Serum tocopherol levels in very preterm infants after a single dose of vitamin E at birth.
OBJECTIVE
Our aim was to examine the impact of a single enteral dose of vitamin E on serum tocopherol levels. The study was undertaken to see whether a single dose of vitamin E soon after birth can rapidly increase the low α-tocopherol levels seen in very preterm infants. If so, this intervention could be tested as a means of reducing the risk of intracranial hemorrhage.


METHODS
Ninety-three infants <27 weeks' gestation and <1000 g were randomly assigned to receive a single dose of vitamin E or placebo by gastric tube within 4 hours of birth. The vitamin E group received 50 IU/kg of vitamin E as dl-α-tocopheryl acetate (Aquasol E). The placebo group received sterile water. Blood samples were taken for measurement of serum tocopherol levels by high-performance liquid chromatography before dosing and 24 hours and 7 days after dosing.


RESULTS
Eighty-eight infants received the study drug and were included in the analyses. The α-tocopherol levels were similar between the groups at baseline but higher in the vitamin E group at 24 hours (median 0.63 mg/dL vs. 0.42 mg/dL, P = .003) and 7 days (2.21 mg/dL vs 1.86 mg/dL, P = .04). There were no differences between groups in γ-tocopherol levels. At 24 hours, 30% of vitamin E infants and 62% of placebo infants had α-tocopherol levels <0.5 mg/dL.


CONCLUSIONS
A 50-IU/kg dose of vitamin E raised serum α-tocopherol levels, but to consistently achieve α-tocopherol levels >0.5 mg/dL, a higher dose or several doses of vitamin E may be needed.
Department of Pediatrics, University of Iowa, 200 Hawkins Dr, Iowa City, IA 52242. edward-bell@uiowa.edu.
Edward F
EF
Bell
Nellie I
NI
Hansen
Luc P
LP
Brion
Richard A
RA
Ehrenkranz
Kathleen A
KA
Kennedy
Michele C
MC
Walsh
Seetha
S
Shankaran
Michael J
MJ
Acarregui
Karen J
KJ
Johnson
Ellen C
EC
Hale
Lynn A
LA
Messina
Margaret M
MM
Crawford
Abbot R
AR
Laptook
Ronald N
RN
Goldberg
Krisa P
KP
Van Meurs
Waldemar A
WA
Carlo
Brenda B
BB
Poindexter
Roger G
RG
Faix
David P
DP
Carlton
Kristi L
KL
Watterberg
Dan L
DL
Ellsbury
Abhik
A
Das
Rosemary D
RD
Higgins
D015415:Biomarkers / Q000097:blood; D002851:Chromatography, High Pressure Liquid; D004334:Drug Administration Schedule; D004750:Enteral Nutrition; D005260:Female; D006801:Humans; D062071:Infant, Extremely Premature / Q000097:blood*; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy*; D008297:Male; D024505:Tocopherols / Q000627:therapeutic use*; D016896:Treatment Outcome; D014811:Vitamin E Deficiency / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy*; D014815:Vitamins / Q000627:therapeutic use*; D024502:alpha-Tocopherol / Q000097:blood*
D015415:Biomarkers; D014815:Vitamins; D024502:alpha-Tocopherol; D024505:Tocopherols
preterm infants; vitamin E