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Serum tocopherol levels in very preterm infants after a single dose of vitamin E at birth.

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 ?-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-?-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 ?-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 ?-tocopherol levels. At 24 hours, 30% of vitamin E infants and 62% of placebo infants had ?-tocopherol levels <0.5 mg/dL. CONCLUSIONS:A 50-IU/kg dose of vitamin E raised serum ?-tocopherol levels, but to consistently achieve ?-tocopherol levels >0.5 mg/dL, a higher dose or several doses of vitamin E may be needed.

SUBMITTER: Bell EF

PROVIDER: S-EPMC3838534 | biostudies-literature | 2013 Dec

REPOSITORIES: biostudies-literature

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Serum tocopherol levels in very preterm infants after a single dose of vitamin E at birth.

Bell Edward F EF Hansen Nellie I NI Brion Luc P LP Ehrenkranz Richard A RA Kennedy Kathleen A KA Walsh Michele C MC Shankaran Seetha S Acarregui Michael J MJ Johnson Karen J KJ Hale Ellen C EC Messina Lynn A LA Crawford Margaret M MM Laptook Abbot R AR Goldberg Ronald N RN Van Meurs Krisa P KP Carlo Waldemar A WA Poindexter Brenda B BB Faix Roger G RG Carlton David P DP Watterberg Kristi L KL Ellsbury Dan L DL Das Abhik A Higgins Rosemary D RD

Pediatrics 20131111 6

<h4>Objective</h4>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.<h4>Methods</h4>Ninety-three infants <27 weeks' gestation and <1000 g were randomly assigned to receive a single dose o ...[more]

PMID: 24218460

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Project description:The aim of the present study was to examine the changes in bacteria in hospitalized preterm infants during the first month of life.Rectal swabs were collected daily from 12 preterm infants. DNA was extracted from swabs from day of birth and weekly thereafter. Bacterial taxa were identified with next generation sequencing using universal bacterial primers targeted at the 16S ribosomal DNA on a 454 Roche titanium platform. Sequences were clustered into operational taxonomic units, and taxonomy was assigned against the Greengenes databank using Quantitative Insights Into Microbial Ecology version 1.4. Quantitative polymerase chain reaction was used to determine the abundance of Bifidobacterium spp. Functional assessment of the microbiome was performed with Phylogenetic Investigation of Communities by Reconstruction of Unobserved States (PICRUSt).Average birth weight and gestational age were 1055 g and 28 weeks, respectively. There were 6 to 35 different bacterial families identified in the day-of-birth samples, unrelated to the mode of delivery. Richness decreased through hospitalization (week 1, 16.9?±?7.7 vs weeks 3-5, 10.7?±?3.4, P?<?0.001). The Shannon diversity index demonstrated the lowest diversity at birth, an increase at week 2, followed by a rapid decline at weeks 3 to 5, suggesting the development of a more uniform microbiota composition after 2 weeks of stay at a neonatal intensive care unit. Enterobacteriaceae, Staphylococcaceae, and Enterococcaceae constituted the majority of the bacterial families. Bifidobacterium spp were infrequently detected at extremely low levels. PICRUSt analysis revealed the enhancement of peroxisome, PPAR, and adipocytokine signaling; plant-pathogen interaction; and aminobenzoate degradation pathways in week 1 samples.Our results suggest that although preterm infants have individualized microbiota that are detectable at birth, the differences decrease during the neonatal intensive care unit hospitalization with increasing prominence of pathogenic microbiota.

Dataset Information

Serum tocopherol levels in very preterm infants after a single dose of vitamin E at birth.

Publications

Serum tocopherol levels in very preterm infants after a single dose of vitamin E at birth.

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