title: Clinical effects of L-carnitine supplementation on apnea and growth in very low birth weight infants.
abstract: 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.
authors.affiliation: Division of Neonatology, Department of Pediatrics, Baylor University Medical Center, Dallas, Texas 75246, USA. jonathaw@baylorhealth.edu
authors.forename: Jonathan
authors.initials: J
authors.lastname: Whitfield
authors.forename: Twyala
authors.initials: T
authors.lastname: Smith
authors.forename: Heather
authors.initials: H
authors.lastname: Sollohub
authors.forename: Lawrence
authors.initials: L
authors.lastname: Sweetman
authors.forename: Charles R
authors.initials: CR
authors.lastname: Roe
mesh_terms: 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
chemical_list: D002331:Carnitine