Serum retinol levels and neonatal outcomes in preterm infants

Background/PurposeGlucocorticoids are frequently administered to preterm infants, both antenatally and postnatally; however, the effect on serum retinol levels has not been determined. The risk of bronchopulmonary dysplasia is increased in premature infants with low retinol concentrations.ObjectivesOur purpose was to determine the effect of glucocorticoid administration on serum retinol levels in preterm infants.MethodsAll infants <1250 g or <29 weeks' gestation admitted to the neonatal intensive care unit within 48 h of birth were eligible for inclusion. A retinol concentration <20 μg/dL during the first 48 h of birth was defined as low serum retinol, and a level <10 μg/dL as retinol deficiency.ResultsData from 115 premature infants were collected during a 7-year period, from 2005 to 2012. Neither antenatal nor postnatal steroid administration affected retinol concentrations. Retinol deficiency was associated with an increased risk for severe respiratory distress syndrome and adverse pulmonary outcome (death during the first 28 days of life and long-term oxygen dependence >90 days); low retinol levels conferred an increased risk for bronchopulmonary dysplasia. Prolonged duration of total parenteral nutrition (>21 days) was associated with serum retinol deficiency during hospitalization (P < 0.05). Retinol deficiency was associated with an increased risk for delayed neurological development in 1-year-old and 2-year-old children.ConclusionGlucocorticoids do not affect retinol levels in premature infants, but retinol concentrations are correlated with respiratory and neurological outcomes.