Vitamin A supplementation in premature neonates with postnatal lung injury. Italian Collaborative Group on Preterm Delivery (ICGPD).

Vitamin A is widely used in neonatal intensive care units (NICU) to prevent and reduce lung injury in premature infants who require mechanical ventilation. As part of a project to assess the management in NICU, this study was designed to establish whether vitamin A supplementation in neonates at risk for bronchopulmonary dysplasia (BPD) increased and maintained their plasma levels to at least 20 micrograms/dl. Twenty-five preterm babies, 24-34 weeks gestation, 600-1,770 g birth weight, received 1,000 IU/day of vitamin A intravenously for the first 28 days of life. At birth the majority had plasma vitamin A lower than 20 micrograms/dl which rapidly rose during supplementation. Even though expected therapeutic plasma concentrations were reached in the majority of infants without exceeding the toxic level, no association was found between vitamin A plasma concentrations and maternal or newborns characteristics at delivery and clinical status or outcome of infants. Thus, even if dosage schedule may be furtherly optimized to reach and maintain wanted therapeutic ranges, the efficacy of routine therapeutic vitamin A supplementation has to be adequately proved.