Protective effect of vitamin E on intraventricular haemorrhage in the newborn.

Forty-four consecutively born babies of birth weights under 1751 g were randomly selected to receive a daily intramuscular injection of vitamin E (all-rac-alpha-tocopheryl acetate) from the day of birth (Day 0) until Day 3, or were allocated to a non-supplemented control group. Frequent ultrasound examinations of the brain were made during the first week of life and babies were classified as having 'no haemorrhage', 'subependymal haemorrhage (SEH) only' or 'intraventricular haemorrhage' (IVH). The incidence of SEH or IVH was similar in supplemented (42.9%) and control babies (43.5%). SEH or IVH was observed only in babies of less than 32 weeks gestation; when only babies under 32 weeks were considered, IVH was less common in those supplemented (18.8%) than in the controls (56.3%). Babies with IVH had lower median plasma vitamin E concentrations when compared with babies without any haemorrhage and compared with those with only SEH. Three supplemented babies suffered IVH and they were the three with the lowest plasma vitamin E concentrations among the babies supplemented with vitamin E from Day 0 to Day 3. We speculate that vitamin E protects endothelial cell membranes of capillaries in the subependymal layer of the brain against oxidative damage and disruption and thereby limits the magnitude of haemorrhage in the subependymal layer, and reduces the risk of extension into the ventricles.