Randomised controlled trial of oral vitamin A supplementation in preterm infants to prevent chronic lung disease
S P Wardle, A Hughes, S Chen, N J Shaw
Liverpool Women's
Hospital, Liverpool L8 7SS, UK
Correspondence to: Dr Wardle, Department of Child Health, Liverpool Women's Hospital, Crown Street, Liverpool L8 7SS, UK s.p.wardle{at}liverpool.ac.uk
Accepted 27 July 2000
BACKGROUND
Intramuscular
supplementation with vitamin A in large doses may reduce the incidence
of chronic lung disease.
AIMTo investigate whether oral supplementation with
vitamin A would reduce the incidence of chronic lung disease in a group
of extremely low birthweight infants.
METHODSInfants with
birth weight < 1000 g were randomised at birth to receive oral
vitamin A supplementation (5000 IU/day) or placebo for 28 days. The
primary outcome was oxygen dependency at 28 days of age or death.
RESULTSA total of 154 infants were randomised; 77 received vitamin A (median birth weight
(interquartile range) 806 (710-890) g), and 77 received placebo
(median birth weight (interquartile range) 782 (662-880) g). Plasma
vitamin A concentrations in the supplemented group were significantly
higher at 24 hours of age but did not differ significantly at birth, 12 hours of age, 7 days, or 28 days of life. There were no significant
differences in the proportion of infants who survived, required oxygen
at 28 days, required oxygen at 36 weeks postmenstrual age, survived
without chronic lung disease at 36 weeks, survived without significant
retinopathy, or who survived without significant intraventricular haemorrhage.
CONCLUSIONSOral
supplementation with 5000 IU vitamin A in extremely low birthweight
infants does not significantly alter the incidence of chronic lung
disease. However, this dose may have been inadequate to achieve optimal
serum retinol concentrations.
Keywords: chronic lung disease; lungs; preterm; vitamin A; retinol
© 2001 by Archives of Disease in Childhood
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