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Vitamin A status of preterm infants during infancy
J M Peeples1, S E Carlson, S H Werkman
1Department of Pediatrics, University of Tennessee, Memphis.
Insights
Preterm infants often experience low vitamin A levels, specifically plasma retinol and retinol-binding protein (RBP), for months after hospital discharge. This suboptimal vitamin A status requires monitoring and intervention in high-risk infants.
Area of Science:
- Nutritional Science
- Neonatology
- Pediatric Nutrition
Background:
- Preterm infants require careful nutritional management to ensure adequate vitamin status.
- Vitamin A is crucial for infant development, but preterm infants are at risk for deficiency.
Purpose of the Study:
- To assess plasma retinol and retinol-binding protein (RBP) levels in enterally fed preterm infants post-discharge.
- To identify the duration and prevalence of suboptimal vitamin A status in this population.
Main Methods:
- Plasma retinol and RBP concentrations were measured in 67 preterm infants at 33 weeks postconceptional age (PCA) and at regular intervals up to one year.
- Infants were fed a term-infant formula after discharge.
- Correlations between vitamin status and factors like intravenous nutrition duration and birth order were analyzed.
Main Results:
- Plasma retinol and RBP declined by 35 weeks PCA and remained low at 38 weeks, with 48% showing low retinol concentrations.
- Despite rising levels, significant numbers of infants experienced hyporetinolemia (low vitamin A) up to 57 weeks PCA.
- Low vitamin A levels at 33-38 weeks correlated with longer intravenous nutrition, and at 57-69 weeks with higher birth order.
Conclusions:
- Suboptimal vitamin A status is common and can persist for many months after preterm infants are discharged.
- Monitoring vitamin A levels and considering targeted interventions are crucial for preterm infants post-discharge.
- Longer initial nutritional support and birth order may be indicators of infants at higher risk for vitamin A deficiency.
Abstract:
Plasma retinol and retinol-binding protein (RBP) were measured in 67 enterally fed preterm infants (750-1398 g) at 33 +/- 2 wk postconceptional age (PCA), and at regular intervals during infancy. Retinol and RBP declined by 35 +/- 2 wk PCA and remained low at 38 wk after discharge, with the infants fed a term-infant formula. At 38 +/- 2 wk PCA, 48% (32 of 67) of these infants had plasma retinol concentrations less than 0.35 mumol/L. Mean retinol and RBP rose over the next 7 mo, but large numbers of infants (26 of 59 at 48 wk, 10 of 61 at 57 wk) had hyporetinolemia (0.35-0.67 mumol/L). Plasma RBP leveled off at 57 +/- 2 wk PCA and remained low (less than 0.95 mumol/L) in many infants throughout the first year of life. Lower plasma retinol and RBP concentrations at 33 and 38 wk correlated with longer periods of intravenous nutrition. At 57 and 69 wk, lower retinol and RBP correlated with higher birth order. Suboptimal vitamin A status may occur for many months after preterm infants are discharged from the hospital.