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Relationship of vitamin A (retinol) status to lung disease in the preterm infant
Insights
Many preterm infants are born with vitamin A deficiency, indicated by low retinol levels. This deficiency may increase the risk of developing bronchopulmonary dysplasia, a chronic lung disease.
Area of Science:
- Neonatology
- Nutritional Science
- Pediatric Pulmonology
Background:
- Preterm infants often experience nutritional deficiencies.
- Vitamin A is crucial for immune function and tissue repair.
Purpose of the Study:
- To investigate vitamin A status in preterm infants.
- To determine the relationship between vitamin A levels and the development of bronchopulmonary dysplasia (BPD).
Main Methods:
- Measured plasma concentrations of retinol and retinol-binding protein (RBP) at birth and serially up to 21 days in 91 preterm infants.
- Compared vitamin A levels between infants with and without respiratory distress syndrome (RDS) and BPD.
Main Results:
- 64% of preterm infants had retinol levels below 20 micrograms/dl at birth, indicating vitamin A deficiency.
- Infants who developed BPD had significantly lower retinol concentrations at birth and on day 21 compared to those without BPD.
- Retinol-binding protein levels were lower on day 3 in infants with RDS.
Conclusions:
- Vitamin A deficiency is common in preterm infants at birth.
- Inadequate vitamin A status may contribute to the development of chronic lung disease, such as BPD, in preterm infants.
- Correction of vitamin A deficiency may be important for preventing BPD in this vulnerable population.
Abstract:
Plasma concentrations of retinol and retinol-binding protein were measured at birth in 91 preterm infants. In 64% of these babies retinol values were less than 20 micrograms/dl, suggestive of vitamin A deficiency. Forty-seven of these infants were observed with sequential measurements of retinol and retinol binding protein through 21 days of age. In babies with respiratory distress syndrome retinol values were similar to those in babies without respiratory distress syndrome. The retinol binding protein levels were lower on the third day of life in babies with respiratory distress syndrome. Babies who developed bronchopulmonary dysplasia had lower concentrations of retinol at birth (P less than 0.05) and on day 21 (P less than 0.05) than did babies who did not develop bronchopulmonary dysplasia, despite receiving recommended intakes of vitamin A. Many preterm infants are deficient in vitamin A at birth, and failure to correct this deficiency may contribute to the development of chronic lung disease.