The study, published in the journal Pediatrics & Neonatology, looked at the prevalence and risk factors for the deficiencies in Tunisian very low birth weight (VLBW) newborns.
The lower the birth weight and gestational age - the embryonic or foetal age plus two weeks – the greater the prevalence of A, E and D deficiency, they found. Vitamin D deficiency was significantly higher among twin VLBW babies.
Meanwhile, vitamin E and D deficiency were significantly more common in neonates whose mothers suffered from pre-eclampsia - a condition that affects some pregnant women during the second half of pregnancy or just after delivery.
Vitamin E deficiency was more frequent in the case of gestational diabetes – a condition whereby women with no previous history of diabetes develop high blood glucose levels during pregnancy.
Such deficiencies expose infants to increased chances of morbidity and mortality, the Tunisian researchers said.
Supplementing the problem
The study included 607 preterm VLBW newborns with a birth weight of less than 1500 g and gestational age of less than 37 weeks admitted to an intensive care unit, and 300 full-term newborns from the same hospital with a birth weight between 2500 g and 3500 g as the control group.
Of these two groups, prevalence of vitamin A deficiency was 75.9% compared to 63.3% for full-term babies, while for vitamin E this stood at 71.3% vs. 55.5% and for D 65.2% vs. 40.4%, respectively.
The El Manar University researchers said sustained efforts should be undertaken to combat vitamin deficiencies in newborns. “The strategy should include improvement of mothers' dietary intake and sun exposure, and vitamin supplementation when needed, as well as a tight control of pre-eclampsia and gestational diabetes,” they wrote.
“Vitamin supplementation in preterm infants would be reconsidered and doses adapted according to populations' standard of living and socioeconomic rank. A higher dose of vitamin supplements may be considered in high-risk preterm infants from the underdeveloped world."
The researchers said the public maternity hospital serviced women of, “low to average socioeconomic rank”. Malformed neonates, those with chromosomal abnormality, of birth weight less than 650 g or gestational age of less than 27 weeks were excluded.
The study revealed no differences according to sex, delivery method, or antenatal corticosteroids treatment - medication given to pregnant women in anticipation of preterm delivery.
Source: Pediatrics & Neonatology
Vol. 55, Iss. 3, pp. 196-201, DOI: 10.1016/j.pedneo.2013.09.006
“Vitamin A, E, and D Deficiencies in Tunisian Very Low Birth Weight Neonates: Prevalence and Risk Factors”
Authors: S. Fares, M. Marouane Sethom, C. Khouaja-Mokrani, S. Jabnoun, M. Feki, N. Kaabachi