title: Vitamin A status after prophylactic intramuscular vitamin A supplementation in extremely low birth weight infants.
abstract: BACKGROUND
  Vitamin A supplementation (VAS) is recommended to prevent bronchopulmonary dysplasia (BPD). Our objective was to evaluate the effect of VAS on vitamin A (VA) status. We hypothesized that VAS would improve VA status in extremely low birth weight (ELBW) infants.
  
  
  METHODS
  Retrospective chart review of infants 1 year before and after initiation of VAS (5000 IU 3 times a week intramuscularly [IM]; total 12 doses). Linear regression was used to model impact of VAS on VA status (retinol level and retinol/retinol binding protein [RBP] ratio). Models were adjusted for time and generalized estimating equations were used to account for intraindividual correlation.
  
  
  RESULTS
  Sixty-seven infants (mean gestational age 26 ± 2 weeks; mean body weight 803 ± 142 g) were included; 35 received VAS and 32 did not (no-VAS). Both groups had similar baseline characteristics. Infants who received VAS had mean retinol levels that were 9.0 mcg/dL (95% confidence interval [CI], 4.9-13.2; P < .001) higher and mean retinol/RBP ratios that were 0.21 (95% CI, 0.07-0.36; P = .005) higher than the no-VAS group. Retinol and retinol/RBP ratio increased with time (P < .001). Fewer infants in the VAS group had VA deficiency (retinol/RBP ratios <0.7) compared with the no-VAS group. Culture-positive sepsis was more common in the VAS group (48% vs 12%; P = .002).
  
  
  CONCLUSIONS
  VA status in ELBW infants was improved and maintained over the first month of life with IM VAS. Because of concerns for potential risks of repeated injections, further studies are indicated to evaluate the optimal mode of VA delivery in preterm infants.
authors: Department of Pediatrics, University of Washington School of Medicine, Seattle, WA 98195, USA. schabra@uw.edu
authors: Shilpi
authors: S
authors: Chabra
authors: Dennis E
authors: DE
authors: Mayock
authors: Joan
authors: J
authors: Zerzan
authors: Rachel
authors: R
authors: Bittner
authors: Michael D
authors: MD
authors: Neufeld
authors: Christine A
authors: CA
authors: Gleason
mesh_terms: D001724:Birth Weight; D001997:Bronchopulmonary Dysplasia / Q000517:prevention & control*; D005260:Female; D006801:Humans; D052577:Infant, Extremely Low Birth Weight; D007231:Infant, Newborn; D007234:Infant, Premature; D007273:Injections, Intramuscular; D016014:Linear Models; D008297:Male; D012177:Retinol-Binding Proteins / Q000235:genetics / Q000378:metabolism; D012189:Retrospective Studies; D018805:Sepsis / Q000382:microbiology; D016896:Treatment Outcome; D014801:Vitamin A / Q000008:administration & dosage* / Q000097:blood*; D014802:Vitamin A Deficiency / Q000188:drug therapy*
chemical_list: D012177:Retinol-Binding Proteins; D014801:Vitamin A
keywords: extremely low birth weight infant; premature infant; retinol; retinol-binding proteins; vitamin A supplementation