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Vitamin A Supplementation in Preterm Infants

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT00063596
Recruitment Status : Unknown
Verified November 2004 by Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD).
Recruitment status was:  Active, not recruiting
First Posted : July 2, 2003
Last Update Posted : June 24, 2005
Information provided by:
Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)

Brief Summary:
Extremely low birth weight infants have decreased blood levels of Vitamin A. This Vitamin A deficiency may increase the risk of infections and chronic lung disease in these infants. This study will examine the effects of Vitamin A supplementation in premature babies born weighing less than 1500 grams (3.3 lbs).

Condition or disease Intervention/treatment Phase
Infant, Premature Drug: Vitamin A supplementation Not Applicable

Detailed Description:

Vitamin A and its derivative retinoic acid (RA) have been recognized as important factors in potentiating the immune response and protecting against infection. In developing nations, Vitamin A deficiency is associated with infectious gastroenteritis and increased susceptibility to a number of infections, such as measles. RA is an important regulator of cell growth and differentiation and can augment IgM production from core blood mononuclear cells in response to a polyclonal B-cell activator. This augmentation in immunoglobulin secretion is mediated by the effects of RA on both T and B cells, in part through the production of certain cytokines (e.g., IL-6 and IL-10) important in the terminal differentiation of B-cells to plasma cells. In animal models, correction of Vitamin A deficiency improves immune response to vaccination.

Infants with extremely low birth weight have low plasma and tissue concentrations of Vitamin A. Vitamin A supplementation of pre-term infants reduces chronic lung disease and the risk of sepsis. Because the immune system of the pre-term infant is immature, the response of pre-term infants to Hepatitis B vaccine is diminished compared to full-term babies. This study will determine whether Vitamin A supplementation of pre-term infants will enhance the response of these infants to immunization with Hepatitis B vaccine. The study will also evaluate the effect of Vitamin A supplementation on survival, chronic lung disease, and infection rate.

Low birth weight pre-term infants will be randomized to receive either Vitamin A supplementation or placebo. The Vitamin A treatment group will receive 5,000 IU of Vitamin A (retinyl palmitate) by intramuscular injection 3 times weekly for 28 days starting on postnatal day 2. To avoid pain and discomfort, the placebo group will receive a sham procedure rather than a placebo saline injection. The staff of the neonatal intensive care unit will retain the responsibility for decisions regarding the use of other therapies, such as parental fluids, mechanical ventilation, glucocorticoids, hyperalimentation, and blood replacement. All infants will be assessed for potential Vitamin A toxicity. While in the neonatal intensive care unit, infants will have blood tests at Days 0, 14, 30, and 60. After discharge from the neonatal intensive care unit, patients return for clinic assessment and blood samples at Months 4, 6, and 9. Infants will be given Hepatitis B vaccine at 2, 4, and 6 months chronological age. Primary outcome measures will include Hepatitis B antibody levels, chronic lung disease, rate of infection while in the neonatal intensive care unit, and the incidence and severity of infections during the first 9 months of life.

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Study Type : Interventional  (Clinical Trial)
Enrollment : 220 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double
Primary Purpose: Treatment
Official Title: Vitamin A Therapy in Preterm Infants: Vaccine Response
Study Start Date : January 2000
Study Completion Date : May 2004

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Vitamin A

Primary Outcome Measures :
  1. Response to Hepatitis B vaccine

Secondary Outcome Measures :
  1. Chronic lung disease
  2. Length of hospital stay
  3. Respiratory and GI infections to 9 months of age
  4. T-cell cytokine production and development
  5. T-cell subset development

Information from the National Library of Medicine

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Ages Eligible for Study:   up to 3 Days   (Child)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria

  • Born at less than 32 weeks gestation
  • Weigh less than 1500 g (3.3 lbs) and more than 500 g (1.1 lbs)

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT00063596

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United States, New York
Women's and Children's Hospital of Buffalo
Buffalo, New York, United States, 14222
Sponsors and Collaborators
Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)
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Principal Investigator: Mark Ballow, MD State University of New York at Buffalo
Layout table for additonal information Identifier: NCT00063596    
Other Study ID Numbers: 5R01HD037263 ( U.S. NIH Grant/Contract )
First Posted: July 2, 2003    Key Record Dates
Last Update Posted: June 24, 2005
Last Verified: November 2004
Keywords provided by Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD):
Vitamin A
Hepatitis B vaccine
Immune responses
T-cell subsets
Chronic lung disease
Cytokines, intracytoplasmic
Antibodies, hepatitis B and tetanus toxoid
Additional relevant MeSH terms:
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Vitamin A
Growth Substances
Physiological Effects of Drugs