Effect of Vitamin C on Collagen Structure of Cardinal and Uterosacral Ligaments During Pregnancy

Abstract

Objective This study aimed to investigate changes in collagen structure in the cardinal and uterosacral ligaments of rats that were administered vitamin C during pregnancy. Study design Eighteen female rats were divided into three groups: six pregnant rats administered 1.25 mg/ml/day of vitamin C during pregnancy (Group A); six non-pregnant rats that were not administered vitamin C (Group B); and six pregnant rats that were not administered vitamin C during pregnancy (Group C). Fifteen days after delivery, the uteruses of all rats were removed. The intensity of staining (mild, moderate or severe) and the extent of positive staining areas (%) of type I and type III collagen H scores for types I and III collagen, and intensity of elastin fibres in the cardinal and uterosacral ligaments were investigated immunohistochemically. Differences between groups were analysed using Kruskal-Wallis and independent samples tests. Results The intensity and extent of type I and type III collagen, the H scores for type I and type III collagen, and the ratio of type III collagen H score: type I collagen H score differed significantly between groups. Pregnant rats administered vitamin C (Group A) had significantly higher values compared with non-pregnant rats (Group B): intensity of type I collagen (p = 0.001), extent of type I collagen (p ≤ 0.001), H score for type I collagen (p ≤ 0.001), intensity for type III collagen (p = 0.002), extent of type IV collagen (p = 0.007), H score for type III collagen (p = 0.017), type III collagen H score: type I collagen H score (p = 0.039) and intensity of elastin fibres (p = 0.097). A significant difference in the ratio of type III collagen H score: type I collagen H score was found between pregnant rats administered vitamin C (Group A) and pregnant rats not administered vitamin C (Group C) (p = 0.002). Conclusions The administration of vitamin C to rats during pregnancy had a favourable impact on collagen structure in the cardinal and uterosacral ligaments, suggesting that vitamin C supplementation during pregnancy may help to prevent pelvic organ prolapse and stress urinary incontinence. © 2016 Elsevier Ireland Ltd. All rights reserved.