Vitamin A Supplementation for Prevention of Bronchopulmonary Dysplasia in Very-Low-Birth-Weight Premature Thai Infants: A Randomized Trial
Pakaphan Kiatchoosakun MD*, Junya Jirapradittha MD*, Charnchai Panthongviriyakul MD*, Tueanjit Khampitak MD*, Puangrat Yongvanit PhD**, Patcharee Boonsiri PhD**
Affiliation : * Department of Pediatrics, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand ** Department of Biochemistry, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
Background : Bronchopulmonary dysplasia (BPD) is one of the most significant complications among very-low-birth-weight
(VLBW) premature infants. Vitamin A deficiency increases the risk of BPD in VLBW infants.
Objective : To assess the effect of vitamin A supplementation for prevention of bronchopulmonary dysplasia in VLBW
premature Thai infants.
Study design : Randomized control trial.
Material and Method: Eighty premature infants weighing <1,500 g who received mechanical ventilation or oxygen
supplementation at 24 hours of age-admitted to Neonatal units of Srinagarind Hospital, Khon Kaen University, Khon Kaen,
Thailand-were assigned to receive either intramuscular vitamin A 5,000 IU 3 times/week (treatment group) or sham procedure
(control group) for four weeks. Serum vitamin A levels were measured before and after administration of the vitamin A.
Results : The baseline of mean serum vitamin A levels were similar in both groups. The mean serum level of vitamin A was
significantly higher in the vitamin A supplemented infants than in the control infants on day 7 (1.41+0.48 vs. 0.92+0.38 μmol/
L, p<0.001), day 14 (1.48+0.90 vs. 0.96+0.36 μmol/L, p = 0.001) and day 28 (1.42+0.63 vs. 0.76+0.30 μmol/L, p<0.001)
after vitamin A supplementation. None of the infants in the vitamin A supplemented group, compared to 5% of the infants in
the control group, had vitamin A level <0.35 μmol/L, (indicating severe vitamin A deficiency) at 28 days. Fewer of the
premature infants in the vitamin A supplemented group required oxygen supplementation at 36 weeks postmenstrual age than
in the control group albeit not statistically significant (22.5 vs. 35% relative risk 0.71; 95% CI 0.40-1.26; p = 0.21).
Supplementation with vitamin A was also associated with a significant reduction in the duration of intubation (10.8+3.1 days
vitamin A supplemented group vs. 26.1+6.4 days control group, p = 0.03), days on oxygen therapy (29.8+5.1 days vitamin
A supplemented group vs. 58.2+9.1 days control group, p = 0.01) and length of hospital stay (61.9+4.2 days vitamin A
supplemented group vs. 88.3+7.2 days control group, p = 0.002).
Conclusion : The dose of vitamin A used in this study reduced biochemical evidence of vitamin A deficiency and, without
complications, resulted in reducing duration of intubation, days of oxygen therapy, and length of hospital stay in premature
infants suffering VLBW.
Keywords : Bronchopulmonary dysplasia, Premature infants, Vitamin A
