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Archives of Disease in Childhood. Fetal and Neonatal Edition logoLink to Archives of Disease in Childhood. Fetal and Neonatal Edition
. 2001 Jan;84(1):F9–F13. doi: 10.1136/fn.84.1.F9

Randomised controlled trial of oral vitamin A supplementation in preterm infants to prevent chronic lung disease

S Wardle, A Hughes, S Chen, N Shaw
PMCID: PMC1721189  PMID: 11124916

Abstract

BACKGROUND—Intramuscular supplementation with vitamin A in large doses may reduce the incidence of chronic lung disease.
AIM—To investigate whether oral supplementation with vitamin A would reduce the incidence of chronic lung disease in a group of extremely low birthweight infants.
METHODS—Infants with birth weight < 1000 g were randomised at birth to receive oral vitamin A supplementation (5000 IU/day) or placebo for 28 days. The primary outcome was oxygen dependency at 28 days of age or death.
RESULTS—A total of 154 infants were randomised; 77 received vitamin A (median birth weight (interquartile range) 806 (710-890) g), and 77 received placebo (median birth weight (interquartile range) 782 (662-880) g). Plasma vitamin A concentrations in the supplemented group were significantly higher at 24 hours of age but did not differ significantly at birth, 12 hours of age, 7 days, or 28days of life. There were no significant differences in the proportion of infants who survived, required oxygen at 28 days, required oxygen at 36 weeks postmenstrual age, survived without chronic lung disease at 36 weeks, survived without significant retinopathy, or who survived without significant intraventricular haemorrhage.
CONCLUSIONS—Oral supplementation with 5000 IU vitamin A in extremely low birthweight infants does not significantly alter the incidence of chronic lung disease. However, this dose may have been inadequate to achieve optimal serum retinol concentrations.



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Selected References

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  1. Greene H. L., Phillips B. L., Franck L., Fillmore C. M., Said H. M., Murrell J. E., Moore M. E., Briggs R. Persistently low blood retinol levels during and after parenteral feeding of very low birth weight infants: examination of losses into intravenous administration sets and a method of prevention by addition to a lipid emulsion. Pediatrics. 1987 Jun;79(6):894–900. [PubMed] [Google Scholar]
  2. Hathcock J. N., Hattan D. G., Jenkins M. Y., McDonald J. T., Sundaresan P. R., Wilkening V. L. Evaluation of vitamin A toxicity. Am J Clin Nutr. 1990 Aug;52(2):183–202. doi: 10.1093/ajcn/52.2.183. [DOI] [PubMed] [Google Scholar]
  3. Inder T. E., Graham P. J., Winterbourn C. C., Austin N. C., Darlow B. A. Plasma vitamin A levels in the very low birthweight infant--relationship to respiratory outcome. Early Hum Dev. 1998 Sep;52(2):155–168. doi: 10.1016/s0378-3782(98)00026-7. [DOI] [PubMed] [Google Scholar]
  4. Landman J., Sive A., Heese H. D., Van der Elst C., Sacks R. Comparison of enteral and intramuscular vitamin A supplementation in preterm infants. Early Hum Dev. 1992 Sep;30(2):163–170. doi: 10.1016/0378-3782(92)90143-5. [DOI] [PubMed] [Google Scholar]
  5. Pearson E., Bose C., Snidow T., Ransom L., Young T., Bose G., Stiles A. Trial of vitamin A supplementation in very low birth weight infants at risk for bronchopulmonary dysplasia. J Pediatr. 1992 Sep;121(3):420–427. doi: 10.1016/s0022-3476(05)81800-1. [DOI] [PubMed] [Google Scholar]
  6. Rush M. G., Shenai J. P., Parker R. A., Chytil F. Intramuscular versus enteral vitamin A supplementation in very low birth weight neonates. J Pediatr. 1994 Sep;125(3):458–462. doi: 10.1016/s0022-3476(05)83295-0. [DOI] [PubMed] [Google Scholar]
  7. Shenai J. P., Chytil F., Stahlman M. T. Vitamin A status of neonates with bronchopulmonary dysplasia. Pediatr Res. 1985 Feb;19(2):185–188. doi: 10.1203/00006450-198502000-00007. [DOI] [PubMed] [Google Scholar]
  8. Shenai J. P., Kennedy K. A., Chytil F., Stahlman M. T. Clinical trial of vitamin A supplementation in infants susceptible to bronchopulmonary dysplasia. J Pediatr. 1987 Aug;111(2):269–277. doi: 10.1016/s0022-3476(87)80086-0. [DOI] [PubMed] [Google Scholar]
  9. Shenai J. P., Rush M. G., Stahlman M. T., Chytil F. Plasma retinol-binding protein response to vitamin A administration in infants susceptible to bronchopulmonary dysplasia. J Pediatr. 1990 Apr;116(4):607–614. doi: 10.1016/s0022-3476(05)81614-2. [DOI] [PubMed] [Google Scholar]
  10. Shenai J. P. Vitamin A supplementation in very low birth weight neonates: rationale and evidence. Pediatrics. 1999 Dec;104(6):1369–1374. doi: 10.1542/peds.104.6.1369. [DOI] [PubMed] [Google Scholar]
  11. Tyson J. E., Wright L. L., Oh W., Kennedy K. A., Mele L., Ehrenkranz R. A., Stoll B. J., Lemons J. A., Stevenson D. K., Bauer C. R. Vitamin A supplementation for extremely-low-birth-weight infants. National Institute of Child Health and Human Development Neonatal Research Network. N Engl J Med. 1999 Jun 24;340(25):1962–1968. doi: 10.1056/NEJM199906243402505. [DOI] [PubMed] [Google Scholar]
  12. Werkman S. H., Peeples J. M., Cooke R. J., Tolley E. A., Carlson S. E. Effect of vitamin A supplementation of intravenous lipids on early vitamin A intake and status of premature infants. Am J Clin Nutr. 1994 Mar;59(3):586–592. doi: 10.1093/ajcn/59.3.586. [DOI] [PubMed] [Google Scholar]

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