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Vitamin E and preterm infants.
1Division of Neonatology, Department of Pediatrics, Osaka Medical and Pharmaceutical University, Takatsuki, Osaka, Japan.
Free Radical Biology & Medicine
|December 6, 2021
Summary
Evaluating vitamin E (VE) status in preterm infants requires comparison with healthy term infants, not adults, and assessment by gestational age. Past VE supplementation trials in preterm infants yielded limited success, necessitating a re-evaluation before new trials.
Area of Science:
- Neonatal Medicine
- Nutritional Science
- Pediatric Research
Background:
- Vitamin E (VE) nutritional status in preterm infants is complex and requires careful comparison with healthy term infants, considering gestational age (GA) rather than birth weight (BW).
- Limited historical data show no significant correlation between GA and VE concentrations in various infant tissues.
- Preterm infants exhibit lower oxidizability of polyunsaturated fatty acids (PUFAs), suggesting a different role for VE.
Purpose of the Study:
- To review the current understanding of vitamin E status in preterm infants.
- To evaluate the efficacy of past vitamin E supplementation trials for diseases like retinopathy of prematurity (ROP), bronchopulmonary dysplasia (BPD), and intraventricular hemorrhage (IVH).
- To determine the relevance of historical data in the context of modern neonatal intensive care and propose future research directions.
Main Methods:
- Literature review of studies on vitamin E in preterm infants.
- Analysis of historical clinical trials of VE supplementation.
- Discussion of recent advances in neonatal medicine and pathophysiology of ROP, BPD, and GMH-IVH.
Main Results:
- Past VE supplementation trials in preterm infants, primarily conducted before the surfactant era, showed limited benefits, with some exceptions for IVH prevention.
- Current understanding of VE status in preterm infants is limited by a lack of data on hepatic VE levels.
- Reactive oxygen species (ROS)-induced damage is implicated in BPD and ROP development, with antioxidants showing promise in animal models.
Conclusions:
- Historical VE supplementation trial results are not directly applicable to modern neonatal care due to significant changes in treatment protocols and patient populations.
- Further research is needed to understand VE's role in modern neonatal medicine, considering advancements in oxygen supplementation and disease management.
- Vitamin E may be a valuable complementary therapy for ROP, BPD, and GMH-IVH when combined with other treatments, warranting re-investigation due to its safety profile.
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