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Vitamin C (Ascorbic Acid)

Vitamin C levels fluctuate in pregnancy due to hemodilution, altered transport, and increased fetal/placental utilization. The following reference intervals reflect trimester-specific physiologic changes.

Units Nonpregnant Adult 1st Trimester 2nd Trimester 3rd Trimester
mg/dL 0.4-1.0 1.0-1.4 0.8-1.2 0.8-1.2
µmol/L 23-57 57-80 45-68 45-68
Causes of Low Vitamin C Levels
  • Poor dietary intake (low fruits and vegetables)
  • Smoking (increases oxidative turnover of Vitamin C)
  • Malabsorption (e.g., inflammatory bowel disease, gastric surgery)
  • Hyperemesis gravidarum
  • Acute or chronic illness increasing metabolic demand
  • Increased fetal and placental utilization
  • Hemodilution from expanded plasma volume
Clinical Notes
  • Vitamin C is important for collagen synthesis, wound healing, and immune function.
  • Low levels may increase risk of anemia, premature rupture of membranes, or impaired wound healing.
  • Deficiency can coexist with poor intake of other micronutrients (folate, B vitamins).

References

  1. Kratz A, Ferraro M, Sluss PM, Lewandrowski KB. Laboratory reference values. N Engl J Med. 2004;351:1548-1563. PMID: 15470219
  2. Knight EM, et al. Biochemical profile of African American women during pregnancy. J Nutr. 1994;124:943S-953S. PMID: 8201445