Does prophylactic vitamin E prevent anaemia of Prematurity and reduce the need for transfusion?
Date First Published:
April 30, 2007
Last Updated:
April 30, 2007
Report by:
R S Pramod, Senior SHO (Hull Royal Infirmary)
Search checked by:
R S Pramod, Hull Royal Infirmary
Three-Part Question:
In [pre term infants] does [prophylactic vitamin E ]prevent [anaemia of Prematurity and reduce the need for transfusion?]
Clinical Scenario:
In certain neonatal units there is the practice of supplementing vitamin E in therapeutic doses in order to prevent anaemia of prematurity.
Search Strategy:
[vitamin E] or [anemia of prematurity] limited to human and english
Outcome:
Medline search came out with 89 results of which 3 were found to be relevant
Relevant Paper(s):
| Study Title | Patient Group | Study type (level of evidence) | Outcomes | Key results | Study Weaknesses |
|---|---|---|---|---|---|
| Vitamin E supplementation for prevention of morbidity and mortality in preterm infants. Brion LP, Bell EF, Raghuveer TS. 2003 USA | Preterm less than 37 wks and 2500 gm | Cochrane review of randomised control trials and semi randomised control trials | Vitmain E supplementation significantly increased haemoglobin but it did not affect the need of transfusion | Too many variable relating to this search | |
| Effects of vitamin E supplementation during erythropoietin treatment of the anaemia of prematurity Pathak A, Roth P, Piscitelli J, Johnson L 2003 USA | 30 infant ,32 weaks or 1250 gm | Randomised, double blind, placebo controlled trial | Oral vitamin E supplementation at 50 IU/day does not increase the response of preterm infants to erythropoietin and iron | only 30 infants are studied | |
| Oral vitamin E supplementation for the prevention of anemia in premature infants: a controlled trial Zipursky A,Brown EJ, Watts J, Milner , RandC, Blanchette VS, Bell EF,Paes B 1987 USA | 178 infants <1500gm | Randomized, controlled, and blinded trial. | At 6 weeks of age, there was no significant difference between the supplemented and un supplemented |
Author Commentary:
There was some evidence(1)mostly based on evidence from 1980's, that vitamin E administration will increase haemoglobin in preterm infants and but there is no evidence that Vitamin E supplementation will reduce the need for transfusion But recent evidence shows there is no significant difference in haemoglobin in both groups
Bottom Line:
There is no role of prophylatic Vitamin E in preterm babies for prevention of anemia of prematurity
References:
- Brion LP, Bell EF, Raghuveer TS.. Vitamin E supplementation for prevention of morbidity and mortality in preterm infants.
- Pathak A, Roth P, Piscitelli J, Johnson L. Effects of vitamin E supplementation during erythropoietin treatment of the anaemia of prematurity
- Zipursky A,Brown EJ, Watts J, Milner , RandC, Blanchette VS, Bell EF,Paes B. Oral vitamin E supplementation for the prevention of anemia in premature infants: a controlled trial