VitaminA, E, and D deficiencies in tunisian very low birth weight neonates: prevalence and risk factors
Samira Fares1, Mohamed Marouane Sethom1, Chahnez Khouaja-Mokrani2
1UR05/08-08, Department of Biochemistry, Rabta Hospital and Faculty of Medicine of Tunis, El Manar University, 1007 Tunis, Tunisia.
Insights
Very low birth weight (VLBW) neonates in Tunisia have alarmingly high rates of vitamin A, E, and D deficiencies. These deficiencies are linked to maternal health conditions like pre-eclampsia, necessitating improved prenatal care and infant supplementation.
Area of Science:
- Neonatology
- Nutritional Science
- Public Health
Background:
- Preterm neonates, particularly very low birth weight (VLBW) infants, face significant risks of vitamin deficiencies.
- These deficiencies can lead to increased morbidity and mortality in vulnerable newborns.
Purpose of the Study:
- To determine the prevalence of vitamin A, E, and D deficiencies in Tunisian VLBW neonates.
- To identify risk factors associated with these deficiencies in this population.
Main Methods:
- A study involving 607 VLBW neonates and 300 term neonates.
- Plasma vitamin A and E levels measured using high-performance liquid chromatography.
- Plasma vitamin D levels measured using radioimmunoassay.
Main Results:
- VLBW neonates exhibited significantly higher prevalence of vitamin A (75.9%), E (71.3%), and D (65.2%) deficiencies compared to term neonates.
- Deficiency rates correlated with lower gestational age and birth weight.
- Vitamin E deficiency linked to pre-eclampsia and gestational diabetes; Vitamin D deficiency linked to twin pregnancy and pre-eclampsia.
Conclusions:
- Vitamin A, E, and D deficiencies are highly prevalent in Tunisian VLBW neonates.
- Maternal pre-eclampsia is a significant associated factor for both vitamin E and D deficiencies.
- Enhanced maternal nutritional support and high-dose vitamin supplementation for VLBW infants are crucial in Tunisia.
Background:
Preterm neonates are at high risk of vitamin deficiencies, which may expose them to increased morbidity and mortality. This study aimed to determine the prevalence and risk factors for vitamin A, E, and D deficiencies in Tunisian very low birth weight (VLBW) neonates.
Methods:
A total of 607 VLBW and 300 term neonates were included in the study. Plasma vitamins A and E were assessed by high performance liquid chromatography and vitamin D was assessed by radioimmunoassay.
Results:
Prevalence of vitamin A, E, and D deficiencies were dramatically elevated in VLBW neonates and were significantly higher than term neonates (75.9% vs. 63.3%; 71.3% vs. 55.5%; and 65.2% vs. 40.4%, respectively). In VLBW neonates, the prevalence of vitamin deficiencies was significantly higher in lower classes of gestational age and birth weight. Vitamin E deficiency was associated with pre-eclampsia [odds ratio (OR) (95% confidence interval, 95% CI), 1.56 (1.01-2.44); p < 0.01] and gestational diabetes [4.01 (1.05-17.0); p < 0.01]. Vitamin D deficiency was associated with twin pregnancy [OR (95% CI), 2.66 (1.33-5.35); p < 0.01] and pre-eclampsia [2.89 (1.36-6.40); p < 0.01].
Conclusion:
Vitamin A, E, and D deficiencies are very common in Tunisian VLBW neonates and are associated with pre-eclampsia. Improved nutritional and health support for pregnant women and high dose vitamins A, E, and D supplementation in VLBW neonates are strongly required in Tunisia.
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