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Vitamin A Status in Preterm Infants Is Associated with Inflammation and Dexamethasone Exposure

Madelaine Eloranta Rossholt1,2,3, Kristina Wendel1,3, Marianne Bratlie2

  • 1Department of Neonatal Intensive Care, Oslo University Hospital, 0450 Oslo, Norway.

Nutrients
|January 21, 2023
PubMed

Insights

Very premature infants (<29 weeks gestation) often have vitamin A deficiency, increasing bronchopulmonary dysplasia risk. Inflammation and dexamethasone treatment impact vitamin A levels, requiring careful monitoring in these vulnerable infants.

Area of Science:

  • Neonatalogy
  • Nutritional Biochemistry
  • Pediatric Pulmonology

Background:

  • Vitamin A is crucial for lung development, and deficiency is linked to bronchopulmonary dysplasia risk.
  • Preterm infants, especially those <29 weeks gestation, may have altered vitamin A status.
  • Inflammation and corticosteroid use are common in preterm infants and may affect nutrient levels.

Purpose of the Study:

  • To investigate vitamin A status in preterm infants (<29 weeks gestation).
  • To evaluate the impact of inflammation and postnatal dexamethasone exposure on blood vitamin A concentrations.
  • To analyze factors associated with vitamin A deficiency in early life.

Main Methods:

  • Secondary cohort analysis of the ImNuT trial (NCT03555019).
  • Measurement of vitamin A (retinol) biochemistry, intake, inflammatory markers (interleukin-6), and dexamethasone exposure.
  • Comparison of vitamin A levels between dexamethasone-exposed and unexposed infants.

Main Results:

  • Infants exposed to dexamethasone showed significantly higher vitamin A concentrations after four weeks (1.0 vs. 0.56 µmol/L, p < 0.001).
  • Pretreatment retinol levels were lower in the dexamethasone group, with 88% deficiency at one week versus 60% in the unexposed group.
  • Small size for gestational age, mechanical ventilation, and elevated interleukin-6 were negatively associated with first-week retinol.

Conclusions:

  • Preterm infants (<29 weeks gestation) are at high risk of vitamin A deficiency, even with recommended intakes.
  • Inflammation and dexamethasone exposure significantly influence vitamin A status in preterm infants.
  • Clinical interpretation of vitamin A status requires consideration of inflammatory markers and dexamethasone treatment.

Keywords:
bronchopulmonary dysplasiadexamethasoneinflammationpreterm infantvitamin A

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