Is routine vitamin E administration justified in very low-birthweight infants?
Analysis of nine randomised controlled trials of prophylactic vitamin E supplementation in very low-birthweight infants (less than 1500g) showed no statistically significant reduction in the incidence of acute retinopathy of prematurity. There was a significant reduction (49 per cent) in the incidence of intraventricular haemorrhage, but no clear evidence for a corresponding reduction in intracerebral haemorrhage and no reduction in the incidence of haemorrhage confined to the germinal matrix. By combining the estimated reduction with the known incidence of long-term neurological disability associated with intracranial haemorrhage alone, it was shown that only 1.5 per cent (point estimate) and not more than about 4 per cent of all very low-birthweight infants are likely to benefit from routine vitamin E supplementation. In view of this, and data suggesting toxicity of vitamin E at concentrations close to those considered therapeutic, the routine use of vitamin E in very low-birthweight infants is not justified on present evidence. Only large randomised trials can establish whether currently used vitamin E preparations do more good than harm.
Department of Environmental and Preventive Medicine, Medical College of St. Bartholomew's Hospital, Charterhouse Square, London.
M R
MR
Law
K
K
Wijewardene
N J
NJ
Wald
D002543:Cerebral Hemorrhage / Q000517:prevention & control*; D005500:Follow-Up Studies; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D016032:Randomized Controlled Trials as Topic; D012178:Retinopathy of Prematurity / Q000517:prevention & control*; D012307:Risk Factors; D014810:Vitamin E / Q000008:administration & dosage* / Q000009:adverse effects
D014810:Vitamin E