Deficiency of vitamin A (retinol) has been suggested as an
important contributing cause in the pathogenesis of bronchopulmonary
dysplasia (BPD) in premature newborns with
severe lung disease. Although the efficacy of vitamin A supple-
mentation has yet to be clearly confirmed, it is widely employed,
at different dosages and schedules, in neonatal intensive
care units (NICU). Since in Italy today no suitable formulation
of vitamin A is available, the present observational
study was designed to define the profile of plasma vitamin A
and retinol-binding protein (RBP) concentrations in supplemented
infants at risk for BPD admitted to seven Italian
NICU. Twelve babies (average 27 weeks of gestation, birth
weight 1,008 g), supplemented with vitamin A, were observed
with sequential measurements of retinol and RBP up to 28
days of age. At birth retinol and RBP plasma concentrations
were both adequate in the infants and half their mothers’ levels.
During supplementation the levels rose with wide variability
according to the differences in dosing and timing in the
different units. Plasma levels of retinol and RBP were the
same in infants who had BPD and those who did not. A routine
standardized therapeutic approach using vitamin A supplementation
in Italian NICU will be more than welcome.
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