Vitamin A Supplementation Improves Retinal Function in Infants at Risk of Retinopathy of Prematurity

详细信息    查看全文

• 作者：Helen Mactier ; MD¹ ; ^{helen.mactier@ggc.scot.nhs.uk} ; Daphne L. McCulloch ; PhD² ; Ruth Hamilton ; PhD³ ; ⁵ ; Peter Galloway ; MB ; ChB⁶ ; Michael S. Bradnam ; PhD³ ; David Young ; PhD⁸ ; Timothy Lavy ; MBBS⁷ ; Lesley Farrell ; MSc² ; Lawrence T. Weaver ; MD⁴
• 关键词：DHA ; Docosahexanoic acid ; ERG ; Electroretinogram ; GA ; Gestational age ; IM ; Intramuscular ; MEBM ; Maternal expressed breast milk ; PMA ; Postmenstrual age ; RDR ; Relative dose response ; ROP ; Retinopathy of prematurity
• 刊名：The Journal of Pediatrics
• 出版年：2012
• 出版时间：June, 2012
• 年：2012
• 卷：160
• 期：6
• 页码：954-959.e1
• 全文大小：394 K

文摘

| Figures/TablesFigures/Tables | ReferencesReferences

Objective

Preterm infants show reduced retinal sensitivity at term corrected age compared with newborn term infants. We tested the hypothesis that retinal sensitivity in preterm infants is improved by early, high-dose vitamin A.

Study design

We report a double-blind, randomized controlled trial of infants <32 weeks¡¯ gestation and/or <1501 g birth weight. Supplemented infants received additional intramuscular vitamin A 10?000 IU 3 times weekly from day 2 for a minimum of 2 weeks or until establishment of oral feeding. Hepatic stores were assessed by relative dose response (RDR). The primary outcome measure was cone-corrected dark-adapted retinal rod sensitivity measured by electroretinogram at 36 weeks¡¯ postmenstrual age (PMA).

Results

Eighty-nine infants (42 supplemented and 47 controls) were recruited. Plasma retinol was higher in supplemented infants at 7 and 28 days (median, 1.0 vs 0.5 ¦Ìmol/L and 0.7 vs 0.6 ¦Ìmol/L; P < .001 and .03, respectively). Neither plasma retinol nor RDR differed between groups at 36 weeks¡¯ PMA. Retinal sensitivity was greater in supplemented infants (?0.81 vs ?0.61 log cd ? s ? m^?2; P < .03) and was not related to RDR.

Conclusions

Early high-dose intramuscular vitamin A supplementation for infants at risk of retinopathy of prematurity improves retinal function at 36 weeks¡¯ PMA.