Cost effectiveness of vitamin c supplementation for pregnant smokers to improve offspring lung function at birth and reduce childhood wheeze/asthma

• Published in: Journal of perinatology Vol. 38; no. 7; pp. 820 - 827
• Main Authors: Yieh, Leah, McEvoy, Cindy T., Hoffman, Scott W., Caughey, Aaron B., MacDonald, Kelvin D., Dukhovny, Dmitry
• Format: Journal Article
• Language: English
• Published: New York Nature Publishing Group US 01.07.2018; Nature Publishing Group
• Subjects: 692/699/1785; 692/700/1720; 692/700/3934; 692/700/459/1994; 692/700/478/174; Adolescent; Analysis; Ascorbic acid; Ascorbic Acid - administration & dosage; Ascorbic Acid - economics; Asthma; Asthma - economics; Asthma - prevention & control; Child; Child, Preschool; Childbirth & labor; Childhood asthma; Children; Cost analysis; Cost effectiveness; Cost-Benefit Analysis; Decision analysis; Decision Support Techniques; Dietary Supplements - economics; Female; Health aspects; Humans; Impact analysis; Infant; Infant Health; Infant, Newborn; Lungs; Mathematical models; Medicine; Medicine & Public Health; Offspring; Patient outcomes; Pediatric research; Pediatric Surgery; Pediatrics; Pregnancy; Pregnant women; Prenatal Care - economics; Prenatal Care - methods; Prevalence studies (Epidemiology); Prevention; Primary Prevention - economics; Primary Prevention - methods; Quality-Adjusted Life Years; Respiratory function; Respiratory Function Tests; Respiratory Sounds - drug effects; Risk Assessment; Sensitivity analysis; Smokers; Smoking; Smoking - adverse effects; Smoking - epidemiology; Smoking in pregnancy; Supplements; Tobacco; United States; Vitamin C; Vitamins; Young Adult; United States
• ISSN: 0743-8346; 1476-5543
• DOI: 10.1038/s41372-018-0135-6

Objective: To determine the implications of supplemental vitamin C for pregnant tobacco smokers and its effects on the prevalence of pediatric asthma, asthma-related mortality, and associated costs. Study design: A decision-analytic model built via TreeAge compared the outcome of asthma in a theoretical annual cohort of 480,000 children born to pregnant smokers through 18 years of life. Vitamin C supplementation (500 mg/day) with a standard prenatal vitamin was compared to a prenatal vitamin (60 mg/day). Model inputs were derived from the literature. Deterministic and probabilistic sensitivity analyses assessed the impact of assumptions. Result: Additional vitamin C during pregnancy would prevent 1637 cases of asthma at the age of 18 per birth cohort of pregnant smokers. Vitamin C would reduce asthma-related childhood deaths and save $31,420,800 in societal costs over 18 years per birth cohort. Conclusion: Vitamin C supplementation in pregnant smokers is a safe and inexpensive intervention that may reduce the economic burden of pediatric asthma.