NEW YORK (Reuters Health) - Women who get little vitamin C both before and during their pregnancies have an increased risk of suffering a ruptured membrane and subsequently delivering prematurely, according to research presented this week at the Society for Maternal-Fetal Medicine's annual meeting in New Orleans, Louisiana.

``Vitamin C plays a role in the structure of collagen in the fetal membrane, and when it's not there, it makes the membrane weaker,'' lead author Dr. Anna Siega-Riz, an assistant professor of maternal and child health and nutrition at the University of North Carolina at Chapel Hill, told Reuters Health.

Women with a low vitamin C intake have been found to be more susceptible to premature rupture of the membrane attached to the placenta, leading to an increased risk of premature delivery.

To further investigate the relationship between intake of the vitamin and membrane rupture, the researchers studied 2,247 pregnant women enrolled in a study funded by the National Institute of Child Health and Human Development. The women were given a questionnaire asking them to detail their intake of various foods before their pregnancy as well as during their second trimester of pregnancy.

The investigators found a strong relationship between a lack of vitamin C in a woman's diet and a tendency toward rupturing the placental membrane.

For example, the women who were in the bottom 10th percentile of vitamin C consumers before pregnancy, meaning they took in less than 21 milligrams (mg) of vitamin C daily, had twice the risk of suffering a premature ruptured membrane during their pregnancy.

Similarly, women who were in the bottom 10th percentile of vitamin C users during their second trimester of pregnancy, consuming less than 65 mg of vitamin C daily, were at 70% increased risk of suffering a premature ruptured membrane.

The researchers controlled for other factors that could contribute to membrane rupture, such as cigarette smoking, age and race. But other factors the researchers didn't account for could be responsible for the association seen in the study, Siega-Riz noted. For example, women with high vitamin C intake tend to be in better health and have better overall nutritional habits.

``We can't say causality, because you can't base anything on observational studies,'' she said. ``This is another study that shows there is a potential for a causal pathway for vitamin C leading to rupture of membranes, which needs to be verified with randomized, clinical trials.''

The researchers found that only 28% of the women said they had taken vitamin C supplements before pregnancy, while 80% reported taking a multivitamin by the 30th week of pregnancy. The study's results suggest that starting vitamins after becoming pregnant is not enough to ward off rupture risk.

``The best advice we can give is for women to take a multivitamin preconceptually and throughout pregnancy,'' Siega-Riz said. ``You can't ignore the preconceptual period--women have to be in good physical well-being when they become pregnant.''

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