The Efficacy and Safety of Early Vitamin AD Supplementation in Very Preterm Infants

Zhengzhou Children's Hospital, China

Status: Completed

Conditions: Efficacy and Safety

Treatments: Other: Vitamin AD; Other: Control

Study type: Interventional

Funder types: Other

Identifiers

NCT03779776

VAD-PRETERM

Details and patient eligibility

About

Bronchopulmonary dysplasia (BPD) is the most prevalent longterm morbidity among surviving extremely preterm infants and has a multifactorial etiology. BPD is associated with later risk of reactive airways disease, such as asthma, post neonatal mortality and adverse neurodevelopmental outcomes.Retinopathy of prematurity (ROP) is a common retinal neovascular disorder and a major cause of vision impairment or blindness in preterm infants, even with aggressed current standard care.Accumulating epidemiologic evidence suggests that vitamin D (VD) deficiency or insufficiency is associated with respiratory disease and metabolic bone disease in premature children.Vitamin A (VA) plays an integral part in lung growth and differentiation. VA is an essential micronutrient for normal visual function.

Our prospective double-blinded randomized controlled trial will include infants born at <32 weeks' gestation and admitted to six tertiary NICUs in China. Infants in the intervention (vitamin AD drops) group will receive the daily dose VA at 1500 IU/day with VD 500 IU/day, added to their enteral feeds in drop form as soon as minimal feeding was introduced, and continued to 28 days or discharge. Infants in the control group will receive an equivalent volume of a placebo solution. Following informed consent, enrolled infants will be randomly allocated to the control or VAD group. The primary outcome is bronchopulmonary dysplasia (BPD) , ROP, or metabolic bone disease and the secondary outcomes are mortality; NEC ≥ stage 2; ; late-onset sepsis; weight gain, change in weight, increase in length, increase in head circumference; time to full enteral feeds; and number and type of critical incident reports.

Enrollment: 676 patients

Sex: All

Ages: 1 to 96 hours old

Volunteers: No Healthy Volunteers

Inclusion criteria

• gestational age<32 weeks,
• <96 hours of age

Exclusion criteria

• genetic metabolic diseases;
• congenital major abnormalities;
• congenital non-bacterial infection with overt signs at birth;
• terminal stage of illness (pH < 7.0 or hypoxia with bradycardia>2 h);
• ≥ grade III intracranial hemorrhage;
• lacking parental consent.

Trial design

Primary purpose: Prevention

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

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676 participants in 2 patient groups, including a placebo group

Vitamin AD

Experimental group

Description:

In Vitamin AD group, the very preterm infants will receive the daily vitamin AD with vitamin A at1500 IU/day and vitamin D at 500 IU/day in drop form added to their enteral feeds when minimal feeding is introduced, and continue to 28 days or discharge. In this group ,the patient also will receive standard intravenous multivitamin preparation (1 ml/kg/d, containing VA 230 IU/kg/d, VD 80 IU/kg/d) within daily on parenteral nutrition until fed 120ml/kg.

Treatment:

Other: Vitamin AD

Control

Placebo Comparator group

Description:

In this group ,the patient will only receive standard intravenous multivitamin preparation (1 ml/kg/d,containing VA 230 IU/kg/d,VD 80 IU/kg/d ) within daily on parenteral nutrition until fed 120ml/kg.

Treatment:

Other: Control