Clinical effects of L-carnitine supplementation on apnea and growth in very low birth weight infants.
OBJECTIVE
Systemic carnitine deficiency may present with apnea, hypotonia, and poor growth. Premature infants often manifest these symptoms and are at risk of developing carnitine deficiency because of immaturity of the biosynthetic pathway, lack of sufficient predelivery transplacental transport, and lack of sufficient exogenous supplementation. This study was undertaken to examine the effect of carnitine supplementation in premature infants.


METHODS
Eighty preterm infants <1500 g were enrolled in a prospective, double-blind, placebo-controlled study of carnitine supplementation within 96 hours of delivery. Growth, length of hospital stay, and frequency and severity of apnea were the primary outcome measures.


RESULTS
Weight gain and change in length, fronto-occipital head circumference, mid arm circumference, and triceps skinfold thickness were similar between the carnitine-supplemented and placebo groups. The amount and severity of apnea and the overall length of hospitalization were also similar between the 2 groups. The carnitine levels in the supplemented group were significantly higher than in the placebo group at 4 and 8 weeks after study entry.


CONCLUSIONS
Although preterm infants <1500 g have low carnitine levels, routine supplementation with carnitine has no demonstrable effect on growth, apnea, or length of hospitalization and thus seems to be unnecessary.
Whitfield
Jonathan
J
Division of Neonatology, Department of Pediatrics, Baylor University Medical Center, Dallas, Texas 75246, USA. jonathaw@baylorhealth.edu
Smith
Twyala
T
Sollohub
Heather
H
Sweetman
Lawrence
L
Roe
Charles R
CR
D001049:Apnea / Q000628:therapy*; D001238:Asphyxia Neonatorum / Q000628:therapy; D002331:Carnitine / Q000097:blood* / Q000494:pharmacology / Q000627:therapeutic use*; D002657:Child Development / Q000187:drug effects* / Q000502:physiology; D006128:Growth / Q000187:drug effects* / Q000502:physiology; D006801:Humans; D007227:Infant Nutritional Physiological Phenomena; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight / Q000097:blood* / Q000254:growth & development; D007262:Infusions, Intravenous; D007363:Intensive Care Units, Neonatal; D007902:Length of Stay; D010288:Parenteral Nutrition; D012121:Respiration, Artificial; D016896:Treatment Outcome
D002331:Carnitine