title: Vitamin A supplementation for extremely-low-birth-weight infants. National Institute of Child Health and Human Development Neonatal Research Network.
abstract: BACKGROUND
  Vitamin A supplementation may reduce the risk of chronic lung disease and sepsis in extremely-low-birth-weight infants. The results of our pilot study suggested that a dose of 5000 IU administered intramuscularly three times per week for four weeks was more effective than the lower doses given in past trials.
  
  
  METHODS
  We performed a multicenter, blinded, randomized trial to assess the effectiveness and safety of this regimen as compared with sham treatment in 807 infants in need of respiratory support 24 hours after birth. The mean birth weight was 770 g in the vitamin A group and 769 g in the control group, and the respective gestational ages were 26.8 and 26.7 weeks.
  
  
  RESULTS
  By 36 weeks' postmenstrual age, 59 of the 405 infants (15 percent) in the vitamin A group and 55 of the 402 infants (14 percent) in the control group had died. The primary outcome - death or chronic lung disease at 36 weeks' postmenstrual age - occurred in significantly fewer infants in the vitamin A group than in the control group (55 percent vs. 62 percent; relative risk, 0.89; 95 percent confidence interval, 0.80 to 0.99). Overall, 1 additional infant survived without chronic lung disease for every 14 to 15 infants who received vitamin A supplements. The proportions of infants in the vitamin A group and the control group who had signs of potential vitamin A toxicity were similar. The proportion of infants with serum retinol values below 20 microg per deciliter (0.70 micromol per liter) was lower in the vitamin A group than in the control group (25 percent vs. 54 percent, P<0.001).
  
  
  CONCLUSIONS
  Intramuscular administration of 5000 IU of vitamin A three times per week for four weeks reduced biochemical evidence of vitamin A deficiency and slightly decreased the risk of chronic lung disease in extremely-low-birth-weight infants.
authors.affiliation: University of Texas Southwestern Medical Center, Dallas, USA.
authors.forename: J E
authors.initials: JE
authors.lastname: Tyson
authors.forename: L L
authors.initials: LL
authors.lastname: Wright
authors.forename: W
authors.initials: W
authors.lastname: Oh
authors.forename: K A
authors.initials: KA
authors.lastname: Kennedy
authors.forename: L
authors.initials: L
authors.lastname: Mele
authors.forename: R A
authors.initials: RA
authors.lastname: Ehrenkranz
authors.forename: B J
authors.initials: BJ
authors.lastname: Stoll
authors.forename: J A
authors.initials: JA
authors.lastname: Lemons
authors.forename: D K
authors.initials: DK
authors.lastname: Stevenson
authors.forename: C R
authors.initials: CR
authors.lastname: Bauer
authors.forename: S B
authors.initials: SB
authors.lastname: Korones
authors.forename: A A
authors.initials: AA
authors.lastname: Fanaroff
mesh_terms: D002908:Chronic Disease; D003428:Cross Infection / Q000517:prevention & control; D006801:Humans; D007226:Infant Mortality; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight / Q000097:blood; D007273:Injections, Intramuscular; D008171:Lung Diseases / Q000517:prevention & control*; D018805:Sepsis / Q000517:prevention & control; D016037:Single-Blind Method; D014801:Vitamin A / Q000097:blood / Q000627:therapeutic use*
chemical_list: D014801:Vitamin A