Saliva for Assessing Vitamin A Status in Extremely Preterm Infants: A Diagnostic Study

Neonatology ◽  
2020 ◽  
Vol 117 (3) ◽  
pp. 365-368
Author(s):  
Abhijeet A. Rakshasbhuvankar ◽  
Michael W. Clarke ◽  
Karen Simmer ◽  
Sanjay K. Patole ◽  
J. Jane Pillow
Keyword(s):  
Vitamin A ◽  
Preterm Infants ◽  
High Performance ◽  
Invasive Procedure ◽  
Enzyme Linked Immunosorbent Assay ◽  
Diagnostic Study ◽  
Vitamin A Status ◽  
Extremely Preterm ◽  
Extremely Preterm Infants ◽  
Plasma Retinol

<b><i>Background:</i></b> Salivary measurement of hormones and vitamins is gaining prominence as a minimally invasive procedure with the negligible potential for harm. We aimed to assess the utility of saliva for assessing vitamin A status in extremely preterm infants. <b><i>Methods:</i></b> Paired saliva and blood samples were collected at 4 weeks of age from infants born &#x3c;28 weeks of gestation using a proprietary polymer swab. Plasma retinol was measured using high-performance liquid chromatography, and salivary retinol was measured using enzyme-linked immunosorbent assay. <b><i>Results:</i></b> Thirty infants were recruited with a median (IQR) gestation and birth weight of 26.2 weeks (24.8–27.2) and 865 g (718–1,002), respectively. An adequate volume of saliva (&#x3e;50 µL) was obtained in 68%. There was no significant correlation (Spearman’s correlation coefficient = 0.16, <i>p</i> = 0.3) between individual plasma and salivary retinol levels. Bland-Altman analysis showed wide limits of agreement (–113 to +119%) between individual plasma and salivary retinol levels. <b><i>Conclusion:</i></b> Individual vitamin A status cannot be determined reliably from saliva in extremely preterm infants using current collection materials and analysis techniques.

Retinol-binding protein, retinol, and modified-relative-dose response in Ugandan children aged 12–23 months and their non-pregnant caregivers

2021 ◽  
pp. 153537022098547
Author(s):  
Ralph D Whitehead ◽  
Nicole D Ford ◽  
Carine Mapango ◽  
Laird J Ruth ◽  
Ming Zhang ◽  
...  
Keyword(s):  
Vitamin A ◽  
Dose Response ◽  
High Performance ◽  
Binding Protein ◽  
Retinol Binding Protein ◽  
Enzyme Linked Immunosorbent Assay ◽  
Vitamin A Status ◽  
Plasma Retinol ◽  
Commercial Enzyme Immunoassay ◽  
Modified Relative Dose Response

Retinol-binding protein (RBP), retinol, and modified-relative-dose response (MRDR) are used to assess vitamin A status. We describe vitamin A status in Ugandan children and women using dried blood spot (DBS) RBP, serum RBP, plasma retinol, and MRDR and compare DBS-RBP, serum RBP, and plasma retinol. Blood was collected from 39 children aged 12–23 months and 28 non-pregnant mothers aged 15–49 years as a subsample from a survey in Amuria district, Uganda, in 2016. DBS RBP was assessed using a commercial enzyme immunoassay kit, serum RBP using an in-house sandwich enzyme-linked immunosorbent assay, and plasma retinol/MRDR test using high-performance liquid chromatography. We examined (a) median concentration or value (Q1, Q3); (b) R2 between DBS-RBP, serum RBP, and plasma retinol; and (c) Bland-Altman plots. Median (Q1, Q3) for children and mothers, respectively, were as follows: DBS-RBP 1.15 µmol/L (0.97, 1.42) and 1.73 (1.52, 1.96), serum RBP 0.95 µmol/L (0.78, 1.18) and 1.47 µmol/L (1.30, 1.79), plasma retinol 0.82 µmol/L (0.67, 0.99) and 1.33 µmol/L (1.22, 1.58), and MRDR 0.025 (0.014, 0.042) and 0.014 (0.009, 0.019). DBS RBP-serum RBP R2 was 0.09 for both children and mothers. The mean biases were −0.19 µmol/L (95% limits of agreement [LOA] 0.62, −0.99) for children and −0.01 µmol/L (95% LOA −1.11, −1.31) for mothers. DBS RBP-plasma retinol R2 was 0.11 for children and 0.13 for mothers. Mean biases were 0.33 µmol/L (95% LOA −0.37, 1.03) for children, and 0.29 µmol/L (95% LOA −0.69, 1.27) for mothers. Serum RBP-plasma retinol R2 was 0.75 for children and 0.55 for mothers, with mean biases of 0.13 µmol/L (95% LOA −0.23, 0.49) for children and 0.18 µmol/L (95% LOA −0.61, 0.96) for mothers. Results varied by indicator and matrix. The serum RBP-retinol R2 for children was moderate (0.75), but poor for other comparisons. Understanding the relationships among vitamin A indicators across contexts and population groups is needed.

Inadequacy of IV vitamin A supplementation of extremely preterm infants?

2005 ◽  
Vol 146 (6) ◽  
pp. 846-847 ◽  
Author(s):  
Helen Mactier ◽  
Peter Galloway ◽  
Ruth Hamilton ◽  
Lawrence Weaver
Keyword(s):  
Vitamin A ◽  
Preterm Infants ◽  
Vitamin A Supplementation ◽  
Extremely Preterm ◽  
Extremely Preterm Infants

Effect of Enteral Vitamin A on Fecal Calprotectin in Extremely Preterm Infants: A Nested Prospective Observational Study

Neonatology ◽  
2021 ◽  
pp. 1-7
Author(s):  
Abhijeet A. Rakshasbhuvankar ◽  
J. Jane Pillow ◽  
Sanjay Keshav Patole ◽  
Elizabeth A. Nathan ◽  
Karen Simmer
Keyword(s):  
Placebo Group ◽  
Vitamin A ◽  
Observational Study ◽  
Preterm Infants ◽  
Prospective Observational Study ◽  
Fecal Calprotectin ◽  
Water Soluble ◽  
Water Soluble Vitamin ◽  
Extremely Preterm ◽  
Extremely Preterm Infants

<b><i>Background:</i></b> Vitamin A has anti-inflammatory and immune-modulating properties. We aimed to assess whether enteral water-soluble vitamin A supplementation in extremely preterm infants decreases fecal calprotectin, a marker of intestinal inflammation. <b><i>Methods:</i></b> This was a prospective observational study nested in a randomized, double-blind, placebo-controlled clinical trial investigating enteral vitamin A (5,000 IU/day) for reducing the severity of bronchopulmonary dysplasia (BPD) in extremely preterm infants. Fecal calprotectin levels were measured using enzyme-linked immunosorbent assay after 28 days of Vitamin A or placebo supplementation. <b><i>Results:</i></b> Fecal calprotectin was measured in 66 infants (Vitamin A: 33, Placebo: 33). The mean (standard deviation) gestational age (25.5 [1.55] vs. 25.8 [1.48]; <i>p</i> = 0.341) (week), birth weight (810 [200] vs. 877 [251]; <i>p</i> = 0.240) (gram), and factors influencing fecal calprotectin levels were comparable between the vitamin A versus placebo group infants. All infants were exclusively fed with mother’s or donor’s human breast milk if mother’s milk was unavailable using a standardized feeding regimen and received prophylactic probiotic supplementation. Fecal calprotectin levels (median; 25th–75th centiles) (micrograms/gram of feces) were not significantly different between vitamin A (152; 97–212) and placebo groups (179; 91–313) (<i>p</i> = 0.195). Two infants in the vitamin A group developed definite necrotizing enterocolitis compared to none in the placebo group. Incidence of BPD at 36 weeks postmenstrual age was similar between the groups (vitamin A: 18/33, placebo: 13/33, <i>p</i> = 0.218). <b><i>Conclusion:</i></b> Enteral supplementation with water-soluble vitamin A did not affect fecal calprotectin levels in extremely preterm infants. Studies with a larger sample size are required to confirm the findings.

Life expectancy of extremely preterm infants

2007 ◽  
Vol 148 (48) ◽  
pp. 2279-2284 ◽  
Author(s):  
Gabriella Vida ◽  
Ilona Sárkány ◽  
Simone Funke ◽  
Judit Gyarmati ◽  
Judit Storcz ◽  
...  
Keyword(s):  
Life Expectancy ◽  
Preterm Infants ◽  
Extremely Preterm ◽  
Extremely Preterm Infants

Optimális esetben a 24–28. gesztációs hét közötti, igen éretlen újszülöttek olyan szülészeti intézményben születnek, ahol neonatalis intenzív centrum működik, így mind az akut, mind a hosszú távú ellátásukat magas színvonalon biztosítják. A PTE OEKK ÁOK Szülészeti és Nőgyógyászati Klinikán 2000. január 1. és 2004. december 31. között 7499 újszülött született. A koraszülési frekvencia 20% (1499/7499), ezen belül az extrém alacsony gesztációs korúak aránya (≦28. gesztációs hét) 18% (272/1499), míg a 25. gesztációs hét alattiaké 3,2% (48/1499) volt. A túlélés a gesztációs hetek emelkedésével fokozatosan javul. Az életben maradt koraszülöttek későbbi életkilátásai és társadalmi beilleszkedése függ az olyan maradandó károsodásoktól, mint a látáscsökkenés, halláskárosodás, somatomentalis fejlődés zavarai, krónikus tüdőbetegség. A klinikán vizsgált alacsony gesztációs korú csoportban az összes fogyatékkal élő betegek aránya 15,3%. Döntő többségük a 25. gesztációs hétnél korábban született koraszülöttek közül kerül ki. A 26. gesztációs héttől a koraszülöttek több mint fele tartós károsodás nélkül éli túl az extrém éretlenség társuló problémáit. Megállapították, hogy a korai koponya-ultrahangvizsgálattal, szemészeti szűréssel, otoacusticus emissio mérésével jól prognosztizálhatók a maradandó károsodások, így lehetővé válik a korai kezelés.

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