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Vitamin E in the Preterm Infant: A Forgotten Cause of Hemolytic Anemia

Enrique Gomez-Pomar1, Emily Hatfield2, Karen Garlitz3

  • 1Division of Neonatology, Department of Pediatrics, University of Kentucky, Lexington, Kentucky.

American Journal of Perinatology
|October 11, 2017
PubMed

Insights

Some preterm infants still develop hemolytic anemia despite vitamin E supplementation. Those with low hematocrit and high reticulocyte counts may benefit from additional vitamin E therapy.

Area of Science:

  • Neonatalogy
  • Hematology
  • Nutritional Science

Background:

  • Vitamin E deficiency is linked to hemolytic anemia in premature infants.
  • Supplementation in preterm formulas and parenteral nutrition reduced incidence.
  • Some infants still develop hemolytic anemia requiring treatment.

Purpose of the Study:

  • To identify factors associated with vitamin E treatment response in preterm infants with hemolytic anemia.
  • To determine predictors of adequate response to vitamin E therapy.

Main Methods:

  • Retrospective analysis of 70 preterm infants with hemolytic anemia treated with vitamin E.
  • Infants classified into responders and non-responders.
  • Descriptive statistics and marginal logistic regression used.

Main Results:

  • Low hematocrit and high reticulocytosis before treatment predicted adequate response.
  • Hematocrit ≤26% and reticulocyte count ≥36.1% were associated with better response.
  • Short duration of parenteral nutrition and oxygen use were not associated with response.

Conclusions:

  • Preterm infants may develop hemolytic anemia despite standard vitamin E supplementation.
  • Additional vitamin E may benefit infants with anemia, reticulocytosis, and oxygen requirements.
Abstract

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