Vitamin A to prevent bronchopulmonary dysplasia in extremely low birth weight infants: a systematic review and meta-analysis

Study answer

What this study found

Vitamin A supplementation reduced oxygen dependency at postmenstrual age 36 weeks in survivors (RR 0.88; 95% CI 0.77–0.99; 4 trials, 841 infants; moderate certainty). No significant reductions were observed for neonatal death, oxygen use at 28 days in survivors, duration of mechanical ventilation, intraventricular hemorrhage, retinopathy of prematurity, or necrotizing enterocolitis. Length of hospital stay was reduced in Kiatchoosakun 2014 (MD −49.9; 95% CI −88.78 to −11.02; 20 infants; low certainty). Conclusion: VA supplementation in ELBWIs may decrease oxygen dependency at 36 weeks PMA,…

Study & population

Four randomized controlled trials enrolling extremely low birth weight infants (<1,000 g) in NICUs in the United States, United Kingdom, and Thailand; total participants: 1,011; study designs: randomized controlled trials; blinding reported.

Intervention

Vitamin A supplementation regimens varied across trials: Tyson 1999 – intramuscular 5,000 IU, 3×/week for 4 weeks; Wardle 2001 – oral 5,000 IU/kg daily until day 28 (with 23 IU/kg/d vitamin A added to Intralipid when on parenteral nutrition); Kiatchoosakun 2014 – intramuscular 5,000 IU, 3×/week for 4 weeks; Mactier…

Key limitation

Small number of trials (4) with heterogeneous vitamin A dosing routes and schedules; oldest trial (Tyson 1999) may limit applicability to current NICU care; incomplete data for some outcomes; reliance on author-provided data for some trials; generalizability to current practice remains uncertain.

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Original abstract