Cord blood concentrations of vitamin A in preterm infants
Introduction
Vitamin A (retinol) is essential for the maintenance of epithelial mucous-secreting and of the ciliated non-secretory cell integrity in the conducting airways, and vitamin A deficiency produces histopathological changes similar to bronchopulmonary dysplasia (BPD) in the tracheobronchial tree [1]. Prematurely born infants have been shown to have low vitamin A concentrations in plasma and umbilical cord blood [2], [3]. The role of vitamin A deficiency in the development of respiratory distress syndrome (RDS) and BPD is controversial.
Our aim was to investigate, whether vitamin A concentrations in cord blood correlate with outcome, especially with the development of RDS and BPD in preterm infants. We also sought to evaluate possible predictive factors, including maternal dietary habits, contributing to deficient concentrations of vitamin A at birth.
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Patients
The study was approved by the Ethical Committee of Tampere University Hospital.
Fifty-six consecutive infants of gestational ages less than 33 weeks were enrolled provided an informed consent was obtained from their parents, and collection of a cord blood sample had succeeded. Data on perinatal problems, including diseases, pregnancy complications and administration of antenatal glucocorticoids were collected from the mothers’ patient records. Gestational ages were determined based on obstetric
Characteristics of infants with low and normal vitamin A concentrations
Vitamin A concentrations lower than 1.05 μmol/l were measured in umbilical blood samples from 22 infants and concentrations below 0.7 μmol/l in two cases. The clinical characteristics of the low- and normal vitamin A concentration groups are given in Table 1. There were no significant differences between the groups in gender, birth weight, gestational age and number of SGA infants. The correlation coefficient between gestational ages and vitamin A concentrations was 0.054, P=0.6959.
Almost half
Discussion
Plasma retinol concentrations may remain within normal limits in spite of decreased hepatic stores and the diagnosis of vitamin A deficiency cannot therefore be based on these concentrations alone. Circulating retinol concentrations might be indirectly depressed due to lowered levels of the vitamin A-carrying protein in cases with a high risk of protein/calorie malnutrition as in preterm infants [9]. Measurement of retinol-binding protein (RBP), the determination of the plasma retinol/RBP molar
References (28)
- et al.
Clinical trial of vitamin A supplementation in infants susceptible to bronchopulmonary dysplasia
J Pediatr
(1987) - et al.
Serum vitamin A in premature and term neonates
J Pediatr
(1978) - et al.
Plasma vitamin A and retinol-binding protein in premature and term neonates
J Pediatr
(1981) - et al.
Vitamin A status of preterm infants: correlation between plasma retinol concentration and retinol dose response
Am J Clin Nutr
(1987) - et al.
Use of the intramuscular relative dose–response test to predict bronchopulmonary dysplasia in premature infants
Am J Clin Nutr
(1996) - et al.
Trial of vitamin A supplementation in very low birth weight infants at risk for bronchopulmonary dysplasia
J Pediatr
(1992) - et al.
Comparison of enteral and intramuscular vitamin A supplementation in preterm infants
Early Hum Dev
(1992) - et al.
Relationship of vitamin A (retinol) status to lung disease in the preterm infant
J Pediatr
(1984) The placental metabolism of vitamin A
Am J Obstet Gynecol
(1951)- et al.
Liver concentrations of vitamin A and carotenoids, as a function of age and other parameters, of American children who died of various causes
Am J Clin Nutr
(1984)
Essential fatty acid status in plasma phospholipids of mother and neonate after multiple pregnancy
Prostaglandins Leukotr Essent Fatty Acids
Simultaneous determination of retinol and alpha-tocopherol in serum and plasma by liquid chromatography
Clin Chem
Concurrent liquid chromatography assay of retinol, tocopherol, carotene, lycopene and cryptoxanthine in plasma with tocopherol acetate as internal standard
Clin Chem
The lungs and vitamin A
Am J Physiol
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2013, Seminars in Fetal and Neonatal MedicineCitation Excerpt :From the plethora of published data, it can be concluded that a plasma retinol concentration of <0.35 μmol/l (10 mg/dl) in a preterm infant almost certainly indicates depletion of hepatic stores, and that plasma retinol concentrations ≥0.7 μmol/l (20 μg/dl) are probably indicative of vitamin A sufficiency,25,38 at least in those infants who have not received postnatal steroids. Placental cord and infant blood concentrations of vitamin A are increased by antenatal and postnatal steroids respectively9,15,39; in the rat model this increase in serum retinol is at the expense of pulmonary and hepatic stores and is only seen in vitamin A-sufficient subjects.40 Conversely, both hepatic and pulmonary stores of vitamin A were greater in those ELBW infants who had received postnatal steroids in addition to i.m. vitamin A, compared with vitamin A-supplemented infants who had not received postnatal steroids.15
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