Serum tocopherol levels in very preterm infants after a single dose of vitamin E at birth
Bell, E. F., Hansen, N., Brion, L. P., Ehrenkranz, R. A., Kennedy, K. A., Walsh, M. C., ... Higgins, R. D. (2013). Serum tocopherol levels in very preterm infants after a single dose of vitamin E at birth. Pediatrics, 132(6), e1626-e1633. DOI: 10.1542/peds.2013-1684
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 ?-tocopherol levels seen in very preterm infants. If so, this intervention could be tested as a means of reducing the risk of intracranial hemorrhage. <br><br>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-?-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. <br><br>RESULTS: Eighty-eight infants received the study drug and were included in the analyses. The ?-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 ?-tocopherol levels. At 24 hours, 30% of vitamin E infants and 62% of placebo infants had ?-tocopherol levels <0.5 mg/dL. <br><br>CONCLUSIONS: A 50-IU/kg dose of vitamin E raised serum ?-tocopherol levels, but to consistently achieve ?-tocopherol levels >0.5 mg/dL, a higher dose or several doses of vitamin E may be needed.