Effects of vitamin E supplementation during erythropoietin treatment of the anaemia of prematurity

Abstract

Aims: To evaluate the effects of vitamin E supplementation on haemoglobin concentration and the requirement for transfusion in premature infants treated with erythropoietin and iron.

Methods: Randomised, double blind, placebo controlled trial. Thirty infants </=32 weeks gestation and </=1250 g birth weight, who were defined as stable based on minimal requirements for respiratory support and phlebotomy, and absence of major congenital anomalies were enrolled. All were treated with erythropoietin and iron, and were randomised to receive, in addition, either vitamin E 50 IU/day or placebo for eight weeks or until discharge, whichever came first.

Results: Despite higher vitamin E (alpha-tocopherol) levels in the experimental group in weeks 3 (49.0 v 28.1 micro mol/l) and 8 (66.2 v 38.5 micro mol/l), there were no differences in haemoglobin, reticulocyte count, iron concentration, or transfusion requirement.

Conclusions: Oral vitamin E supplementation at 50 IU/day does not increase the response of preterm infants to erythropoietin and iron. Vitamin E obtained through standard nutrition may have been sufficient or higher doses may be required.

Figure 1

Effects of vitamin E on serum vitamin E levels. Serum levels of α-tocopherol (A) and γ-tocopherol (B) were measured over time (weeks) and expressed as mean (SEM). *p < 0.05 versus placebo.

Figure 2

Effects of vitamin E on haematological measurements. Haemoglobin concentrations (A), reticulocyte counts (B), and serum iron concentrations (C) were measured over time (weeks) and expressed as mean (SEM). *p < 0.05 versus placebo.