Effect of vitamin E in prevention of intraventricular hemorrhage in preterm neonates

Abstract

Background:Germinal matrix-intraventricular hemorrhage (IVH) is the most common brain hemorrhage in preterm neonates. The importance of this hemorrhage lies in its severe complications. There is no definite treatment for IVH in neonates; therefore, the prevention of IVH should be considered. Some studies have shown that Vitamin E can probably decrease the risk of IVH and the other study has not shown its efficacy. The aim of this study is to evaluate the effects of Vitamin E on incidence and severity of IVH in preterm neonates.Methods:This study is a randomized clinical trial conducted on 76 neonates with gestational age of ≤30 weeks in the Isfahan University of Medical Science. The neonates were divided into two groups. The group one was administered with 10 units of Vitamin E for 3 days and the second group with placebo. In the 4th and 7th days after birth, brain sonography was conducted to evaluate IVH. The presence of sepsis, incidence of necrotizing enterocolitis, and hypotension were examined.Results:In this study, 76 neonates with the mean age of 28.49 ± 1.46 weeks participated. The incidence of hemorrhage in the 4th day was 26.3% in cases and 42.1% in controls with no significant difference (P = 0.3). The findings of the second sonography reported the incidence of IVH in 17.1% of cases and 36.8% of control group.Conclusions:Based on findings of the current study, Vitamin E use did not significantly decrease IVH in neonates. Further studies with larger sample size are needed.

Enteral Bioactive Factor Supplementation in Preterm Infants: A Systematic Review

“…Five trials (19%) were judged as with an overall high risk of bias, based on various subdomains ( Figure 2 ) [ 21 , 25 , 26 , 31 , 44 ]. Risk of bias assessment revealed some concerns for 13 trials (50%), as they were not preregistered in trial registries, and no predefined statistical analysis plan and/or study protocol was published for these studies, which precluded selective data reporting judgement.…”

“…Vitamin E is an important radical-scavenging antioxidant and has a regulatory role in the functioning of immune cells [ 48 , 49 ]. The effect of enteral vitamin E supplementation in preterm infants was assessed in three studies, all with a low sample size [ 30 , 31 , 32 ]. In the first study, by Bell et al [ 30 ], a single dose (50 IU/kg) vitamin E (dl-α-tocopheryl acetate) within 4 h postnatally did not have an effect on culture-proven sepsis, NEC, IVH stage ≥3, or mortality rates in preterm infants ( n = 93, Table 2 ).…”

“…In the first study, by Bell et al [ 30 ], a single dose (50 IU/kg) vitamin E (dl-α-tocopheryl acetate) within 4 h postnatally did not have an effect on culture-proven sepsis, NEC, IVH stage ≥3, or mortality rates in preterm infants ( n = 93, Table 2 ). In the second study, by Barekatain et al [ 31 ], 80 preterm infants (GA ≤ 30 weeks) were randomly assigned to receive 10 IU/day vitamin E (form of vitamin E unknown) or placebo for the first 3 postnatal days. The incidences of culture-proven sepsis, clinical sepsis, NEC, IVH grade ≥3, and mortality all tended to be lower in the intervention group, but none of the outcomes reached statistical significance ( Table 2 ).…”

“…Administration of vitamin E for 1 day, 3 days, or 8 weeks did not have an effect of morbidity or mortality outcomes [ 30 , 31 , 32 ]. The serum α-tocopherol levels might have been too low to reveal any effect.…”

Early administration of amino acids with different doses in low birth weight premature infants

“…[ 7 ] Complications such as intraventricular hemorrhage, bronchopulmonary dysplasia (BPD), and their involvements in this process may result in longer period of hospitalization for the newborn and in the long run make the living conditions more difficult. [ 8 9 ] The gastrointestinal function of premature infants has not yet matured, and enteral nutrition provides limited energy. Therefore, PN should be used as early as possible within 24 h after birth.…”