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

Not Applicable
Completed
Conditions
Efficacy and Safety
Interventions
Other: Vitamin AD
Other: Control
Registration Number
NCT03779776
Lead Sponsor
Zhengzhou Children's Hospital, China
Brief Summary

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.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
676
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.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Vitamin ADVitamin ADIn 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.
ControlControlIn 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.
Primary Outcome Measures
NameTimeMethod
rates of bronchopulmonary dysplasia1 year

The rates of bronchopulmonary dysplasia with early vitamin AD supplementation

rates of retinopathy of prematurity1 year

The rates of retinopathy of prematurity with early vitamin AD supplementation

Metaboloc bone disease1 year

The rates of Metaboloc bone disease of prematurity with early vitamin AD supplementation

Secondary Outcome Measures
NameTimeMethod
rates of Necrotizing enterocolitis1 year

The rates of Necrotizing enterocolitis with early vitamin AD supplementation

Trial Locations

Locations (1)

Zhengzhou Children's Hospital

🇨🇳

Zhengzhou, Henan, China

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