothers took 500 mg of vitamin C compared to the same dose of a placebo. 

However, that study did not use FEFs to measure lung function, which is what doctors use to diagnose lung disease in adults and older children. 

The infants in this study will continued to be monitored for lung function and to have respiratory outcomes analyzed.

For future studies, the researchers want to see if pregnant women taking vitamin C supplements earlier in pregnancy could provide greater outcomes.  

Dr McEvoy says that although vitamin C may be ‘a safe and inexpensive intervention’, the primary goal should be helping mother quit smoking.  

‘Although vitamin C supplementation may protect to some extent the lungs of babies born to mothers who smoke during pregnancy, those children will still be at greater risk for obesity, behavioral disorders and other serious health issues,’ she said.

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Why natural depression therapies are better than pills

Winter is upon us. And with it comes the annual worsening of depressive symptoms. Sadly, in the United States, suicide continues to claim more lives than firearms, and suicide rates are increasing in nearly all states. The U.S. Centers for Disease Control and Prevention reports that death by suicide has increased by 30 per cent since 1999 and a similar trend is observed in Canada.

I was distressed but not surprised to learn that these increases occurred over a period of time in which use of antidepressants skyrocketed by 65 per cent. By 2014, around one in eight Americans over the age of 12 reported recent antidepressant use.

I practice critical-care medicine in Guelph, Ontario. Sadly, 10 to 15 per cent of my practice is the resuscitation and life support of suicide and overdose patients.

It is not uncommon for these patients to have overdosed on the very antidepressants they were prescribed to prevent such a desperate act. The failures of antidepressants are a clear and present part of my clinical experience.

Wedded to drugs that barely work

Ten years ago, when finishing medical school, I carefully considered going into psychiatry. Ultimately, I was turned off by my impression that thought leaders in psychiatry were mistakenly wedded to a drug treatment that barely works.

A 2004 review by the Cochrane Foundation found that when compared against an “active” placebo (one that causes side effects similar to antidepressants), antidepressants were statistically of almost undetectable benefit.

Studies that compared antidepressants to “dummy” placebos showed larger but still underwhelming results. On the 52-point Hamilton Depression Rating Scale (HDRS), patients who took the antidepressants fluoxetine (Paxil) or venlafaxine (Effexor) experienced an average decrease of 11.8 points, whereas those taking the placebo experienced an average decrease of 9.6 points.

I am not suggesting that antidepressants do not work. I am suggesting that they are given a precedence in our thinking about mental health that they do not deserve.

I leave it to readers to look at the Hamilton Depression Rating Scale and decide for themselves whether a drop of 2.5 points is worth taking a pill with myriad potential side effects including weight gain, erectile dysfunction and internal bleeding.

It might be, but do note that taking an antidepressant does not seem to decrease the risk of suicide.

Natural therapies that work

The far more exciting and underplayed point, to me, is that multiple non-drug treatments have been shown to be as effective. As a staunch critic of alternative medical regimes such as chiropractic, acupuncture and homeopathy, it surprises me to note that the following “natural” therapies have rigorous, peer-reviewed scientific studies to support their use:

1. Exercise

In 2007, researchers at Duke University Medical Center in North Carolina randomly assigned patients to 30 minutes of walking or jogging three times a week, a commonly prescribed antidepressant (Zoloft), or placebo. Their results? Exercise was more effective than pills!

A 2016 review of all the available studies of exercise for depression confirms it: Exercise is an effective therapy. And it’s free!

2. Bright light therapy

You know how you just feel better after an hour out in the sun? There probably is something to it. Bright light therapy is an effort to duplicate the sun’s cheering effects in a controlled fashion. Typically, patients are asked to sit in front of a “light box” generating 10,000 Lux from 30 to 60 minutes first thing in the morning.

A review of studies using this therapy showed significant effect. The largest study showed a 2.5 point drop on the HDRS, roughly equal to that seen from antidepressants.

The sun gives 100,000 lux on a clear day and I can’t think of a reason why sunlight itself wouldn’t work, weather permitting.

3. Mediterranean diet

This one surprised me when it came out last year. Researchers in Australia randomly assigned depressed patients to receive either nutritional counselling or placebo social support.

The nutritionists recommended a Mediterranean diet, modified to include local unprocessed foods.

Thirty-two per cent of the depressed dieters experienced remission versus eight per cent of those who only received social support, a far larger effect than seen in antidepressant trials.

4. Cognitive Behavioural Therapy (CBT)

This is the best recognized of the “natural” treatments for depression and the evidence is indisputable.

CBT is as effective as antidepressants but more expensive in the short term. However, antidepressants stop working when you stop taking them, whereas the benefits of CBT seem to last.

And as an aside, it is very difficult to overdose fatally on a bottle of therapy.

I freely admit that the trials I have mentioned are smaller than the major antidepressant trials. But whereas antidepressants are projected to bring in almost $17 billion a year for the pharmaceutical industry globally by 2020, the jogging and sunlight industries will never have the resources to fund massive international trials. With this in mind, I am convinced that they are at least as worthwhile as the pills.

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