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Vitamin E levels in premature infants during and after intravenous multivitamin supplementation
B Phillips1, L S Franck, H L Greene
1Department of Neonatology, Children's Hospital, Oakland, California 94609.
Insights
Higher doses of vitamin E supplementation in premature infants achieved sufficiency faster and maintained higher levels. Lower doses were less effective and led to insufficient vitamin E after discontinuation.
Area of Science:
- Neonatal nutrition
- Pediatric pharmacology
- Vitamin E metabolism
Background:
- Premature infants are at risk for vitamin E deficiency.
- Vitamin E is crucial for infant health and development.
- Standardized supplementation protocols are needed for vulnerable neonates.
Purpose of the Study:
- To evaluate the efficacy of different MVI Pediatric (multivitamin) doses on serum vitamin E levels in premature infants.
- To determine the time to achieve vitamin E sufficiency with varying supplementation levels.
- To assess vitamin E levels after supplementation discontinuation.
Main Methods:
- Serum vitamin E levels were measured in three groups of infants (<1 kg and 1.0-1.5 kg).
- Infants received either 65% or 30% of a vial of MVI Pediatric daily, starting within 12 hours of birth.
- Levels were re-assessed after supplementation cessation in one group.
Main Results:
- Vitamin E sufficiency (≥0.5 mg/dL) was achieved in 48 hours with 65% vial dose and 72 hours with 30% vial dose.
- 56% of infants on the 30% dose had levels <1 mg/dL, compared to 6% on the 65% dose (P < .01).
- Higher serum levels (>3.5 mg/dL) were observed in 31% of infants on the 65% dose versus 0% on the 30% dose (P < .05).
- Vitamin E levels decreased significantly after MVI Pediatric discontinuation, with some infants becoming insufficient.
Conclusions:
- A 65% vial dose of MVI Pediatric effectively achieves and maintains vitamin E sufficiency in premature infants.
- A 30% vial dose may be insufficient, particularly for maintaining levels after discontinuation.
- Optimal vitamin E dosing strategies are critical for preventing deficiency in high-risk neonatal populations.
Abstract:
Serum vitamin E levels were measured in 19 infants weighing 1.0 to 1.5 kg, in 16 infants weighing less than 1 kg who received 65% of a vial (4.6 mg of vitamin E) of multivitamins (MVI Pediatric) daily, and in another group of 16 infants weighing less than 1 kg who received 30% of a vial (2.1 mg of vitamin E) daily. Supplementation was started within 12 hours of birth. Serum vitamin E levels were also measured after supplementation was discontinued in infants who had received 65% of a vial daily. Vitamin E sufficiency (levels equal to or greater than 0.5 mg/dL) was attained after 48 hours of supplementation in all infants receiving 65% of a vial daily and after 72 hours of supplementation in all infants receiving 30% of a vial daily. Vitamin E sufficiency was not maintained in all infants receiving 30% of a vial daily. Of the infants weighing less than 1 kg who received 65% of a vial daily, 31% had serum levels greater than 3.5 mg/dL, whereas no infant weighing less than 1 kg who received 30% of a vial daily had a level greater than 3.5 mg/dL (P less than .05). Of the infants weighing less than 1 kg who received 30% of a vial daily, 56% had levels less than 1 mg/dL v 6% of infants less than 1 kg who received 65% of a vial daily (P less than .01). Vitamin E levels decreased after MVI Pediatric supplementation with 65% of a vial was discontinued (P less than .05). After MVI Pediatric was discontinued, some infants became vitamin E insufficient.