Nutritional practice effectiveness to achieve adequate plasma vitamin A, E and D during the early postnatal life in Tunisian very low birth weight infants

Objective: To look at changes in plasma vitamin A, E and D concentrations during the early postnatal life and to study their link with growth and mortality in Tunisian very low birth weight (VLBW) infants. Patients and methods: A cohort of 607 VLBW infants had been followed from birth until hospital discharge or death. Blood was collected at birth, at time of maximal weight loss and at time of recovering birth weight. Retinol and alpha-tocopherol were analyzed using HPLC and 25 hydroxy vitamin D using radioimmunoassay. Results: Vitamin A, D and E deficiencies were very common at birth (75.9%, 74.1% and 65.2%, respectively). The prevalence's have decreased throughout hospital stay, but remained high at time of recovering birth weight (59.4%, 31.2% and 28.8%, respectively). Vitamin A deficiency was associated with longer hospital stay [OR (95% CI), 1.66 (1.03-2.93)] and vitamin E deficiency was associated with increased neonatal mortality [1.44 (1.01-2.23)]. Conclusions: Current nutritional practices are ineffective to achieve adequate vitamins A, E and D status in Tunisian VLBW infants during the early postnatal life and should be revised. Further work is needed to establish recommended doses of vitamins supplements in these preterm infants.