Premature infants require additional folate and vitamin B-12 to reduce the severity of the anemia of prematurity

Abstract

One hundred eighty-four premature infants, < 1800 g at birth and < 36 wk gestation, were entered into a study investigating the role of additional folate and vitamin B-12 supplementation of the anemia of prematurity. All patients initially received vitamin E and iron in accordance with accepted standards. Patients were randomly assigned to four groups to receive orally 0.1 mg folate/d for 4 mo, 100 micrograms vitamin B-12 intramuscularly monthly for 4 mo, both supplements, or neither. All other activities including parenteral nutrition were carried out according to established practices, irrespective of study group. By 10-12 wk, infants treated with vitamin B-12 alone or combined with folate had higher hemoglobin values than the untreated (P < 0.0005) or solely folate-treated (P < 0.01) groups. These findings held true irrespective of wide variations in treatment and feeding practices. The only uncontrolled hematologic nutritional factor, selenium, showed a similar pattern of decline for 10-12 wk in all study patients, whether or not they received additional vitamin supplements.

Urinary Selenium Excretion in Infancy: Comparison between Term and Preterm Infants

“…Sick preterm infants are thought to be at risk of developing low Se levels during early life due to the small Se stores resulting from the short gestation period and from the lim ited dietary intake of Se [1,[3][4][5][6]9]. Previous observations [3][4][5][6]9] showed that blood Se indices fall progressively after birth in pre term infants, unless their diet is supple mented with Se.…”

“…Previous observations [3][4][5][6]9] showed that blood Se indices fall progressively after birth in pre term infants, unless their diet is supple mented with Se. The postnatal change in uri nary Se in our preterm infants was strikingly different from that of the term infants.…”

Cobalamin status in children

“…at 6 weeks was associated with a normal cobalamin status at 4 months (median serum cobalamin 420 pmol/L; median plasma tHcy 4.57 µmol/L) (Bjorke- Monsen et al 2008). This dose represents approximately twice the RDA of cobalamin for the first year of life (Table 1) and has been associated with increased hemoglobin levels (Worthingtonwhite et al 1994) and reduced tHcy and MMA levels in premature infants (Bjørke- Monsen et al, unpublished observations 2003). In severe cobalamin deficiency, different regimes have been proposed (Rasmussen et al 2001).…”

Quelle place reste-t-il pour l’érythropoïétine en néonatalogie ?

“…Des apports de folates (100 μg/kg par jour) et vitamine B12 (100 μg/kg par mois) sans Epo augmentent l'érythro-poïèse chez le nouveau-né prématuré [39].…”