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A comparison of three vitamin A dosing regimens in extremely-low-birth-weight infants. J Pediatr 2003 Jun;142(6):656-61

Date

07/03/2003

Pubmed ID

12838194

DOI

10.1067/mpd.2003.214

Scopus ID

2-s2.0-0038132958 (requires institutional sign-in at Scopus site)   70 Citations

Abstract

OBJECTIVE: Vitamin A supplementation reduces bronchopulmonary dysplasia (BPD)/death in extremely low birth weight neonates. It was hypothesized that compared with the standard regimen of 5000 IU 3 times per week for 4 weeks, (1) a higher dose (10,000 IU 3 x per week) would increase serum retinol and retinol binding protein (RBP) and lower relative dose responses (RDR), and (2) once-per-week dosing (15,000 IU once per week) would lead to equivalent levels, RBP, and RDR.

STUDY DESIGN: Extremely low birth weight neonates (n = 120) receiving O(2)/mechanical ventilation at 24 hours were randomly assigned to (1) standard, (2) higher dose, or (3) once-per-week regimens. Measures of vitamin A deficiency were serum retinol <20 microg/dL, RBP <2.5 mg/dL, and/or RDR >10% on day 28. BPD was defined as O(2)/mechanical ventilation at 36 weeks' postmenstrual age.

RESULTS: Groups were similar at enrollment (median gestational age, 25 weeks; birth weight, 689 g). Possible toxicity was seen in <5%. The higher dose regimen did not increase retinol or RBP, decrease RDR, or improve outcomes. Infants in the once-per-week regimen had lower retinol levels and higher RDR without an effect on outcomes.

CONCLUSIONS: Compared with the standard regimen, once-per-week dosing worsened, and higher doses did not reduce, vitamin A deficiency. Therefore, the standard regimen is recommended.

Author List

Ambalavanan N, Wu TJ, Tyson JE, Kennedy KA, Roane C, Carlo WA

Author

Tzong-Jin Wu MD Associate Professor in the Pediatrics department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Bronchopulmonary Dysplasia
Female
Humans
Infant, Newborn
Infant, Premature
Infant, Premature, Diseases
Infant, Very Low Birth Weight
Male
Retinol-Binding Proteins
Vitamin A