The relationship between umbilical cord blood vitamin A levels and late preterm infant morbidities: a prospective cohort study

Abstract

Background: Low plasma vitamin A levels increases the risk of neonates' morbidity. However, the relationship between umbilical cord blood (UCB) vitamin A levels and late-preterm infant (LPI) consequences is inconclusive. Herein, we attempted to clarify the association between UCB vitamin A levels and LPI morbidities. Methods: We conducted a prospective cohort study of 208 LPI (from 34+0 to 36+6 weeks gestational age) between January 1, 2014 and June 30, 2015. UCB specimens were collected shortly after birth, and vitamin A levels were determined by enzyme-linked immunosorbent assay. Jaundice, sepsis, respiratory distress syndrome, bronchopulmonary dysplasia, necrotizing enterocolitis, and death were recorded. Results: Prevalence of low UCB vitamin A level <0.7 μmol/L was 37.5% in LPI. Cesarean section was an independent risk factor of UCB vitamin A level < 0.7 μmol/L. Nevertheless, UCB vitamin A levels did not correlate with gestational age, birthweight, and gender. UCB vitamin A level < 0.7 μmol/L was not an independent risk factor for hospitalization, oxygen supplementation, hyperbilirubinemia, sepsis and respiratory distress syndrome. However, cesarean section, gestational age < 35 weeks and birthweight < 2500 g were independent risk factors for hospitalization and RDS. In addition, cesarean section increased the risk of oxygen supplementation, while gestational age < 35 weeks increased the risk of hyperbilirubinemia. Conclusions: Cesarean section delivery is an independent risk factor of low UCB vitamin A levels, and increases the risk of RDS. On the basis of our results, there is no association between low vitamin A levels and morbidity of late-preterm infants, including hyperbilirubinemia, sepsis and respiratory distress syndrome. Trial registration: Not applicable. Background Late-preterm infants (LPI) (with gestational age between 34+0 and 36+6 weeks) is common in preterm infants. LPI has a higher morbidity of apnea, respiratory distress, kernicterus [1], and mortality rates when compared to term infants [2, 3]. Pediatricians are responsible for caring for

Gestational Age Is Positively Associated with Retinol and α-Tocopherol in Preterm Infants: The Mediating Role of Birth Weight

“…No sex differences were observed regarding the vitamin status in our study. This is in line with the findings of other studies for retinol [40,45] and α-tocopherol [53]. It is noted that male infants had a lower retinol concentration than females in another study [70]; however, after adjusting for birth weight and length, the difference was not significant [70].…”

“…Although retinol cutoffs for defining a deficiency differ across studies, a retinol concentration of less than 200 µg/mL was considered as a deficiency [15] in this and other studies [11,40,44]. The retinol deficiency of infants in this study (10%) was lower than that reported by others (42-82%) [11,[45][46][47]. Moreover, SGA infants have been reported to have low levels of retinol-binding protein [48], which is well correlated to serum retinol [49].…”

The association between umbilical cord blood fat-soluble vitamin concentrations and infant birth weight

“…This finding suggests that there might be a role of vitamin A in determining birth weight and underscores the importance of vitamin A nutrition in fetal growth. However, some studies have shown that maternal vitamin A concentrations were not associated with birth weight ( 10 , 25 ). The reasons behind these discrepancies might be partly due to different study participants.…”

“…However, Enfu Tao et al. found that cord blood vitamin A concentration in late preterm infants was not associated with birth weight ( 10 ). Some meta-analysis relating to vitamin revealed that maternal vitamin D deficiency increased the risk of SGA (OR=1.588, 95% CI 1.138-2.216) ( 11 ) and LBW (OR=2.39, 95% CI 1.25-4.57) ( 12 ).…”

“…Recent studies have shown that premature low birth weight (LBW) infants have significantly lower cord blood vitamin A levels, and vitamin A levels in LBW infants correlate with their birth weight (9). However, Enfu Tao et al found that cord blood vitamin A concentration in late preterm infants was not associated with birth weight (10). Some meta-analysis relating to vitamin revealed that maternal vitamin D deficiency increased the risk of SGA (OR=1.588, 95% CI 1.138-2.216) (11) and LBW (OR=2.39, 95% CI 1.25-4.57) (12).…”