JOURNAL ARTICLE
REVIEW
Add like
Add dislike
Add to saved papers

Vitamin A supplementation for preventing morbidity and mortality in very low birthweight infants.

BACKGROUND: Vitamin A is necessary for normal lung growth and the ongoing integrity of respiratory tract epithelial cells. Preterm infants have low vitamin A status at birth and this has been associated with increased risk of developing chronic lung disease. Several studies have been undertaken to assess whether vitamin A supplementation beyond that routinely given in multivitamin preparations can reduce the incidence of this outcome.

OBJECTIVES: To assess the benefit of supplementation with vitamin A in very low birthweight infants.

SEARCH STRATEGY: Searches were made of the Oxford Database of Perinatal Trials, MEDLINE up to June 2002, Cochrane Controlled Trials Register (The Cochrane Library, Issue 2, 2002), and Science Citation Index. The reference lists of relevant trials, recent issues of paediatric and nutrition journals, abstracts and proceedings from relevant conferences in the English language were hand searched.

SELECTION CRITERIA: Randomised controlled trials which compared the effects of supplemental vitamin A with standard vitamin A regimes in infants with birthweight
DATA COLLECTION AND ANALYSIS: Data on mortality, requirement for supplemental oxygen at one month of age and at 36 weeks post-menstrual age, retinopathy of prematurity and nosocomial sepsis were excerpted by both reviewers independently. Data analysis was conducted according to the standards of the Cochrane Neonatal Review Group.

MAIN RESULTS: Seven eligible trials were identified, one having a much larger sample size than the others combined. The meta-analysis suggests supplementation with vitamin A results in benefit in terms of reducing death or oxygen requirement at one month of age [summary RR 0.93 (0.88, 0.99), RD -0.05 (-0.10, -0.01), NNT 20 (10, 100) and oxygen requirement at 36 weeks post-menstrual age [summary RR 0.87 (0.77, 0.99), RD -0.07 (-0.14, -0.01), NNT 14 (7, 100)], and trends towards reduction in oxygen requirement in survivors at one month of age [summary RR 0.93 (0.86, 1.01) and death or oxygen requirement at 36 weeks post-menstrual age [summary RR 0.91 (0.83, 1.00)]. Meta-analysis of the three studies from which data on retinopathy of prematurity are available suggests a trend towards reduced incidence in vitamin A supplemented infants.

REVIEWER'S CONCLUSIONS: Supplementing very low birthweight infants with vitamin A is associated with a reduction in death or oxygen requirement at one month of age, and oxygen requirement amongst survivors at 36 weeks post-menstrual age, with this latter outcome being confined to infants with birthweight less than 1000g. Whether clinicians decide to utilise repeat intramuscular doses of vitamin A to prevent chronic lung disease may depend upon the local incidence of this outcome and the value attached to achieving a modest reduction in this outcome, balanced against the lack of other proven benefits and the acceptability of treatment. The benefits, in terms of vitamin A status, safety and acceptability of delivering vitamin A in an intravenous emulsion compared with repeat intramuscular injections, should be assessed in a further trial.

Full text links

We have located links that may give you full text access.
Can't access the paper?
Try logging in through your university/institutional subscription. For a smoother one-click institutional access experience, please use our mobile app.

For the best experience, use the Read mobile app

Mobile app image

Get seemless 1-tap access through your institution/university

For the best experience, use the Read mobile app

All material on this website is protected by copyright, Copyright © 1994-2024 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.

By using this service, you agree to our terms of use and privacy policy.

Your Privacy Choices Toggle icon

You can now claim free CME credits for this literature searchClaim now

Get seemless 1-tap access through your institution/university

For the best experience, use the Read mobile app