• Leah Yieh, Cindy T McEvoy, Scott W Hoffman, Aaron B Caughey, Kelvin D MacDonald, and Dmitry Dukhovny.
• Department of Pediatrics, Oregon Health and Science University, Portland, OR, USA. yieh@ohsu.edu.
• J Perinatol. 2018 Jul 1; 38 (7): 820-827.

ObjectiveTo 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 DesignA 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.ResultAdditional 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.ConclusionVitamin C supplementation in pregnant smokers is a safe and inexpensive intervention that may reduce the economic burden of pediatric asthma.

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