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. MATERIALS AND 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.
Subject(s)
Bronchopulmonary Dysplasia/prevention & control , Injections, Intramuscular , Vitamin A Deficiency/drug therapy , Vitamin A/administration & dosage , Vitamin A/blood , Birth Weight , Female , Humans , Infant, Extremely Low Birth Weight , Infant, Newborn , Infant, Premature , Linear Models , Male , Retinol-Binding Proteins/genetics , Retinol-Binding Proteins/metabolism , Retrospective Studies , Sepsis/microbiology , Treatment OutcomeABSTRACT
OBJECTIVE: We tested the hypothesis that term and preterm infants exposed to maternal infection at the time of delivery are at increased risk of developing cerebral palsy (CP). STUDY DESIGN: A population-based case-control study was conducted using Washington State birth certificate data linked to hospital discharge data. Cases (688) were children Subject(s)
Cerebral Palsy/etiology
, Infant, Premature, Diseases/etiology
, Pregnancy Complications, Infectious
, Case-Control Studies
, Chorioamnionitis/complications
, Cystitis/complications
, Female
, Fever/complications
, Humans
, Infant, Newborn
, Infant, Premature
, Pregnancy
, Risk Factors
, Urinary Tract Infections/complications
