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Published on: December 31, 2015
Serum retinol levels and neonatal outcomes in preterm infants
Hsing-Jin Chen1, Chyong-Hsin Hsu2, Bor-Luen Chiang3
1Graduate Institute of Clinical Medicine College of Medicine of National Taiwan University, Taipei, Taiwan.
Insights
Glucocorticoids do not impact serum retinol levels in preterm infants. However, low retinol concentrations are linked to increased risks of respiratory issues and delayed neurological development.
Area of Science:
- Neonatal Medicine
- Pediatric Nutrition
- Clinical Research
Background:
- Glucocorticoids are commonly used in preterm infants.
- The impact of glucocorticoids on serum retinol levels in neonates is unknown.
- Low retinol levels are associated with bronchopulmonary dysplasia in premature infants.
Purpose of the Study:
- To investigate the effect of antenatal and postnatal glucocorticoid administration on serum retinol levels in preterm infants.
Main Methods:
- Study included infants <1250g or <29 weeks gestation.
- Low serum retinol defined as <20 μg/dL; retinol deficiency as <10 μg/dL within 48 hours of birth.
- Data collected from 115 infants over 7 years (2005-2012).
Main Results:
- Neither antenatal nor postnatal glucocorticoid use affected retinol concentrations.
- Retinol deficiency correlated with increased risk of severe respiratory distress syndrome and adverse pulmonary outcomes.
- Low retinol levels increased the risk of bronchopulmonary dysplasia.
- Prolonged total parenteral nutrition (>21 days) was linked to retinol deficiency.
- Retinol deficiency was associated with delayed neurological development at 1 and 2 years.
Conclusions:
- Glucocorticoids do not alter serum retinol levels in preterm infants.
- Serum retinol concentrations are significantly correlated with respiratory and neurological outcomes in premature infants.
Background/Purpose:
Glucocorticoids are frequently administered to preterm infants, both antenatally and postnatally; however, the effect on serum retinol levels has not been determined. The risk of bronchopulmonary dysplasia is increased in premature infants with low retinol concentrations.
Objectives:
Our purpose was to determine the effect of glucocorticoid administration on serum retinol levels in preterm infants.
Methods:
All infants <1250 g or <29 weeks' gestation admitted to the neonatal intensive care unit within 48 h of birth were eligible for inclusion. A retinol concentration <20 μg/dL during the first 48 h of birth was defined as low serum retinol, and a level <10 μg/dL as retinol deficiency.
Results:
Data from 115 premature infants were collected during a 7-year period, from 2005 to 2012. Neither antenatal nor postnatal steroid administration affected retinol concentrations. Retinol deficiency was associated with an increased risk for severe respiratory distress syndrome and adverse pulmonary outcome (death during the first 28 days of life and long-term oxygen dependence >90 days); low retinol levels conferred an increased risk for bronchopulmonary dysplasia. Prolonged duration of total parenteral nutrition (>21 days) was associated with serum retinol deficiency during hospitalization (P < 0.05). Retinol deficiency was associated with an increased risk for delayed neurological development in 1-year-old and 2-year-old children.
Conclusion:
Glucocorticoids do not affect retinol levels in premature infants, but retinol concentrations are correlated with respiratory and neurological outcomes.
