Randomised controlled trial of oral vitamin A supplementation in preterm infants to prevent chronic lung disease.
BACKGROUND
Intramuscular supplementation with vitamin A in large doses may reduce the incidence of chronic lung disease.


OBJECTIVE
To investigate whether oral supplementation with vitamin A would reduce the incidence of chronic lung disease in a group of extremely low birthweight infants.


METHODS
Infants 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.


RESULTS
A 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.


CONCLUSIONS
Oral 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.
Wardle
S P
SP
Liverpool Women's Hospital, Liverpool L8 7SS, UK. s.p.wardle@liverpool.ac.uk
Hughes
A
A
Chen
S
S
Shaw
N J
NJ
D002908:Chronic Disease; D004311:Double-Blind Method; D004374:Ductus Arteriosus, Patent / Q000188:drug therapy; D020345:Enterocolitis, Necrotizing / Q000188:drug therapy; D006801:Humans; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000628:therapy*; D019102:Infant, Very Low Birth Weight; D020300:Intracranial Hemorrhages / Q000188:drug therapy; D008171:Lung Diseases / Q000628:therapy*; D010102:Oxygen Inhalation Therapy; D011446:Prospective Studies; D012178:Retinopathy of Prematurity / Q000188:drug therapy; D018709:Statistics, Nonparametric; D016896:Treatment Outcome; D014801:Vitamin A / Q000097:blood / Q000627:therapeutic use*
D014801:Vitamin A