Vitamin A supplementation in extremely low-birth-weight infants: subgroup analysis in small-for-gestational-age infants.
Vitamin A supplementation in extremely low-birth-weight infants: subgroup analysis in small-for-gestational-age infants.
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DOI：
10.1055/s-0032-1333410
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发表时间：
2013-10
影响因子：
2
通讯作者：
Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network
中科院分区：
文献类型：
--
作者：
Londhe VA;Nolen TL;Das A;Higgins RD;Tyson JE;Oh W;Devaskar SU;Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network
宫内生长受限的早产儿发生呼吸窘迫综合征和支气管肺发育不良的风险增加。Eunice Kennedy Shriver国家儿童健康和人类发展研究所（NICHD）新生儿研究网络的一项随机临床试验表明，需要早期呼吸支持的极低出生体重（ELBW）早产儿补充维生素A可降低发生BPD的风险。对来自最初NICHD试验的小于胎龄儿（SGA）进行亚组分析，以检验以下假设：在需要早期呼吸支持的婴儿中，维生素A补充剂降低早产SGA婴儿BPD或死亡的相对风险的程度大于胎龄相当的维生素A治疗的适于胎龄儿（阿加）婴儿。尽管补充维生素A显著增加了阿加ELBW婴儿的血清视黄醇浓度（中位数[第5百分位数，第95百分位数]：16.3 [-7.0，68.8] vs 2.4 [-13.9，55.1]; p < 0.001），但在SGA ELBW婴儿中没有观察到增加。由于SGA婴儿数量较少，该分析的效力有限，因此这些数据未提供证据支持以下假设：与早产阿加婴儿相比，需要早期呼吸支持的早产SGA婴儿补充维生素A可降低BPD或死亡的相对风险。
Preterm infants with intrauterine growth restriction are at increased risk of respiratory distress syndrome and bronchopulmonary dysplasia (BPD). A randomized clinical trial by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Neonatal Research Network demonstrated that vitamin A supplementation in extremely low-birth-weight (ELBW) preterm infants requiring early respiratory support decreased the risk of developing BPD. A subgroup analysis of small-for-gestational-age (SGA) infants from the original NICHD trial was performed to test the hypothesis that in infants requiring early respiratory support, vitamin A supplementation decreases the relative risk of BPD or death in premature SGA infants to a greater extent than in gestational age–equivalent vitamin A–treated appropriate-for-gestational-age (AGA) infants. Although vitamin A supplementation significantly increased serum retinol concentrations in AGA ELBW infants (median [5th percentile, 95th percentile]: 16.3 [−7.0, 68.8] versus 2.4 [−13.9, 55.1]; p < 0.001), no increases were noted in SGA ELBW infants. Given the limited power of this analysis due to a low number of SGA infants, these data did not provide evidence to support the hypothesis that vitamin A supplementation in preterm SGA infants requiring early respiratory support decreases the relative risk of BPD or death as compared with preterm AGA infants.
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