Vitamin A for Premature Babies: Does It Help Lung Problems?
Quick Summary: A recent study looked at whether giving very premature babies high doses of Vitamin A could prevent lung problems. The study found that extra Vitamin A didn't help reduce lung disease or death in these babies.
What The Research Found
Giving premature babies a high dose of Vitamin A did not lower their chances of getting moderate or severe lung problems, or of dying. The study showed that about the same number of babies in both groups (those getting extra Vitamin A and those not) had these problems.
Study Details
- Who was studied: 915 babies born very early (before 32 weeks of pregnancy) and weighing between 400 and 1000 grams (less than 2.2 pounds).
- How long: The study lasted for 28 days after birth.
- What they took: Some babies got a high dose of Vitamin A (5000 IU/kg per day), while others got a placebo (peanut oil). Both groups also received standard Vitamin A supplementation.
What This Means For You
If your baby is born very early, this study suggests that giving them a high dose of Vitamin A on top of the usual amount is unlikely to improve their lung health or chances of survival. Talk to your baby's doctor about the best care plan for your child.
Study Limitations
- All babies in the study already received some Vitamin A, which might have made it harder to see if the extra dose helped.
- The study only looked at babies born very early and with low birth weights, so the results might not apply to other babies.
Technical Analysis Details
Key Findings
The NeoVitaA trial found that early high-dose enteral vitamin A supplementation (5000 IU/kg/day) did not reduce the combined outcome of moderate/severe bronchopulmonary dysplasia (BPD) or death in extremely low birthweight (ELBW) infants compared to placebo. Incidence was identical at 38% in both groups (171/449 in vitamin A group vs. 178/466 in control; adjusted odds ratio [aOR] 0.99, 95% CI 0.73–1.55). Serum retinol levels showed no meaningful increase at intervention end or 36 weeks postmenstrual age. Adverse events were comparable (57% vs. 60%), confirming safety but no efficacy benefit.
Study Design
This was a multicenter, randomized, double-blind, placebo-controlled phase 3 trial conducted across 29 neonatal intensive care units in Austria and Germany. It enrolled 915 ELBW infants (birthweight 400–999 g; gestational age ≤32 weeks) between March 2015 and February 2022. Infants were randomized to high-dose vitamin A (n=449) or placebo (peanut oil; n=466). Mean gestational age was 26.5 weeks (SD 2.0), and mean birthweight was 765 g (SD 162).
Dosage & Administration
Vitamin A was administered enterally as 5000 IU/kg/day of fat-soluble retinyl palmitate dissolved in peanut oil, starting within 24 hours of birth and continuing for 28 days. The control group received identical-appearing peanut oil placebo. Both groups received standard recommended enteral vitamin A supplementation (approximately 1500 IU/kg/day) per clinical guidelines.
Results & Efficacy
The primary composite outcome (moderate/severe BPD or death) occurred in 38% of the vitamin A group versus 38% of controls (aOR 0.99, 95% CI 0.73–1.55; p-value not significant as CI includes 1.0). No subgroup showed benefit. Serum retinol concentrations remained statistically similar between groups at baseline, day 28, and 36 weeks postmenstrual age. Safety profiles were equivalent, with adverse events in 57% (vitamin A) vs. 60% (control) of participants.
Limitations
The study’s background standard vitamin A supplementation (1500 IU/kg/day) may have masked potential benefits of higher dosing. Peanut oil placebo could theoretically influence outcomes, though no biological rationale exists. The trial excluded infants with severe congenital anomalies, limiting generalizability. Statistical power assumptions relied on historical BPD rates that may have changed due to evolving neonatal care during the 7-year recruitment period.
Clinical Relevance
For ELBW infants, adding high-dose enteral vitamin A (5000 IU/kg/day) to standard supplementation does not reduce BPD or mortality risk. Clinicians should maintain current guideline-recommended doses (1500 IU/kg/day) without escalating to 5000 IU/kg/day, as this confers no additional benefit despite safety. Future research should explore alternative dosing strategies or patient subgroups, but this trial definitively negates routine use of this specific high-dose protocol in modern NICU settings.
Original Study Reference
Early postnatal high-dose fat-soluble enteral vitamin A supplementation for moderate or severe bronchopulmonary dysplasia or death in extremely low birthweight infants (NeoVitaA): a multicentre, randomised, parallel-group, double-blind, placebo-controlled, investigator-initiated phase 3 trial.
Source: PubMed
Published: 2024
📄 Read Full Study (PMID: 38643780)
