SynthesisPloS one2015
Maternal Antioxidant Levels in Pregnancy and Risk of Preeclampsia and Small for Gestational Age Birth: A Systematic Review and Meta-Analysis.
Synthesis in PloS one, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
29 citing papers in PubMed, 3 syntheses or guidelines pooled it, 67 citations in OpenAlex.
- Oxidative stress biomarkers in fetal growth restriction: a systematic review and meta-analysis.Archives of gynecology and obstetrics · 2025Pooled it
- Should We 'Eat a Rainbow'? An Umbrella Review of the Health Effects of Colorful Bioactive Pigments in Fruits and Vegetables.Molecules (Basel, Switzerland) · 2022Pooled it
- Association between maternal lipid levels during pregnancy and delivery of small for gestational age: A systematic review and meta-analysis.Frontiers in pediatrics · 2022Pooled it
- Trial
- Altered Lipid Profile and Oxidative Stress During Pregnancy: Impact on the Fetus and Risk of Metabolic Disorders in Adulthood.International journal of molecular sciences · 2026Review
- Oxidative Stress in Pathogenesis of Preeclampsia: Mechanistic and Clinical Insights.Antioxidants (Basel, Switzerland) · 2026Review
- Study on the epidemiological characteristics and associated factors of small for gestational age in a large pregnancy cohort in Hebei China.BMC public health · 2025Article
- Oxidative Stress and Inflammation in Uterine-Vascular Adaptation During Pregnancy.Antioxidants (Basel, Switzerland) · 2025Review
- Pregnancy Under Pressure: Oxidative Stress as a Common Thread in Maternal Disorders.Life (Basel, Switzerland) · 2025Review
- BMI modifies the effect of pregnancy complications on risk of small- or large-for-gestational-age newborns.Pediatric research · 2025Article
- Paradoxes: Cholesterol and Hypoxia in Preeclampsia.Biomolecules · 2024Review
- The relationship between vitamin A and E levels and the severity of disease and oxidative stress injury in patients with preeclampsia.American journal of translational research · 2024Article
- An evidence review and nutritional conceptual framework for pre-eclampsia prevention.The British journal of nutrition · 2023Review
- Prevalence of vitamin E inadequacy, dietary intake and sources of alpha-tocopherol, and predictors of alpha- and gamma-tocopherol status in adolescent girls in Central Mozambique.Journal of nutritional science · 2023Article
- Maternal nutritional risk factors for pre-eclampsia incidence: findings from a narrative scoping review.Reproductive health · 2022Article
- Dietary carotenoid intake and risk of developing preeclampsia: a hospital-based case-control study.BMC pregnancy and childbirth · 2022Article
- Carotenoids and Vitamin A in Breastmilk of Hong Kong Lactating Mothers and Their Relationships with Maternal Diet.Nutrients · 2022Article
- Plasma Levels of Vitamin A in Early Pregnancy and Correlationship with Hypertensive Disorder.Computational and mathematical methods in medicine · 2022Article
- Predictive value of vitamin A and E levels in pre-eclampsia and postpartum kidney injury.American journal of translational research · 2021Article
- Epidemiology and pathogenesis of maternal-fetal transmission of Trypanosoma cruzi and a case for vaccine development against congenital Chagas disease.Biochimica et biophysica acta. Molecular basis of disease · 2020Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundOxidative stress in preeclampsia and small for gestational age (SGA) birth suggests antioxidant supplementation could prevent these conditions. However, it remains unclear whether maternal antioxidant levels are systematically lower in these pregnancies.
objectiveTo conduct a systematic review of the association between maternal antioxidant levels during pregnancy and preeclampsia or SGA.
methodsWe searched PubMed, Embase, and several other databases from 1970-2013 for observational studies that measured maternal blood levels of non-enzymatic antioxidants (vitamins A, C, E, and carotenoids) during pregnancy or within 72 hours of delivery. The entire review process was done in duplicate. Study quality was assessed using the Newcastle-Ottawa Scale and additional questions. We pooled the standardized mean difference (SMD) across studies, stratified by outcome and pregnancy trimester, and investigated heterogeneity using meta-regression.
resultsWe reviewed 1,882 unique citations and 64 studies were included. Most studies were small with important risk of bias. Among studies that addressed preeclampsia (n = 58) and SGA (n = 9), 16% and 66%, respectively, measured levels prior to diagnosis. The SMDs for vitamins A, C, and E were significantly negative for overall preeclampsia, but not for mild or severe preeclampsia subtypes. Significant heterogeneity was observed in all meta-analyses and most could not be explained. Evidence for lower carotenoid antioxidants in preeclampsia and SGA was limited and inconclusive. Publication bias appears likely.
conclusionsSmall, low-quality studies limit conclusions that can be drawn from the available literature. Observational studies inconsistently show that vitamins C and E or other antioxidants are lower in women who develop preeclampsia or SGA. Reverse causality remains a possible explanation for associations observed. New clinical trials are not warranted in light of this evidence; however, additional rigorous observational studies measuring antioxidant levels before clinical detection of preeclampsia and SGA may clarify whether levels are altered at a causally-relevant time of pregnancy.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.