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Fat-soluble vitamins in breast-fed preterm and term infants
C Henriksen1, I B Helland, A Rønnestad
1Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway.
Insights
Very low birth weight (VLBW) infants show altered fat-soluble vitamin levels, specifically lower retinol and higher vitamin D, compared to normal birth weight (NBW) infants. Further research is needed to optimize vitamin supplementation for VLBW infants.
Area of Science:
- Neonatology
- Nutritional Biochemistry
- Pediatric Research
Background:
- Very low birth weight (VLBW) infants are at risk for nutritional deficiencies.
- Fat-soluble vitamin status is critical for the growth and development of preterm infants.
Purpose of the Study:
- To compare the levels of fat-soluble vitamins (retinol, 25-OH-vitamin D, alpha-tocopherol, and vitamin K1) in VLBW infants versus normal birth weight (NBW) infants.
- To assess changes in these vitamin levels during the early neonatal period in VLBW infants.
Main Methods:
- A longitudinal study involving 40 VLBW infants and 33 NBW infants (reference group).
- Plasma samples were collected at 1 week and hospital discharge.
- High-performance liquid chromatography was used to analyze retinol, 25-OH-vitamin D, alpha-tocopherol, and phylloquinone (vitamin K1).
Main Results:
- VLBW infants exhibited lower plasma retinol and higher plasma 25-OH-vitamin D at discharge compared to NBW infants.
- Plasma phylloquinone (vitamin K1) was initially very high in VLBW infants but decreased significantly by discharge.
- Plasma retinol levels decreased, while 25-OH-vitamin D levels increased in VLBW infants during the study.
Conclusions:
- Significant alterations in retinol and 25-OH-vitamin D concentrations were observed in VLBW infants.
- These findings highlight distinct differences in fat-soluble vitamin status between VLBW and NBW infants at hospital discharge.
- Further investigation into vitamin supplementation strategies is warranted to improve clinical outcomes for VLBW infants.
Objective:
To examine the supply and status of fat-soluble vitamins in very low birth weight (VLBW) infants compared to a reference group of normal birth weight (NBW) infants.
Design:
A longitudinal study of VLBW infants in the early neonatal period. Blood samples were drawn at 1 week of age and at discharge from hospital. Plasma was analyzed for the fat-soluble vitamins: retinol, 25-OH-vitamin D, alpha-tocopherol and phylloquinone (vitamin K(1)) using high-performance liquid chromatography.
Subjects:
A total of 40 VLBW infants were included in the study. A reference group of 33 NBW infants was randomly selected from one of our previous studies.
Results:
The VLBW infants received fortified human milk, and daily oral vitamin supplement (Multibionta). In VLBW infants, plasma retinol concentrations decreased and plasma 25-OH-vitamin D increased during the study period. VLBW infants had significantly lower plasma retinol (0.3 vs 0.7 mu M) and higher plasma 25-OH-vitamin D (166 vs 25 nM) at discharge compared to NBW infants. Plasma phylloquinone concentration in VLBW infants was very high (53 ng/ml) at one week of age, especially in the youngest infants (192 ng/ml), but decreased rapidly during the study period resulting in low/normal plasma concentrations (0.9 ng/ml) at discharge.
Conclusions:
We observed alterations in plasma concentration of retinol and 25-OH-vitamin D in VLBW infants in the early neonatal period, resulting in marked differences between VLBW at discharge and NBW. Further trials are needed to evaluate whether changes in vitamin supplementation may improve clinical outcome in VLBW infants.
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