title: Vitamin E levels during early iron supplementation in preterm infants.
abstract: On the basis of preliminary data, this larger bi-institutional continuation trial evaluating the efficacy and safety of early iron supplementation in preterm infants calls attention to the levels of vitamin E, a marker of antioxidant activity, during iron treatment. A total of 116 preterm infants were randomly assigned to receive at 2 or 4 weeks of age ( N = 62, N = 54, respectively) 5 mg/kg/d of nonionic iron polymaltose complex concomitantly with a daily dose of 25 IU vitamin E (as dl-alpha-tocopherol acetate) from 2 weeks of age. Vitamin E (alpha-tocopherol) levels, iron, ferritin, hemoglobin concentration, and reticulocyte count were recorded from 2 to 8 weeks of age. The morbidities of prematurity associated with free radicals formation were also documented. A gradual increase of alpha-tocopherol levels within physiological range (0.8 to 3.5 mg/dL) was found in the 2-week and 4-week groups during the study period with no difference among the groups ( P > 0.05 for all comparisons). At 8 weeks of age, iron and ferritin levels, hemoglobin concentration, and reticulocyte count were higher in the 2-week group. No correlation was observed between timing of both iron and vitamin E supplement and hemolysis or morbidities associated with prematurity. Thus, treatment of iron with vitamin E supplement at 2 weeks of age is, in our experience, an efficacious and safe treatment for improving anemia in preterm infants.
authors.affiliation: Department of Neonatology, Meir Medical Center, Kfar Saba, Israel.
authors.forename: Shmuel
authors.initials: S
authors.lastname: Arnon
authors.forename: Rivka H
authors.initials: RH
authors.lastname: Regev
authors.forename: Sofia
authors.initials: S
authors.lastname: Bauer
authors.forename: Ruth
authors.initials: R
authors.lastname: Shainkin-Kestenbaum
authors.forename: Yakov
authors.initials: Y
authors.lastname: Shiff
authors.forename: Yoram
authors.initials: Y
authors.lastname: Bental
authors.forename: Tzipora
authors.initials: T
authors.lastname: Dolfin
authors.forename: Ita
authors.initials: I
authors.lastname: Litmanovitz
mesh_terms: D000367:Age Factors; D019587:Dietary Supplements; D005293:Ferritins / Q000097:blood; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature / Q000097:blood*; D007501:Iron / Q000097:blood / Q000627:therapeutic use*; D011446:Prospective Studies; D017701:Reticulocyte Count; D014810:Vitamin E / Q000008:administration & dosage / Q000097:blood*; D024502:alpha-Tocopherol / Q000097:blood
chemical_list: D006454:Hemoglobins; D014810:Vitamin E; D005293:Ferritins; D007501:Iron; D024502:alpha-Tocopherol