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Umbilical cord blood plasma vitamin A levels in low birth weight (LBW) babies
K M Adhikari1, B L Somani2, Suprita Kalra3
1Senior Advisor (Paediatric) INHS Dhanvantari, Port Blair.
Insights
Vitamin A levels are significantly lower in preterm low birth weight (LBW) infants. Supplementing LBW babies with vitamin A may reduce neonatal morbidity and mortality.
Area of Science:
- Neonatal nutrition
- Pediatric vitamin research
Background:
- Vitamin A supplementation is known to reduce infant mortality, particularly in low birth weight (LBW) infants.
- Objective measurement of vitamin A levels in neonates, especially LBW babies, is crucial for evidence-based recommendations.
Purpose of the Study:
- To investigate cord blood vitamin A levels in LBW neonates.
- To compare vitamin A levels between preterm LBW, LBW-term small for gestational age (SGA), and normal birth weight infants.
- To explore the correlation between vitamin A levels and birth weight in LBW infants.
Main Methods:
- Analyzed cord blood plasma vitamin A (retinol) levels using High-Performance Liquid Chromatography (HPLC).
- Included 154 LBW infants (birth weight 1505-2455g) and 55 normal birth weight infants.
- Subdivided LBW infants into preterm LBW and LBW-term SGA groups.
Main Results:
- Preterm LBW infants (n=92) exhibited significantly lower mean cord blood vitamin A levels compared to normal birth weight (n=55) and LBW-term SGA (n=62) infants.
- No significant difference in vitamin A levels was found between normal birth weight and LBW-term SGA groups.
- A significant positive correlation was observed between cord blood vitamin A levels and birth weight in all LBW infants (n=154; r=0.37, P < 0.0001).
Conclusions:
- Preterm LBW infants demonstrate significantly lower cord blood vitamin A levels, which correlate with birth weight.
- Evidence suggests a link between vitamin A deficiency and neonatal morbidity.
- Further research is needed to establish vitamin A level norms and evaluate the benefits of postnatal vitamin A supplementation for LBW infants.
Background:
Role of vitamin A in reducing the mortality in infants more than six months of age is well known. Supplementing newborn infants with vitamin A within 48 hours of birth reduces infant mortality by almost a quarter, with the greatest benefit to those of low birth weight (LBW). Studies that could highlight deficiency states in neonates, particularly LBW babies by objective measurement of vitamin A levels would help in formulating the recommendations to supplement these babies with vitamin A.
Methods:
Cord blood plasma vitamin A levels of 154 LBW babies with birth weight in the range of 1505-2455 were analysed for plasma vitamin A (retinol) levels by HPLC method. Samples of 55 babies with normal birth weight were also analysed. LBW babies were divided into two subgroups of preterm LBW and LBW-term small for gestational age (SGA).
Results:
Of the 154 babies with LBW, 92 were preterm LBW and 52 were LBW-term SGA. Mean cord blood plasma vitamin A levels were significantly lower in the preterm LBW group (n = 92) compared to levels observed in babies with normal birth weight (n = 55) and LBW-term SGA subgroups (n = 62). There was no significant difference in the mean vitamin A values between the normal birth weight babies and LBW-term SGA group. There was significant positive correlation of cord blood vitamin A levels with birth weight in the entire set of (n = 154) LBW babies (r=0.37, P < 0.0001).
Conclusion:
This study revealed significantly lower cord blood vitamin A levels in the preterm LBW babies. The level of vitamin A in LBW babies also correlated with their birth weight. There are enough evidence to support causative association between vitamin A deficiency state and neonatal morbidity. Simple interventions like vitamin A supplementation during a crucial stage of an infant's life may be beneficial in the long run. There is a need to establish norms for vitamin A levels and seriously examine the role of vitamin A supplementation for LBW babies during the immediate postnatal period.
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