Randomised controlled trial of oral vitamin A supplementation in preterm infants to prevent chronic lung disease

Background-Intramuscular supplementation with vitamin A in large doses may reduce the incidence of chronic lung disease. Aim-To investigate whether oral supplementation with vitamin A would reduce the incidence of chronic lung disease in a group of extremely low birthwei ght infants. Methods-Infants with birth weight < 1000 g were randomised at birth to rece ive oral vitamin A supplementation (5000 IU/day) or placebo for 28 days. Th e primary outcome was oxygen dependency at 28 days of age or death. Results-A total of 154 infants were randomised; 77 received vitamin A (medi an birth weight (interquartile range) 806 (710-890) g), and 77 received pla cebo (median birth weight (interquartile range) 782 (662-880) g). Plasma vi tamin A concentrations in the supplemented group were significantly higher at 24 hours of age but did not differ significantly at birth, 12 hours of a ge, 7 days, or 28 days of life. There were no significant differences in th e proportion of infants who survived, required oxygen at 28 days, required oxygen at 36 weeks postmenstrual age, survived without chronic lung disease at 36 weeks, survived without significant retinopathy, or who survived wit hout significant intraventricular haemorrhage. Conclusions-Oral supplementation with 5000 IU vitamin A in extremely low bi rthweight infants does not significantly alter the incidence of chronic lun g disease. However, this dose may have been inadequate to achieve optimal s erum retinol concentrations.