A trial of vitamin A therapy to facilitate ductal closure in premature infants

J Pediatr. 2003 Nov;143(5):644-8. doi: 10.1067/S0022-3476(03)00501-8.

Abstract

Objective: To determine whether postnatal vitamin A therapy increased ductal closure rate in premature infants.

Study design: This was a prospective, double-blind, placebo-controlled trial. Subjects (n=40) were recruited on day of life 1. Inclusion criteria were premature neonates weighing 500 to 1500 g with an indwelling umbilical line. Vitamin A was administered intramuscularly on days 1, 3, and 7. Blood vitamin A and retinol binding protein levels were obtained on days 1 and 3. Echocardiography was performed on days 1, 3, 7, and 14. Failure of ductal closure was defined as the presence of a moderate to large patent ductus arteriosus on day 14, indomethacin therapy, or surgical ligation.

Results: Comparison between the treatment and placebo groups revealed no differences in gestational age, weight, or oxygenation index. Vitamin A and retinol binding protein levels did not differ between the groups at entry but increased significantly after vitamin A treatment. Failure of ductal closure occurred in 22 of 40 babies without any difference between the groups (12/22 vs 10/18, P=NS). Four infants required surgical ligation, all in the treatment group (P=.04). Clinical outcome did not vary between groups.

Conclusion: Postnatal vitamin A therapy did not improve ductal closure rates in premature infants.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial

MeSH terms

  • Birth Weight
  • Double-Blind Method
  • Ductus Arteriosus, Patent / diagnosis
  • Ductus Arteriosus, Patent / drug therapy*
  • Electrocardiography
  • Gestational Age
  • Humans
  • Infant, Newborn
  • Infant, Premature
  • Prospective Studies
  • Severity of Illness Index
  • Vitamin A / therapeutic use*

Substances

  • Vitamin A