The Effect of Vitamin A and Retinol-Binding Protein Levels in Cord Blood of Very Low Birth Weight Infants on Mortality and Morbidity

Abstract

Objectives

Vitamin A is a fat-soluble micronutrient essential for normal embryonic development, cell differentiation, growth, vision, immunity and reproduction. The aim of this study was to evaluate the effect of vitamin A and retinol-binding protein levels in cord blood of babies born at or below the 31^st gestational week on respiratory distress syndrome, intraventricular haemorrhage, necrotising enterocolitis, retinopathy of prematurity and bronchopulmonary dysplasia and mortality.

Methods

Babies born between 25 0/7 and 30 6/7 gestational weeks were included in the study between January 2021 and December 2022. Blood samples were obtained from the cord blood for retinol and retinol-binding protein levels.

Results

Sixty preterm infants born between 25 0/7 and 30 6/7 gestational weeks were included in this study. The mean vitamin A level was 244±140 µg/L and the mean retinol-binding protein level was 1.7±0.4 mg/dL. Among premature infants, 43% had low vitamin A levels and 38% had low retinol-binding protein levels. The retinol-binding protein level was found to be significantly lower in babies with retinopathy of prematurity compared with babies without retinopathy of prematurity (p<0.05).

Conclusions

In our study in which we investigated the effect of vitamin A and retinol-binding protein levels on morbidity and mortality in preterm infants, we showed that retinopathy of prematurity increased with low retinol-binding protein levels in cord blood. Further studies by evaluating the retinol-binding protein level together with the vitamin A level in the later days of life in response to vitamin A supplementation may more accurately show the effect of vitamin A on neonatal morbidities.

Zusammenfassung

Ziele

Vitamin A ist ein fettlöslicher Mikronährstoff, der für die normale Embryonalentwicklung, Zelldifferenzierung, Wachstum, Sehvermögen, Immunität und Reproduktion essentiell ist. Ziel dieser Studie war es, den Einfluss des Vitamin-A- und RBP-Spiegels im Nabelschnurblut von Babys, die in der 31. Schwangerschaftswoche oder früher geboren wurden, auf das Atemnotsyndrom (RDS), intraventrikuläre Blutungen (IVK), nekrotisierende Enterokolitis (NEC), Frühgeborenenretinopathie (ROP) und bronchopulmonale Dysplasie (BPD) sowie die Mortalität zu untersuchen.

Methoden

Babys, die zwischen der 250. und 306. Schwangerschaftswoche geboren wurden, wurden zwischen Januar 2021 und Dezember 2022 in die Studie aufgenommen. Aus dem Nabelschnurblut wurden Blutproben zur Bestimmung der Retinol- und Retinol-bindenden Protein-Spiegel (RBP) entnommen.

Ergebnisse

Sechzig Frühgeborene, die zwischen der 250. und 306. Schwangerschaftswoche geboren wurden, wurden in die Studie aufgenommen. Der mittlere Vitamin-A-Spiegel betrug 244 ± 140 Mikrogramm/l und der mittlere RBP-Spiegel 1,7 ± 0,4 mg/dl. Bei Frühgeborenen hatten 43 % einen niedrigen Vitamin-A-Spiegel und 38 % einen niedrigen RBP-Spiegel. Der RBP-Spiegel war bei Babys mit ROP signifikant niedriger als bei Babys ohne ROP (p<0.05).

Schlussfolgerungen

In unserer Studie, in der wir den Einfluss von Vitamin A und RBP-Spiegeln auf Morbidität und Mortalität bei Frühgeborenen untersuchten, zeigten wir, dass ROP bei niedrigen RBP-Spiegeln im Nabelschnurblut anstieg. Weitere Studien, in denen der RBP-Spiegel zusammen mit dem Vitamin-A-Spiegel in den späteren Lebenstagen als Reaktion auf eine Vitamin-A-Supplementierung bewertet wird, könnten den Einfluss von Vitamin A auf die Morbidität von Neugeborenen genauer aufzeigen.

Schlüsselwörter

Frühgeborene - Frühgeborenen-Retinopathie - Vitamin A - Neugeborenes

Keywords

Preterm - retinopathy of prematurity - vitamin A - newborn

Publication History

Received: 28 March 2025

Accepted after revision: 11 December 2025

Article published online:
26 January 2026

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