Vitamin A Supplementation for Extremely Low Birth Weight Infants

Abstract Extremely low birth weight (ELBW) infants are born with low vitamin A stores, which are associated with higher risk for bronchopulmonary dysplasia (BPD). This trial randomized ELBW infants requiring mechanical ventilation or supplemental oxygen at 24 hours to either 12 intramuscular injections of 5000 IU vitamin A or sham procedures. Infants in the vitamin A group demonstrated a reduced the rate of death or BPD at 36 weeks’ postmenstrual age (55% versus 62%; adjusted relative risk [RR] 0.89, 95% confidence interval [CI] 0.80 to 0.99, p = 0.03). The reduction was mostly due to a reduced rate of BPD in survivors (47% versus 56%; RR 0.85, 95% CI 0.73 to 0.98, p = 0.03). The proportion of infants with serum retinol values below 20 μg/dL (0.70 μmol/L), indicating suboptimal levels, at 28 days was lower in the vitamin A group than in the control group (25% versus 54%; p < 0.001).