EVIDENCE FOR THE SAFETY OF ASCORBIC-ACID ADMINISTRATION TO THE PREMATURE-INFANT

Ascorbic acid (AA), a plasma antioxidant, is maintained at high levels in premature fetal blood and declines rapidly postpartum. The sudden reduction in blood AA levers secondary to premature delivery may incre ase the risk of oxidant injury, that is, bronchopulmonary dysplasia an d intraventricular hemorrhage. There is concern that administration of AA to premature infants, in an effort to increase antioxidant capacit y, may cause hemolysis. We felt that the benefits of early AA administ ration and prevention of the immediate postnatal drop in blood AA leve ls, might outweigh the risks of erthrocyte damage. Fifty one high-risk premature infants were randomized to receive either normal saline or 100 mg/kg of AA, daily for the first week of life. Double-blind compar isons were made of hemoglobin, hematocrit, erythrocyte morphology, bil irubin, number of blood transfusions and days of phototherapy, renal f unction tests, the incidence of infection, bronchopulmonary dysplasia, and intraventricular hemorrhage during the first month;of life. The a dministration of AA prevented the immediate postnatal drop in AA and w as not associated with evidence of increased hemolysis. No significant differences in renal function, rate of infection, bronchopulmonary dy splasia, or intraventricular hemorrhage were seen between the two grou ps. This study suggests that AA administration to the premature infant is safe and supports the designing and performance of larger clinical studies of the antioxidant properties of AA.