Vitamin A supplementation for prevention of bronchopulmonary dysplasia in very-low-birth-weight premature Thai infants: a randomized trial.

Abstract

BACKGROUND:

Bronchopulmonary dysplasia (BPD) is one ofthe most significant complications among very-low-birth-weight (VLBW) premature infants. Vitamin A deficiency increases the risk of BPD in VLBWinfants.

OBJECTIVE:

To assess the effect of vitamin A supplementation for prevention of bronchopulmonary dysplasia in VLBW premature Thai infants.

STUDY DESIGN:

Randomized control trial.

MATERIAL AND METHOD:

Eighty premature infants weighing <1,500 g who received mechanical ventilation or oxygen supplementation at 24 hours ofage-admitted to Neonatal units ofSrinagarind Hospital, Khon Kaen University, Khon Kaen, Thailand-were assigned to receive either intramuscular vitaminA 5, 000 IU3 times/week (treatment group) or sham procedure (control group) for four weeks. Serum vitamin A levels were measured before and after administration of the vitamin A.

RESULTS:

The baseline of mean serum vitamin A levels were similar in both groups. The mean serum level of vitamin A was significantly higher in the vitamin A supplemented infants than in the control infants on day 7 (1.41 +/- 0.48 vs. 0.92+0.38 pmol/ L, p<0.001), day 14 (1.48 +/- 0.90 vs. 0.96 +/- 0.36 micromol/L, p = 0.001) and day 28 (1.42 +/- 0.63 vs. 0.76 +/- 0.30 micromol/L, p<0.001) after vitamin A supplementation. None of the infants in the vitamin A supplemented group, compared to 5% of the infants in the control group, had vitamin A level <0.35 micromol/L, (indicating severe vitamin A deficiency) at 28 days. Fewer of the premature infants in the vitamin A supplemented group required oxygen supplementation at 36 weeks postmenstrual age than in the control group albeit not statistically significant (22.5 vs. 35% relative risk 0.71; 95% CI 0.40 +/- 1.26; p = 0.21). Supplementation with vitamin A was also associated with a significant reduction in the duration ofintubation (10.8 +/- 3.1 days vitamin A supplemented group vs. 26.1 +/- 6.4 days control group, p = 0.03), days on oxygen therapy (29.8 +/- 5.1 days vitamin A supplemented group vs. 58.2 +/- 9.1 days control group, p = 0.01) and length of hospital stay (61.9 +/- 4.2 days vitamin A supplemented group vs. 88.3 +/- 7.2 days control group, p = 0.002).

CONCLUSION:

The dose of vitamin A used in this study reduced biochemical evidence of vitamin A deficiency and, without complications, resulted in reducing duration of intubation, days of oxygen therapy, and length of hospital stay in premature infants suffering VLBW

• Authors: Pakaphan Kiatchoosakun, Junya Jirapradittha, M Charnchai Panthongviriyakul, Tueanjit Khampitak, Puangrat Yongvanit, Patcharee Boonsiri
• Journal: Journal of the Medical Association of Thailand = Chotmaihet thangphaet (J Med Assoc Thai) Vol. 97 Suppl 10 Pg. S82-8 (Oct 2014) ISSN: 0125-2208 [Print] Thailand
• PMID: 25816542 (Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Vitamin A

Topics

• Bronchopulmonary Dysplasia (prevention & control)
• Female
• Humans
• Infant, Newborn
• Infant, Premature
• Infant, Very Low Birth Weight
• Male
• Thailand
• Vitamin A (administration & dosage, blood)