Cordblood vitamin A levels and intraventricular hemorrhage outcomes in preterm infants

Abstract

Background and Aims: Intraventricular hemorrhage (IVH) is a major complication of preterm birth and large haemorrhages may yield significant future disability. Although multifactorial, prematurity and low birth weight are the most important risk factors for IVH. Furthermore, being “born too soon” affects the accretion of Vitamin A (VA) which is essential for normal brain development. We sought out to estimate VA nutrient levels among preterm newborn infants at birth and establish any relationship with IVH occurrence and grade severity. Methods: Ninety infants were recruited over a 6-month period. VA levels were determined by the enzyme-linked immunosorbent assay using cord blood and IVH was assessed by transcranial ultrasound scan done on the 7th day of life. Data analysis was by the Statistical Package for the Social Sciences IBM (SPSS) version 21. P < 0.05 was considered statistically significant. Results: The infants' median interquartile ranges for gestational age, birth weight, and cord blood VA levels were 32 weeks (4.25 weeks), 1580 g (650 g), and 0.31 μmol/L (0.19 μmol/L), respectively. The prevalence of VA deficiency, low VA, and sufficient VA was 67.8%, 25.5%, and 6.7%, respectively. IVH was found in 8 (9.20%) infants, with incidence rates of 5.70%, 2.30%, and 1.10% for Grades I, II, and III, respectively. Although statistically insignificant, the occurrence of IVH was only among infants with abnormal VA status at birth (P = 0.65). Conclusions: Despite low median cord blood VA level of preterm infants in this study, there is no impact on IVH occurrence or grade severity. Further study with larger sample size is warranted.