Vitamin A supplementation in late pregnancy can decrease the incidence of bronchopulmonary dysplasia in newborns
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1Department of Pediatrics, Jawaharlal Institute of Post Graduate Medical Education and Research (JIPMER), Puducherry, India. babuarun@yahoo.com
Insights
Antenatal Vitamin A supplementation for mothers may decrease the incidence of bronchopulmonary dysplasia (BPD) in newborns. This approach, combined with postnatal therapy, offers enhanced BPD prevention and addresses maternal vitamin A deficiency.
Area of Science:
- Neonatal Medicine
- Respiratory Medicine
- Nutritional Science
Background:
- Bronchopulmonary dysplasia (BPD) is a chronic lung disease in infants, often linked to prematurity and mechanical ventilation-induced lung injury.
- Current BPD prevention relies on postnatal Vitamin A administration, but antenatal supplementation is unexplored.
- Vitamin A deficiency in pregnancy is associated with adverse neonatal outcomes, including low birth weight and anemia.
Purpose of the Study:
- To hypothesize that Vitamin A supplementation during late pregnancy can reduce the incidence of bronchopulmonary dysplasia (BPD) in newborns.
- To evaluate the potential of antenatal Vitamin A as an adjunct to current postnatal BPD preventive therapies.
- To address widespread vitamin A deficiency in pregnant mothers and newborns in developing regions.
Main Methods:
- The study proposes a hypothesis based on existing knowledge of Vitamin A's role in lung development and its safety in late pregnancy.
- It suggests combining antenatal maternal supplementation with postnatal newborn supplementation.
- The approach leverages animal model findings on Vitamin A's upregulation of lung growth genes and surfactant production.
Main Results:
- Vitamin A supplementation in late pregnancy is hypothesized to increase cord blood Vitamin A levels.
- This antenatal supplementation is predicted to complement postnatal therapy for more effective BPD prevention.
- The strategy is expected to mitigate risks associated with vitamin A deficiency during pregnancy.
Conclusions:
- Antenatal Vitamin A supplementation represents a promising strategy to decrease BPD incidence.
- Combining maternal and newborn Vitamin A supplementation offers a potentially superior preventive approach.
- This intervention can simultaneously address maternal and neonatal vitamin A deficiency, improving overall health outcomes.
Abstract:
Bronchopulmonary dysplasia (BPD) is a chronic lung disease of infancy which is associated with prematurity and early lung injury resulting from mechanical ventilation. Oxygen toxicity, barotrauma, and volutrauma play key roles in its pathogenesis. Parenteral administration of Vitamin A to the newborn is the current recommended preventive therapy for BPD. Vitamin A has been found to upregulate genes necessary for fetal lung growth and increase surfactant production in animal models. Supplementation of Vitamin A in late pregnancy increases the cord blood vitamin A levels proportionately. Hence, we hypothesize that Vitamin A supplementation during late pregnancy can decrease the incidence of BPD in newborns. This can be an effective adjunct to postnatal preventive therapy. Vitamin A supplementation in late pregnancy carries no risk of teratogenicity unlike in early pregnancy. Moreover, vitamin A deficiency in pregnancy is associated with depressed immune function leading on to increased infectious morbidity and can cause intrauterine growth retardation, low birth weight and anemia in newborns. Combining antenatal Vitamin A supplementation to the mother with postnatal supplementation to the newborn can effectively prevent BPD better than the traditional postnatal preventive therapy alone. It will also treat the highly prevalent vitamin A deficiency in pregnant mothers and newborns of the developing world.
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