Serum Tocopherol Levels in Very Preterm Infants After a Single Dose of Vitamin E at Birth

Edward F Bell; Nellie I Hansen; Kathleen A Kennedy; Michele C Walsh; Seetha Shankaran; Michael J Acarregui; Karen J Johnson; Ellen C Hale; Lynn A Messina; Margaret M Crawford; Abbot R Laptook; Ronald N Goldberg; Krisa P Van Meurs; Waldemar A Carlo; Brenda B Poindexter; Roger G Faix; David P Carlton; Kristi L Watterberg; Dan L Ellsbury; Abhik Das; Rosemary D Higgins; Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network

doi:10.1542/peds.2013-1684

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Serum Tocopherol Levels in Very Preterm Infants After a Single Dose of Vitamin E at Birth

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Serum Tocopherol Levels in Very Preterm Infants After a Single Dose of Vitamin E at Birth

Edward F Bell, Nellie I Hansen, Kathleen A Kennedy, Michele C Walsh, Seetha Shankaran, Michael J Acarregui, Karen J Johnson, Ellen C Hale, Lynn A Messina, Margaret M Crawford, …

Pediatrics (Evanston), Vol.132(6), pp.e1626-e1633

12/2013

DOI: 10.1542/peds.2013-1684

PMCID: PMC3838534

PMID: 24218460

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Abstract

OBJECTIVE: Our aim was to examine the impact of a single enteral dose of vitamin E on serum tocopherol levels. The study was undertaken to see whether a single dose of vitamin E soon after birth can rapidly increase the low α-tocopherol levels seen in very preterm infants. If so, this intervention could be tested as a means of reducing the risk of intracranial hemorrhage. METHODS: Ninety-three infants <27 weeks’ gestation and <1000 g were randomly assigned to receive a single dose of vitamin E or placebo by gastric tube within 4 hours of birth. The vitamin E group received 50 IU/kg of vitamin E as dl-α-tocopheryl acetate (Aquasol E). The placebo group received sterile water. Blood samples were taken for measurement of serum tocopherol levels by high-performance liquid chromatography before dosing and 24 hours and 7 days after dosing. RESULTS: Eighty-eight infants received the study drug and were included in the analyses. The α-tocopherol levels were similar between the groups at baseline but higher in the vitamin E group at 24 hours (median 0.63 mg/dL vs 0.42 mg/dL, P = .003) and 7 days (2.21 mg/dL vs 1.86 mg/dL, P = .04). There were no differences between groups in γ-tocopherol levels. At 24 hours, 30% of vitamin E infants and 62% of placebo infants had α-tocopherol levels <0.5 mg/dL. CONCLUSIONS: A 50-IU/kg dose of vitamin E raised serum α-tocopherol levels, but to consistently achieve α-tocopherol levels >0.5 mg/dL, a higher dose or several doses of vitamin E may be needed.

preterm infants

vitamin E

Details

Title: Subtitle: Serum Tocopherol Levels in Very Preterm Infants After a Single Dose of Vitamin E at Birth
Creators: Edward F Bell - Department of Pediatrics, University of Iowa, Iowa City, Iowa
Nellie I Hansen - Social, Statistical and Environmental Sciences Unit, RTI International, Research Triangle Park, North Carolina
Kathleen A Kennedy - Department of Pediatrics, University of Texas Medical School at Houston, Houston, Texas
Michele C Walsh - Department of Pediatrics, Rainbow Babies & Children's Hospital and Case Western Reserve University, Cleveland, Ohio
Seetha Shankaran - Department of Pediatrics, Wayne State University, Detroit, Michigan
Michael J Acarregui - Department of Pediatrics, University of Iowa, Iowa City, Iowa
Karen J Johnson - Department of Pediatrics, University of Iowa, Iowa City, Iowa
Ellen C Hale - Department of Pediatrics, Emory University School of Medicine and Children's Healthcare of Atlanta, Atlanta, Georgia
Lynn A Messina - Mercy Medical Center, Des Moines, Iowa
Margaret M Crawford - Social, Statistical and Environmental Sciences Unit, RTI International, Rockville, Maryland
Abbot R Laptook - Department of Pediatrics, Women & Infants Hospital of Rhode Island and Brown University, Providence, Rhode Island
Ronald N Goldberg - Department of Pediatrics, Duke University, Durham, North Carolina
Krisa P Van Meurs - Department of Pediatrics, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto, California
Waldemar A Carlo - Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama
Brenda B Poindexter - Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana
Roger G Faix - Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, Utah
David P Carlton - Department of Pediatrics, Emory University School of Medicine and Children's Healthcare of Atlanta, Atlanta, Georgia
Kristi L Watterberg - Department of Pediatrics, University of New Mexico Health Sciences Center, Albuquerque, New Mexico
Dan L Ellsbury - Center for Research, Education, and Quality, Pediatrix Medical Group, Sunrise, Florida; and
Abhik Das - Social, Statistical and Environmental Sciences Unit, RTI International, Rockville, Maryland
Rosemary D Higgins - Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland
Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network
Resource Type: Journal article
Publication Details: Pediatrics (Evanston), Vol.132(6), pp.e1626-e1633
DOI: 10.1542/peds.2013-1684
PMID: 24218460
PMCID: PMC3838534
NLM abbreviation: Pediatrics
ISSN: 0031-4005
eISSN: 1098-4275
Publisher: American Academy of Pediatrics
Language: English
Date published: 12/2013
Academic Unit: Stead Family Department of Pediatrics; Neonatology
Record Identifier: 9984093484002771

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