Causes of Prematurity

Brown, Estelle W.

doi:10.1001/archpedi.1946.02020280027004

Cited by 14 publications

(2 citation statements)

References 5 publications

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“…We chose ␣ ‫ס‬ 0.05 and ␤ ‫ס‬ 0.20. These parameters and the selected data indicated enrolling at least nine patients per group (13,14). We chose to enroll twice as many patients per group because of the risk of clinical problems that might prevent sample collections and because of potential processing and measuring complications.…”

Section: Power Analysismentioning

confidence: 99%

A Modified Vitamin Regimen for Vitamin B2, A, and E Administration in Very‐Low–Birth‐Weight Infants

Porcelli,

Greene,

Adcock

2004

J. pediatr. gastroenterol. nutr.

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Introduction:Very‐low–birth‐weight (VLBW; birth weight, <1,500 g) infants receive preterm infant formulas and parenteral multivitamin preparations that provide more riboflavin (vitamin B2) than does human milk and more than that recommended by the American Society of Clinical Nutrition. VLBW infants who are not breast‐fed may have plasma riboflavin concentrations up to 50 times higher than those in cord blood. The authors examined a vitamin regimen designed to reduce daily riboflavin intake, with the hypothesis that this new regimen would result in lower plasma riboflavin concentrations while maintaining lipid‐soluble vitamin levels.Methods:Preterm infants with birth weight ≤1,000 g received either standard preterm infant nutrition providing 0.42 to 0.75 mg riboflavin/kg/day (standard group), or a modified regimen providing 0.19 to 0.35 mg/kg/day (modified group). The modified group parenteral vitamin infusion was premixed in Intralipid®. Enteral feedings were selected to meet daily riboflavin administration guidelines. Plasma riboflavin, vitamin A, and vitamin E concentrations were measured weekly by high‐performance liquid chromatography. Data were analyzed with the independent t test, χ2, and analysis of variance.Results:The 36 infants (17 standard group, 19 modified group) had birth weight and gestational age of 779 ± 29 g and 25.5 ± 0.3 weeks (mean ± SEM) with no differences between groups. Modified group infants received 38% less riboflavin (0.281 ± 0.009 mg/kg/day), 35% more vitamin A (318.3 ± 11.4 μg/kg/day), and 14% more vitamin E (3.17 ± 0.14 mg/kg/day) than standard group infants. Plasma riboflavin rose from baseline in both groups but was 37% lower in the modified group during the first postnatal month (133.3 ± 9.9 ng/mL). Riboflavin intake and plasma riboflavin concentrations were directly correlated. Plasma vitamin A (0.222 ± 0.022 μg/mL) and vitamin E (22.26 ± 1.61 /mL) concentrations were greater in the modified group.Conclusions:The modified vitamin regimen resulted in reduced riboflavin intake and plasma riboflavin concentration, suggesting plasma riboflavin concentration is partially dose dependent during the first postnatal month in VLBW infants. Modified group plasma vitamin A and vitamin E concentrations were greater during the first month, possibly because the vitamins were premixed with parenteral lipid emulsion. Because of the complexity of this protocol, the authors suggest that a parenteral multivitamin product designed for VLBW infants which uses weight‐based dosing should be developed.

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Section: Power Analysismentioning

confidence: 99%

A Modified Vitamin Regimen for Vitamin B2, A, and E Administration in Very‐Low–Birth‐Weight Infants

Porcelli,

Greene,

Adcock

2004

J. pediatr. gastroenterol. nutr.

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“…To estimate the minimum number of weekly samples needed for analysis, we used power analysis as reviewed by Brown (19). We chose statistical parameters of ␣ ‫ס‬ 0.05 and ␤ ‫ס‬ 0.10.…”

Section: Power Analysismentioning

confidence: 99%

Plasma and Urine Riboflavin During Riboflavin‐Free Nutrition in Very‐Low‐Birth‐Weight Infants

Porcelli,

Rosser,

DelPaggio

et al. 2000

J. pediatr. gastroenterol. nutr.

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BackgroundVery‐low‐birth‐weight (VLBW; birth weight <1500 g) infants receive enteral and parenteral nutriture that provides greater daily riboflavin (vitamin B2) than does term infant nutriture, and elevated plasma riboflavin develops in these infants after birth. The purpose of this study was to measure plasma and urine riboflavin concentrations in VLBW infants during riboflavin‐free nutrition. Our hypothesis was that elevated plasma riboflavin develops in VLBW infants because of high daily intake and immature renal riboflavin elimination.MethodsEighteen clinically healthy VLBW infants received parenteral nutrition and preterm infant formula during the first postnatal month. On postnatal days 10 and 28, the infants received specially prepared riboflavin‐free enteral and parenteral nutrition for the 24‐hour study period. Serial collections of plasma were made at time 0 and at 12 and 24 hours. Urine was collected continuously for the 24‐hour period in 4‐hour aliquots. Samples were analyzed for riboflavin concentration.ResultsDuring the 24‐hour riboflavin‐free study period on postnatal day 10, plasma riboflavin decreased 56% from 185 ± 37 ng/mL (mean ± SEM), and urine riboflavin decreased 75% from 3112 ± 960 mg/mL. Similarly, on postnatal day 28, plasma riboflavin decreased 79% from 184 ± 32 ng/mL, and urine riboflavin concentration decreased 91% from 5092 ± 743 ng/mL during the 24‐hour riboflavin‐free study period. Riboflavin half‐life (t½) was 18.5 hours on postnatal day 10 and decreased 48% by postnatal day 28. Riboflavin elimination was 145.1 ± 20.6 mg/kg per day on postnatal day 10 and increased 40% by postnatal day 28.ConclusionThe VLBW infants who received parenteral nutrition and preterm infant formula had elevated plasma riboflavin on postnatal days 10 and 28. Plasma riboflavin t½ was shorter and renal riboflavin elimination was greater on postnatal day 28 than on postnatal day 10. Plasma riboflavin was normal after 24 hours of riboflavin‐free nutrition. The pattern of plasma and urine riboflavin in VLBW infants suggests a lower daily intake would maintain plasma riboflavin close to normal.

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Fetal and neonatal mortality: Causes and prevention

Mengert

1948

American Journal of Obstetrics and Gynecology

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Causes of Prematurity

Cited by 14 publications

References 5 publications

A Modified Vitamin Regimen for Vitamin B2, A, and E Administration in Very‐Low–Birth‐Weight Infants

A Modified Vitamin Regimen for Vitamin B2, A, and E Administration in Very‐Low–Birth‐Weight Infants

Plasma and Urine Riboflavin During Riboflavin‐Free Nutrition in Very‐Low‐Birth‐Weight Infants

Fetal and neonatal mortality: Causes and prevention

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