Oral vitamin A supplementation for ROP prevention in VLBW preterm infants

Francesca Garofoli, Donatella Barillà, Micol Angelini, Iolanda Mazzucchelli, Annalisa De Silvestri, Rosanna Guagliano, Lidia Decembrino, Chryssoula Tzialla, Francesca Garofoli, Donatella Barillà, Micol Angelini, Iolanda Mazzucchelli, Annalisa De Silvestri, Rosanna Guagliano, Lidia Decembrino, Chryssoula Tzialla

Abstract

Vitamin A administration may decrease any stage of retinopathy of prematurity (ROP) in preterm infants. To evaluate whether vitamin A oral supplementation could be preventive in ROP incidence and severity in VLBW infants, we compared results from 31 preterm infants, (< 1500 g or < 32 weeks) who, during a previous investigation, prospectively received 3000 UI/kg/die oral retinol palmitate drops, for 28 days, with 31 matching preterm newborns hospitalized in our NICU the same period, as control group. Although ROP incidence was similar, in the supplemented group, we had 9 cases of ROP grade 1, no ROP grade ≥ 2, in the un-supplemented group, 4 cases of ROP grade 1 and 6 ROP grade ≥ 2 (p = 0.018). The percentage of babies requiring treatment for ROP was 0 in treated and 16.6 in the un-treated group (p = 0.020). Moreover, Vitamin A administration showed a protective effect with an 88% risk reduction of developing severe ROP. Since vitamin A parenteral/IM administration presents some awareness, the results of this investigation may be important to plan further trials to confirm the usefulness of oral administration in mitigating the ROP severity of VLBW infants.ClinicalTrials.gov NCT02102711; may 03/06/2014.

Keywords: Retinopathy of prematurity (ROP); Very low birth weight (VLBW) infant; Vitamin A.

Conflict of interest statement

The authors declare that have no competing interest.

References

    1. Fang JL, Sorita A, Carey WA, Colby CE, Murad MH, Alahdab F. Interventions to prevent retinopathy of prematurity: a meta-analysis. Pediatrics. 2016;137(4):e20153387. doi: 10.1542/peds.2015-3387.
    1. Sun H, Cheng R, Wang Z. Early vitamin a supplementation improves the outcome of retinopathy of prematurity in extremely preterm infants. Retina. 2019. 10.1097/IAE.0000000000002543.
    1. Ugurbas SC, et al. Comparison of UK and US screening criteria for detection of retinopathy of prematurity in a developing nation. J AAPOS. 2010;14(6):506–510. doi: 10.1016/j.jaapos.2010.07.012.
    1. The International Classification of Retinopathy of Prematurity revisited International Committee for the Classification of retinopathy of prematurity. Arch Ophthalmol. 2005;123(7):991–999. doi: 10.1001/archopht.123.7.991.
    1. Sankar MJ, Sankar J, Chandra P. Anti-vascular endothelial growth factor (VEGF) drugs for treatment of retinopathy of prematurity. Cochrane Database Syst Rev. 2018;2018(1):CD009734.
    1. Aranda JV, Qu J, Valencia GB. Beharry KD pharmacologic interventions for the prevention and treatment of retinopathy of prematurity. Semin Perinatol. 2019;43(6):360–366. doi: 10.1053/j.semperi.2019.05.009.
    1. Garofoli F, Mazzucchelli I, Decembrino L, Bartoli A, Angelini M, Broglia M, et al. Levels and effectiveness of oral retinol supplementation in VLBW preterm infants. Int J Immunopathol Pharmacol. 2018;32:2058738418820484. doi: 10.1177/2058738418820484.
    1. Koletzko B. Poindexter B and Uauy R recommended nutrient intake levels for stable, fully enterally fed very low birth weight infants. World Rev Nutr Diet. 2014;110:297–299. doi: 10.1159/000360195.
    1. Yang SN. Nutritional approach to the prevention of complications of prematurity with emphasis on vitamin a supplementation. Pediatr Neonatol. 2014;55:331–332. doi: 10.1016/j.pedneo.2014.04.005.
    1. Mactier H, McCulloch DL, Hamilton R, Galloway P, Bradnam MS, Young D, et al. Vitamin a supplementation improves retinal function in infants at risk of retinopathy of prematurity. J Pediatr. 2012;160:954–959. doi: 10.1016/j.jpeds.2011.12.013.

Source: PubMed

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