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Vitamin E and selenium in preterm infants: lack of effect on clinical patency of ductus arteriosus
N Rudolph1, M S Schiller, S L Wong
1Department of Pediatrics, State University of New York Health Science Center, Brooklyn.
Insights
Vitamin E supplementation did not affect the closure of the ductus arteriosus in preterm infants. This study found no correlation between vitamin E levels and patent ductus arteriosus in sick neonates.
Area of Science:
- Neonatal physiology
- Antioxidant research
- Perinatal medicine
Background:
- Fetal and neonatal antioxidant defenses, including vitamin E and selenium-dependent glutathione peroxidase (GSH-Px), are typically low.
- Vitamin E and Se-dependent GSH-Px influence eicosanoid biosynthesis, potentially impacting ductus arteriosus patency or closure postnatally.
Purpose of the Study:
- To evaluate antioxidant defense indices in sick low birth weight (LBW) infants in relation to each other and patent ductus arteriosus (PDA).
- To investigate the effect of rapid serum vitamin E level increase on PDA in these infants.
Main Methods:
- Twenty-nine sick preterm infants (750-1750 g BW) were randomized into control and vitamin E supplemented groups.
- The supplemented group received intramuscular dl-alpha-tocopherol (175 mg/kg over four weeks) starting within 12 hours of birth.
- Serum tocopherol levels, antioxidant indices (alpha-tocopherol, Se, GSH-Px, NPS), and clinical PDA were monitored.
Main Results:
- Vitamin E supplementation rapidly increased serum tocopherol levels in infants.
- No significant influence of vitamin E supplementation on the clinical patency or closure of the ductus arteriosus was observed.
- No correlation was found between serum levels of alpha-tocopherol, Se, GSH-Px, or NPS and the presence of PDA.
Conclusions:
- Vitamin E supplementation does not appear to affect ductus arteriosus patency or closure in sick preterm infants.
- There is no established correlation between key antioxidant indices and PDA in this vulnerable population.
- Further research may be needed to explore other factors influencing ductus arteriosus management in neonates.
Abstract:
Levels of antioxidant defenses, which include vitamin E and Se-dependent GSH-Px, are generally relatively low in the fetus and neonate. Se-dependent GSH-Px and vitamin E are known to modulate biosynthesis of eicosanoids and therefore could have the potential for affecting patency or closure of the ductus arteriosus after birth. We evaluated some indices of antioxidant defense in sick LBW infants in relationship to one another as well as to clinical PDA, and investigated the effects of producing a rapid rise in serum vitamin E levels in some of these infants. Twenty-nine sick preterm infants (B. W. 750-1750 g) were randomized into control and vitamin E supplemented groups; the latter received dl-alpha-tocopherol IM., commencing within 12 hours of birth, to a total dosage of 175 mg/kg over four weeks. Most E-supplemented infants attained serum tocopherol levels greater than 0.50 mg/dl (12 mumol/l) within 24 hours of the first dose. Vitamin E supplementation did not influence clinical patency or closure of the ductus arteriosus, and no correlation could be established between serum levels of alpha-tocopherol, Se, GSH-Px or NPS and PDA. At 4 weeks vitamin E-supplemented infants had serum levels of the other antioxidant indices that were not significantly different from the non-supplemented babies.