Login Register Cart 0
Generic placeholder image

Endocrine, Metabolic & Immune Disorders - Drug Targets

Editor-in-Chief

ISSN (Print): 1871-5303
ISSN (Online): 2212-3873

Back
Journal Home About Journal Editorial Board Journal Insight Current Issue Volumes/Issues
Subscribe
Research Article

Serum Vitamin A Levels as a Novel Predictor for Respiratory Distress Syndrome in Neonates: Is It Beneficial?

Author(s): Mohamed Shawky Elfarargy*, Sally Abu-Risha, Ghada Al-Ashmawy and Haidy Khattab

Volume 22, Issue 2, 2022

Published on: 12 January, 2022

Page: [235 - 240] Pages: 6

DOI: 10.2174/1871530321666210921120258

Price: $65

Abstract

Background: Neonatal Respiratory Distress Syndrome (RDS) is a dangerous disease in neonates and is accompanied by neonatal complications and death.

Objective: The aim of this study was the early determination of neonatal serum vitamin A levels as a possible novel predictor for neonatal RDS.

Patients and Methods: A case-control study with the identification number TCTR20210206001, was performed on 100 neonates who were admitted to the Neonatal Intensive Care Unit (NICU) of Tanta University Hospital (TUH) suffering from RDS (patient group) and 100 healthy neonates (control group). Estimation of serum vitamin A (retinol) was made for all neonates of this study within the first four hours after birth before any nutrition or therapies.

Results: The results showed no significant difference between serums retinol (RT) levels in grade 1 & 2 RDS neonates (patient group) and the serum RT levels in the control group, while there was a significant difference between serums retinol levels in grade 3 & 4 RDS neonates (patient group) and the serum retinol levels in the control group where the P-value was 0.006 and 0.002 respectively.

Conclusion: Serum vitamin A levels in neonates were found to be decreased in RDS neonates and could be used as a predictor for the development and severity of RDS. Recommendation: It is recommended to carry out routine estimation of serum vitamin A levels in neonates as a novel predictor for neonatal RDS.

Keywords: Neonates, vitamin A, respiratory distress syndrome, predictor, novel, beneficial.

« Previous Next »
Graphical Abstract

[1]
Haidar Shehadeh, A.M. Non-invasive high flow oscillatory ventilation in comparison with nasal continuous positive pressure ventilation for respiratory distress syndrome, a literature review. J. Matern. Fetal Neonatal Med., 2021, 34(17), 2900-2909.
[http://dx.doi.org/10.1080/14767058.2019.1671332] [PMID: 31590589]
[2]
Sweet, L.R.; Keech, C.; Klein, N.P.; Marshall, H.S.; Tagbo, B.N.; Quine, D.; Kaur, P.; Tikhonov, I.; Nisar, M.I.; Kochhar, S.; Muñoz, F.M. Brighton Collaboration Respiratory Distress in the Neonate Working Group. Respiratory distress in the neonate: Case definition & guidelines for data collection, analysis, and presentation of maternal immunization safety data. Vaccine, 2017, 35(48 Pt A), 6506-6517.
[http://dx.doi.org/10.1016/j.vaccine.2017.01.046] [PMID: 29150056]
[3]
Wang, C.; Guo, L.; Chi, C.; Wang, X.; Guo, L.; Wang, W.; Zhao, N.; Wang, Y.; Zhang, Z.; Li, E. Mechanical ventilation modes for respiratory distress syndrome in infants: a systematic review and network meta-analysis. Crit. Care, 2015, 19, 108.
[http://dx.doi.org/10.1186/s13054-015-0843-7] [PMID: 25881121]
[4]
Inder, T.E.; Graham, P.J.; Winterbourn, C.C.; Austin, N.C.; Darlow, B.A. Plasma vitamin A levels in the very low birthweight infant--relationship to respiratory outcome. Early Hum. Dev., 1998, 52(2), 155-168.
[http://dx.doi.org/10.1016/S0378-3782(98)00026-7] [PMID: 9783817]
[5]
Lupton-Smith, A.; Argent, A.; Rimensberger, P.; Frerichs, I.; Morrow, B. Prone positioning improves ventilation homogeneity in children with acute respiratory distress syndrome. Pediatr. Crit. Care Med., 2017, 18(5), e229-e234.
[http://dx.doi.org/10.1097/PCC.0000000000001145] [PMID: 28328787]
[6]
Wang, C.H.; Du, L.Z.; Ma, X.L.; Shi, L.P.; Tong, X.M.; Liu, H.; Ding, G.F.; Yi, B.; Pan, X.N.; Zhong, D.N.; Liu, L.; Li, M.; Liu, C.Q.; Xia, S.W.; Wang, H.Y.; He, L.; Liang, K.; Zhou, X.Y.; Han, S.P.; Lyu, Q.; Qiu, Y.P.; Shan, R.B.; Mu, D.Z.; Liu, X.H.; Zhuang, S.Q.; Guo, J.; Liu, L.; Zhu, J.J.; Xiong, H. Analysis of in-hospital neonatal death in the tertiary neonatal intensive care unit in China: a multicenter retrospective study. Chin. Med. J. (Engl.), 2016, 129(22), 2652-2658.
[http://dx.doi.org/10.4103/0366-6999.193458] [PMID: 27823995]
[7]
Stephenson, J.; Heslehurst, N.; Hall, J.; Schoenaker, D.A.J.M.; Hutchinson, J.; Cade, J.E.; Poston, L.; Barrett, G.; Crozier, S.R.; Barker, M.; Kumaran, K.; Yajnik, C.S.; Baird, J.; Mishra, G.D. Before the beginning: nutrition and lifestyle in the preconception period and its importance for future health. Lancet, 2018, 391(10132), 1830-1841.
[http://dx.doi.org/10.1016/S0140-6736(18)30311-8] [PMID: 29673873]
[8]
Maden, M.; Hind, M. Retinoic acid in alveolar development, maintenance and regeneration. Philos. Trans. R. Soc. Lond. B Biol. Sci., 2004, 359(1445), 799-808.
[http://dx.doi.org/10.1098/rstb.2004.1470] [PMID: 15293808]
[9]
Chytil, F. The lungs and vitamin A. Am. J. Physiol., 1992, 262(5 Pt 1), L517-L527.
[PMID: 1317113]
[10]
Darlow, B.A.; Graham, P.J.; Rojas-Reyes, M.X. Vitamin A supplementation to prevent mortality and short- and long-term morbidity in very low birth weight infants. Cochrane Database Syst. Rev., 2016, (8), CD000501.
[http://dx.doi.org/10.1002/14651858.CD000501.pub4] [PMID: 27552058]
[11]
Shenai, J.P.; Mellen, B.G.; Chytil, F. Vitamin A status and postnatal dexamethasone treatment in bronchopulmonary dysplasia. Pediatrics, 2000, 106(3), 547-553.
[http://dx.doi.org/10.1542/peds.106.3.547] [PMID: 10969101]
[12]
Huang, Z.; Liu, Y.; Qi, G. David Brand, Song Guo Zheng. Role of Vitamin A in the Immune System. J. Clin. Med., 2018, 7(9), 258.
[http://dx.doi.org/10.3390/jcm7090258]
[13]
Iyer, N.; Grizotte-Lake, M.; Duncan, K.; Gordon, S.R.; Palmer, A.C.S.; Calvin, C.; Zhong, G.; Isoherranen, N.; Vaishnava, S. Epithelium intrinsic vitamin A signaling co-ordinates pathogen clearance in the gut via IL-18. PLoS Pathog., 2020, 16(4), e1008360.
[http://dx.doi.org/10.1371/journal.ppat.1008360] [PMID: 32330185]
[14]
Pecora, F.; Persico, F.; Argentiero, A.; Neglia, C.; Esposito, S. The Role of Micronutrients in Support of the Immune Response against Viral Infections. Nutrients, 2020, 12(10), 3198.
[http://dx.doi.org/10.3390/nu12103198] [PMID: 33092041]
[15]
Timoneda, J.; Rodríguez-Fernández, L.; Zaragozá, R.; Marín, M.P.; Cabezuelo, M.T.; Torres, L.; Viña, J.R.; Barber, T. Vitamin A Deficiency and the Lung. Nutrients, 2018, 10(9), 1132.
[http://dx.doi.org/10.3390/nu10091132] [PMID: 30134568]
[16]
Neonatal Vitamin A Supplementation Evidence group. Early neonatal vitamin A supplementation and infant mortality: an individual participant data meta-analysis of randomised controlled trials. Arch. Dis. Child., 2019, 104(3), 217-226.
[http://dx.doi.org/10.1136/archdischild-2018-315242] [PMID: 30425075]
[17]
Imdad, A.; Rehman, F.; Davis, E.; Attia, S.; Ranjit, D.; Surin, G.S.; Lawler, S.; Smith, A.; Bhutta, Z.A. Effect of Synthetic Vitamin A and Probiotics Supplementation for Prevention of Morbidity and Mortality during the Neonatal Period. A Systematic Review and Meta-Analysis of Studies from Low- and Middle-Income Countries. Nutrients, 2020, 12(3), 791.
[http://dx.doi.org/10.3390/nu12030791] [PMID: 32192165]
[18]
Benn, C.S.; Aaby, P.; Fisker, A.B. Lessons Learned from the Testing of Neonatal Vitamin A Supplementation. Nutrients, 2019, 11(2), 449.
[http://dx.doi.org/10.3390/nu11020449] [PMID: 30795563]
[19]
Dizdar, E.A.; Uras, N.; Oguz, S.; Erdeve, O.; Sari, F.N.; Aydemir, C.; Dilmen, U. Total antioxidant capacity and total oxidant status after surfactant treatment in preterm infants with respiratory distress syndrome. Ann. Clin. Biochem., 2011, 48(Pt 5), 462-467.
[http://dx.doi.org/10.1258/acb.2011.010285] [PMID: 21775575]
[20]
Faix, R.G.; Viscardi, R.M.; DiPietro, M.A.; Nicks, J.J. Adult respiratory distress syndrome in full-term newborns. Pediatrics, 1989, 83(6), 971-976.
[PMID: 2657626]
[21]
Chen, H.J.; Hsu, C.H.; Chiang, B.L. Serum retinol levels and neonatal outcomes in preterm infants. J. Formos. Med. Assoc., 2017, 116(8), 626-633.
[http://dx.doi.org/10.1016/j.jfma.2017.04.019] [PMID: 28549589]
[22]
Woollard, G.A.; Woollard, D.C. The Determination of Serum Retinol by High Performance Liquid Chromatography. J. High Resolut. Chromatogr., 1984, 7(8), 466-472.
[http://dx.doi.org/10.1002/jhrc.1240070804]
[23]
Su, Y.; Yoon, S.S. Epi info - present and future. AMIA Annu. Symp. Proc., 2003, 2003, 1023.
[PMID: 14728526]
[24]
Falciglia, H.S.; Johnson, J.R.; Sullivan, J.; Hall, C.F.; Miller, J.D.; Riechmann, G.C.; Falciglia, G.A. Role of antioxidant nutrients and lipid peroxidation in premature infants with respiratory distress syndrome and bronchopulmonary dysplasia. Am. J. Perinatol., 2003, 20(2), 97-107.
[http://dx.doi.org/10.1055/s-2003-38315] [PMID: 12660915]
[25]
Coutsoudis, A.; Adhikari, M.; Coovadia, H.M. Serum vitamin A (retinol) concentrations and association with respiratory disease in premature infants. J. Trop. Pediatr., 1995, 41(4), 230-233.
[http://dx.doi.org/10.1093/tropej/41.4.230] [PMID: 7563276]
[26]
Hustead, V.A.; Gutcher, G.R.; Anderson, S.A.; Zachman, R.D. Relationship of vitamin A (retinol) status to lung disease in the preterm infant. J. Pediatr., 1984, 105(4), 610-615.
[http://dx.doi.org/10.1016/S0022-3476(84)80432-1] [PMID: 6481538]
[27]
Gao, R.W.; Kong, X.Y.; Zhu, X.X.; Zhu, G.Q.; Ma, J.S.; Liu, X.X. Retinoic acid promotes primary fetal alveolar epithelial type II cell proliferation and differentiation to alveolar epithelial type I cells. In Vitro Cell. Dev. Biol. Anim., 2015, 51(5), 479-487.
[http://dx.doi.org/10.1007/s11626-014-9850-2] [PMID: 25515249]
[28]
Shiraishi, J.; Kusuda, S.; Cho, K.; Nakao, A.; Hiroma, T.; Sugiura, H.; Suzuki, S.; Oshiro, M.; Yoshimoto, S.; Watabe, S. Standardization of nitric oxide inhalation in extremely preterm infants in Japan. Pediatr. Int., 2019, 61(2), 152-157.
[http://dx.doi.org/10.1111/ped.13746] [PMID: 30523661]
[29]
Asson-Batres, M.A. How Dietary Deficiency Studies Have Illuminated the Many Roles of Vitamin A During Development and Postnatal Life. Subcell. Biochem., 2020, 95, 1-26.
[http://dx.doi.org/10.1007/978-3-030-42282-0_1] [PMID: 32297294]
[30]
Ahmad, S.M.; Raqib, R.; Huda, M.N.; Alam, M.J.; Monirujjaman, M.; Akhter, T.; Wagatsuma, Y.; Qadri, F.; Zerofsky, M.S.; Stephensen, C.B. High-Dose Neonatal Vitamin A Supplementation Transiently Decreases Thymic Function in Early Infancy. J. Nutr., 2020, 150(1), 176-183.
[http://dx.doi.org/10.1093/jn/nxz193] [PMID: 31504694]
[31]
Basu, S.; Khanna, P.; Srivastava, R.; Kumar, A. Oral vitamin A supplementation in very low birth weight neonates: a randomized controlled trial. Eur. J. Pediatr., 2019, 178(8), 1255-1265.
[http://dx.doi.org/10.1007/s00431-019-03412-w] [PMID: 31209560]
[32]
Morrisey, E.E.; Savani, R.C. Midkine: a potential bridge between glucocorticoid and retinoid effects on lung vascular development. Am. J. Respir. Cell Mol. Biol., 2003, 28(1), 5-8.
[http://dx.doi.org/10.1165/rcmb.F255] [PMID: 12495926]
[33]
Schwartz, E.; Zelig, R.; Parker, A.; Johnson, S.; Vitamin, A. Vitamin A Supplementation for the Prevention of Bronchopulmonary Dysplasia in Preterm Infants: An Update. Nutr. Clin. Pract., 2017, 32(3), 346-353.
[http://dx.doi.org/10.1177/0884533616673613] [PMID: 28537511]
[34]
Couroucli, X.I.; Placencia, J.L.; Cates, L.A.; Suresh, G.K. Should we still use vitamin A to prevent bronchopulmonary dysplasia? J. Perinatol., 2016, 36(8), 581-585.
[http://dx.doi.org/10.1038/jp.2016.76] [PMID: 27228508]
[35]
Yadav, B.; Sasidharan, R.; Gupta, N. Oral vitamin A for prevention of bronchopulmonary dysplasia. Eur. J. Pediatr., 2019, 178(10), 1601.
[http://dx.doi.org/10.1007/s00431-019-03448-y] [PMID: 31478065]
[36]
Leff, J.A.; Parsons, P.E.; Day, C.E.; Taniguchi, N.; Jochum, M.; Fritz, H.; Moore, F.A.; Moore, E.E.; McCord, J.M.; Repine, J.E. Serum antioxidants as predictors of adult respiratory distress syndrome in patients with sepsis. Lancet, 1993, 341(8848), 777-780.
[http://dx.doi.org/10.1016/0140-6736(93)90558-X] [PMID: 8095998]
[37]
Coutsoudis, A.; Adhikari, M.; Pillay, K.; Kuhn, L.; Coovadia, H.M. Effect of vitamin A supplementation on morbidity of low-birth-weight neonates. S. Afr. Med. J., 2000, 90(7), 730-736.
[PMID: 10985138]
[38]
Yang, C.; Yang, X.; Du, J.; Wang, H.; Li, H.; Zeng, L.; Gu, W.; Jiang, J. Retinoic acid promotes the endogenous repair of lung stem/progenitor cells in combined with simvastatin after acute lung injury: a stereological analysis. Respir. Res., 2015, 16, 140.
[http://dx.doi.org/10.1186/s12931-015-0300-9] [PMID: 26561298]
[39]
Londhe, V.A.; Nolen, T.L.; Das, A.; Higgins, R.D.; Tyson, J.E.; Oh, W.; Devaskar, S.U. Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network. Vitamin A supplementation in extremely low-birth-weight infants: subgroup analysis in small-for-gestational-age infants. Am. J. Perinatol., 2013, 30(9), 771-780.
[http://dx.doi.org/10.1055/s-0032-1333410] [PMID: 23329565]
[40]
Uberos, J.; Miras-Baldo, M.; Jerez-Calero, A.; Narbona-López, E. Effectiveness of vitamin A in the prevention of complications of prematurity. Pediatr. Neonatol., 2014, 55(5), 358-362.
[http://dx.doi.org/10.1016/j.pedneo.2013.12.002] [PMID: 24582166]
[41]
Rahmathullah, L.; Tielsch, J.M.; Thulasiraj, R.D.; Katz, J.; Coles, C.; Devi, S.; John, R.; Prakash, K.; Sadanand, A.V.; Edwin, N.; Kamaraj, C. Impact of supplementing newborn infants with vitamin A on early infant mortality: community based randomised trial in southern India. BMJ, 2003, 327(7409), 254.
[http://dx.doi.org/10.1136/bmj.327.7409.254] [PMID: 12896935]
[42]
Mactier, H.; Weaver, L.T. Vitamin A and preterm infants: what we know, what we don’t know, and what we need to know. Arch. Dis. Child. Fetal Neonatal Ed., 2005, 90(2), F103-F108.
[http://dx.doi.org/10.1136/adc.2004.057547] [PMID: 15724031]
[43]
Chailley-Heu, B.; Chelly, N.; Lelièvre-Pégorier, M.; Barlier-Mur, A.M.; Merlet-Bénichou, C.; Bourbon, J.R. Mild vitamin A deficiency delays fetal lung maturation in the rat. Am. J. Respir. Cell Mol. Biol., 1999, 21(1), 89-96.
[http://dx.doi.org/10.1165/ajrcmb.21.1.3563] [PMID: 10385596]
[44]
Garg, B.D.; Bansal, A.; Kabra, N.S. Role of vitamin A supplementation in prevention of bronchopulmonary dysplasia in extremely low birth weight neonates: a systematic review of randomized trials. J. Matern. Fetal Neonatal Med., 2019, 32(15), 2608-2615.
[http://dx.doi.org/10.1080/14767058.2018.1441282] [PMID: 29447482]
[45]
Garofoli, F.; Barillà, D.; Angelini, M.; Mazzucchelli, I.; De Silvestri, A.; Guagliano, R.; Decembrino, L.; Tzialla, C. Oral vitamin A supplementation for ROP prevention in VLBW preterm infants. Ital. J. Pediatr., 2020, 46(1), 77.
[http://dx.doi.org/10.1186/s13052-020-00837-0] [PMID: 32493448]
[46]
Chandrasekaran, A.; Murki, S. Is early oral vitamin A supplementation useful in preterm neonates at risk for bronchopulmonary dysplasia? Acta Paediatr., 2020, 109(3), 634-635.
[http://dx.doi.org/10.1111/apa.15133] [PMID: 31972047]
[47]
de Souza Mesquita, L.M.; Mennitti, L.V.; de Rosso, V.V.; Pisani, L.P. The role of vitamin A and its pro-vitamin carotenoids in fetal and neonatal programming: gaps in knowledge and metabolic pathways. Nutr. Rev., 2021, 79(1), 76-87.
[http://dx.doi.org/10.1093/nutrit/nuaa075] [PMID: 33301001]

Rights & Permissions Print Cite
Article Metrics
15
1
© 2024 Bentham Science Publishers | Privacy Policy