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South African Medical Journal

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Absorption of high-dose enteral vitamin A in lowbirth- weight neonates

A. Coutsoudis, M. Adhikari, K. Pillay, H. M. Coovadia

Abstract


A randomised, double-blind placebo-controlled trial was designed to detennine whether high-dose (25 000 IU) enteral vitamin A. to correct deficiency, would be absorbed and well tolerated in low-birth-weight (LBW) neonates. Thirty-five LBW infants (950 - 1 700 g; gestational age 27 - 36 weeks) were allocated to receive either placebo or vitamin A (25 000 IU) via nasogastric tube on the first day of the study (between 36 and 60 hours after delivery). The dose was repeated on study days 4 and 8. Serum retinol concentrations were detennined pre- and postsupplementation. Toxic effects of vitamin A were monitored by noting vomiting, drowsiness and irritability, and palpating for a bUlging fontanelle. The mean serum retinol concentration was significantly higher following supplementation in the vitamin A-treated group than in the placebo group (45.n ± 17.07 ug1dl v. 12.88 ± 6.48 ug/dl; P = 0.0001). Toxic effects were not detected in any of the infants. In conclusion, high-dose enteral vitamin A is well absorbed in LBW neonates and three doses of 25 000 IU given over a period of 8 days are not associated with any detectable toxic effects.




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