Vitamin A plays an important role in the regulation of cellular differentiation and proliferation, and may be particularly important for neonatal lung development due to its role in lung surfactant synthesis. Newborn preterm infants have low tissue levels of vitamin A, which may contribute to the development of acute and chronic lung disease. The purpose of the present study is to determine if an oral dose of vitamin A given to pregnant women with premature rupture of membranes is transferred to the fetus. Methods: Subjects include women admitted to Tampa General Hospital with premature rupture of fetal membranes between 24 and 34 weeks gestation. An oral dose of Aquasol A (retinyl palmitate; 100,000 International Units) is administered to subjects within 24 hours of hospital admission. If delivery does not occur within 24 hours, an additional dose of 100,000 IU is administered. Cord blood is collected from infants whose mothers are dosed(study), and from infants whose mothers meet inclusion criteria but for whom consent is not obtained (control). Results: Nine control and twelve study infants have been studied to date. Birthweight and gestational age at delivery among study and control infants are 1653 ± 505 and 1681± 605 gm, and 30.9 ± 2.7 and 31.0 ± 3.0 weeks, respectively. Among study subjects, the mean time between first dose and delivery is 164 hours. Cord blood serum vitamin A levels are significantly higher among infants in the study group: 22.6 ± 3.3 versus 17.4± 3.2 μg/dl, p=0.03. There have been no adverse effects observed in study mothers or infants. Conclusion: High oral doses of vitamin A administered to women with premature rupture of membranes between 24 and 34 weeks gestation may be a safe and effective means of enhancing the vitamin A status of newborn preterm infants.
