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Coenzyme Q10 supplementation during pregnancy reduces the risk of pre-eclampsia

Enrique Teran, Isabel Hernandez, Belen Nieto, Rosio Tavara, Juan Emilio Ocampo, Andres Calle
International Journal of Gynaecology and Obstetrics 2009 105(1):43-45

Bibliography

PubMed
PMID 19154996
DOI
10.1016/j.ijgo.2008.11.033
Funding
No funding statement was identified in the accessible publication record used for this audit.
Competing interests
No competing-interest statement was identified in the accessible publication record used for this audit.

Study snapshot

DesignRandomized, double-blind, placebo-controlled trial; authors state statistical analyses were by intention-to-treat.
ModelPregnant women at increased risk of pre-eclampsia.
Sample235 randomized: 118 CoQ10 and 117 placebo; 197 women (83.8%) were followed to outcome.
InterventionCoQ10 200 mg/day versus placebo from 20 weeks' gestation until delivery.
DurationFrom 20 weeks' gestation until delivery.
EndpointsPrimary: incidence of pre-eclampsia; Follow-up completion

What the study showed, in plain terms

This 2009 double-blind RCT enrolled 235 pregnant women considered at increased risk of pre-eclampsia. Participants were randomized to CoQ10 200 mg/day or placebo beginning at 20 weeks' gestation and continuing until delivery.

Pre-eclampsia occurred in 17 women assigned CoQ10 (14.4%) and 30 assigned placebo (25.6%), corresponding to RR 0.56 (95% CI 0.33–0.96; p=0.035). The absolute difference was about 11.2 percentage points in this high-risk study population.

However, only 197 of 235 women (83.8%) were followed to outcome even though the paper describes its analysis as intention-to-treat. The accessible short report also does not provide the kind of detailed maternal, fetal and neonatal adverse-event reporting needed to establish routine pregnancy safety. This single trial therefore supports a hypothesis of reduced pre-eclampsia risk; it is not sufficient to recommend CoQ10 as standard obstetric prophylaxis.

Key findings

  • 235 randomized: 118 CoQ10 and 117 placebo.
  • 197/235 (83.8%) were followed to outcome.
  • Pre-eclampsia: 17/118 (14.4%) CoQ10 vs 30/117 (25.6%) placebo.
  • Relative risk 0.56 (95% CI 0.33–0.96), p=0.035.
  • The intervention was 200 mg/day from 20 weeks' gestation until delivery.

What this study can and cannot tell us

  • Thirty-eight randomized women were not followed to outcome (16.2%), despite the paper describing an intention-to-treat analysis.
  • Single trial with limited independent replication; effect size may be unstable.
  • Population was specifically high-risk for pre-eclampsia and should not be generalized to all pregnancies.
  • Detailed maternal/fetal/neonatal adverse-event and safety data were not available in the accessible publication record; absence of reported harm in the abstract is not evidence of established pregnancy safety.
  • This study should not be used to replace evidence-based obstetric prevention and monitoring strategies.

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Dr. Khaled Mahmoud, MBBChCritical Care Medicine, Longevity Science & Editorial Direction Dr. Amr Yasser, PhDCardiometabolic, Musculoskeletal, Gut & Bioavailability Dr. Abdulla Mostafa, PhDCellular Senescence, Neurological, Mitochondrial & Brain-Ageing Biology