Related Experiment Videos
Serum tocopherol levels in very preterm infants after a single dose of vitamin E at birth
Edward F Bell1, Nellie I Hansen, Luc P Brion
1Department of Pediatrics, University of Iowa, 200 Hawkins Dr, Iowa City, IA 52242. edward-bell@uiowa.edu.
Insights
A single enteral dose of vitamin E increased serum tocopherol levels in very preterm infants. However, a higher dose or multiple doses may be necessary to consistently achieve optimal alpha-tocopherol levels.
Area of Science:
- Neonatal Medicine
- Nutritional Science
- Pediatric Pharmacology
Background:
- Very preterm infants often have low serum alpha-tocopherol levels shortly after birth.
- Low tocopherol levels in neonates are associated with increased risk of complications, including intracranial hemorrhage.
- Early postnatal interventions are crucial for improving outcomes in extremely premature infants.
Purpose of the Study:
- To evaluate the impact of a single enteral dose of vitamin E on serum tocopherol concentrations in very preterm infants.
- To determine if a single early postnatal dose of vitamin E can rapidly elevate low alpha-tocopherol levels.
- To assess the potential of vitamin E supplementation as a strategy to reduce neonatal complications.
Main Methods:
- A randomized controlled trial involving 93 infants (<27 weeks gestation, <1000 g) was conducted.
- Infants received either a single 50 IU/kg enteral dose of vitamin E (dl-α-tocopheryl acetate) or placebo within 4 hours of birth.
- Serum tocopherol levels were measured using high-performance liquid chromatography at baseline, 24 hours, and 7 days post-dose.
Main Results:
- Serum alpha-tocopherol levels were significantly higher in the vitamin E group compared to placebo at 24 hours (P = .003) and 7 days (P = .04).
- While vitamin E increased levels, 30% of infants in the supplemented group still had levels below 0.5 mg/dL at 24 hours.
- No significant differences in gamma-tocopherol levels were observed between the groups.
Conclusions:
- A single 50 IU/kg enteral dose of vitamin E effectively raises serum alpha-tocopherol levels in very preterm infants.
- Achieving consistently therapeutic alpha-tocopherol levels (>0.5 mg/dL) may require higher doses or multiple administrations of vitamin E.
- Further research is warranted to optimize vitamin E dosing strategies for this vulnerable population.
Objective:
Our aim was to examine the impact of a single enteral dose of vitamin E on serum tocopherol levels. The study was undertaken to see whether a single dose of vitamin E soon after birth can rapidly increase the low α-tocopherol levels seen in very preterm infants. If so, this intervention could be tested as a means of reducing the risk of intracranial hemorrhage.
Methods:
Ninety-three infants <27 weeks' gestation and <1000 g were randomly assigned to receive a single dose of vitamin E or placebo by gastric tube within 4 hours of birth. The vitamin E group received 50 IU/kg of vitamin E as dl-α-tocopheryl acetate (Aquasol E). The placebo group received sterile water. Blood samples were taken for measurement of serum tocopherol levels by high-performance liquid chromatography before dosing and 24 hours and 7 days after dosing.
Results:
Eighty-eight infants received the study drug and were included in the analyses. The α-tocopherol levels were similar between the groups at baseline but higher in the vitamin E group at 24 hours (median 0.63 mg/dL vs. 0.42 mg/dL, P = .003) and 7 days (2.21 mg/dL vs 1.86 mg/dL, P = .04). There were no differences between groups in γ-tocopherol levels. At 24 hours, 30% of vitamin E infants and 62% of placebo infants had α-tocopherol levels <0.5 mg/dL.
Conclusions:
A 50-IU/kg dose of vitamin E raised serum α-tocopherol levels, but to consistently achieve α-tocopherol levels >0.5 mg/dL, a higher dose or several doses of vitamin E may be needed.
Related Concept Videos
01:07Teratogenicity
01:29Drug Dosing: Infants and Children
01:11Bioavailability Study Design: Single Versus Multiple Dose Studies