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Vitamin A status after prophylactic intramuscular vitamin A supplementation in extremely low birth weight infants

Shilpi Chabra1, Dennis E Mayock, Joan Zerzan

  • 1Department of Pediatrics, University of Washington School of Medicine, Seattle, WA 98195, USA. schabra@uw.edu

Nutrition in Clinical Practice : Official Publication of the American Society for Parenteral and Enteral Nutrition
|March 7, 2013
PubMed

Insights

Vitamin A supplementation (VAS) improved vitamin A (VA) status in extremely low birth weight (ELBW) infants. However, the study noted increased sepsis risk with intramuscular injections, suggesting further research into optimal VA delivery methods.

Area of Science:

  • Neonatal Medicine
  • Nutritional Science
  • Pediatric Critical Care

Background:

  • Bronchopulmonary dysplasia (BPD) is a common complication in extremely low birth weight (ELBW) infants.
  • Vitamin A supplementation (VAS) is recommended to prevent BPD.
  • The impact of VAS on vitamin A (VA) status in ELBW infants requires further investigation.

Purpose of the Study:

  • To evaluate the effect of VAS on VA status in ELBW infants.
  • To determine if VAS improves retinol levels and retinol/retinol binding protein (RBP) ratios.
  • To assess the incidence of VA deficiency in infants receiving VAS.

Main Methods:

  • Retrospective chart review of ELBW infants before and after VAS initiation.
  • Intramuscular VAS administered at 5000 IU three times weekly for 12 doses.
  • Linear regression and generalized estimating equations used to model VA status (retinol and retinol/RBP ratio).

Main Results:

  • Infants receiving VAS showed significantly higher mean retinol levels (9.0 mcg/dL) and retinol/RBP ratios (0.21) compared to the no-VAS group.
  • VAS was associated with a reduced incidence of VA deficiency.
  • Culture-positive sepsis was more frequent in the VAS group (48% vs. 12%).

Conclusions:

  • Intramuscular VAS improved and maintained VA status in ELBW infants during the first month of life.
  • Concerns regarding the risks of repeated injections warrant further studies on optimal VA delivery methods.
  • The findings highlight a potential trade-off between improved VA status and increased infection risk with IM VAS.
Abstract

Keywords:
extremely low birth weight infantpremature infantretinolretinol-binding proteinsvitamin A supplementation

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