• Journal Article

Vitamin A Supplementation in Extremely Low-Birth-Weight Infants: Subgroup Analysis in Small-for-Gestational-Age Infants

Citation

Londhe, V. A., Nolen, T., Das, A., Higgins, R. D., Tyson, J. E., Oh, W., & Devaskar, S. U. (2013). Vitamin A Supplementation in Extremely Low-Birth-Weight Infants: Subgroup Analysis in Small-for-Gestational-Age Infants. American Journal of Perinatology, 30(9), 771 - 780. DOI: 10.1055/s-0032-1333410

Abstract

Objective Preterm infants with intrauterine growth restriction are at increased risk of respiratory distress syndrome and bronchopulmonary dysplasia (BPD). A randomized clinical trial by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Neonatal Research Network demonstrated that vitamin A supplementation in extremely low-birth-weight (ELBW) preterm infants requiring early respiratory support decreased the risk of developing BPD. Study Design A subgroup analysis of small-for-gestational-age (SGA) infants from the original NICHD trial was performed to test the hypothesis that in infants requiring early respiratory support, vitamin A supplementation decreases the relative risk of BPD or death in premature SGA infants to a greater extent than in gestational age-equivalent vitamin A-treated appropriate-for-gestational-age (AGA) infants. Results Although vitamin A supplementation significantly increased serum retinol concentrations in AGA ELBW infants (median [5th percentile, 95th percentile]: 16.3 [-7.0, 68.8] versus 2.4 [-13.9, 55.1]; p < 0.001), no increases were noted in SGA ELBW infants. Conclusions Given the limited power of this analysis due to a low number of SGA infants, these data did not provide evidence to support the hypothesis that vitamin A supplementation in preterm SGA infants requiring early respiratory support decreases the relative risk of BPD or death as compared with preterm AGA infants