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Oral vitamin A supplementation for ROP prevention in VLBW preterm infants
Francesca Garofoli1, Donatella Barillà2, Micol Angelini1
1Neonatal Unit and Neonatal Intensive Care Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
Insights
Oral vitamin A supplementation in very low birth weight (VLBW) infants significantly reduced severe retinopathy of prematurity (ROP). This intervention lowered the need for ROP treatment, highlighting vitamin A
Area of Science:
- Neonatalogy
- Ophthalmology
- Nutritional Science
Background:
- Retinopathy of prematurity (ROP) is a significant cause of visual impairment in preterm infants.
- Vitamin A is crucial for visual development, and its deficiency is linked to ROP.
- Previous studies suggested vitamin A may decrease ROP, but oral administration's efficacy in VLBW infants needed further evaluation.
Discussion:
- This study compared oral vitamin A (retinol palmitate) supplementation in VLBW infants with a control group.
- While ROP incidence was similar, severe ROP (grade ≥2) was significantly lower in the vitamin A-supplemented group.
- Fewer supplemented infants required treatment for ROP, indicating a potential protective effect.
Key Insights:
- Oral vitamin A supplementation reduced the incidence of severe ROP (grade ≥2) by 88% in VLBW infants.
- No infants in the vitamin A group required ROP treatment, compared to 16.6% in the control group.
- The study suggests oral vitamin A is a viable option for preventing severe ROP in preterm infants.
Outlook:
- Further clinical trials are warranted to confirm the benefits of oral vitamin A administration for mitigating ROP severity.
- Investigating optimal dosage and duration for oral vitamin A supplementation in VLBW infants is crucial.
- This research may influence clinical guidelines for ROP prevention in vulnerable preterm populations.
Abstract:
Vitamin A administration may decrease any stage of retinopathy of prematurity (ROP) in preterm infants. To evaluate whether vitamin A oral supplementation could be preventive in ROP incidence and severity in VLBW infants, we compared results from 31 preterm infants, (< 1500 g or < 32 weeks) who, during a previous investigation, prospectively received 3000 UI/kg/die oral retinol palmitate drops, for 28 days, with 31 matching preterm newborns hospitalized in our NICU the same period, as control group. Although ROP incidence was similar, in the supplemented group, we had 9 cases of ROP grade 1, no ROP grade ≥ 2, in the un-supplemented group, 4 cases of ROP grade 1 and 6 ROP grade ≥ 2 (p = 0.018). The percentage of babies requiring treatment for ROP was 0 in treated and 16.6 in the un-treated group (p = 0.020). Moreover, Vitamin A administration showed a protective effect with an 88% risk reduction of developing severe ROP. Since vitamin A parenteral/IM administration presents some awareness, the results of this investigation may be important to plan further trials to confirm the usefulness of oral administration in mitigating the ROP severity of VLBW infants.ClinicalTrials.gov NCT02102711; may 03/06/2014.
