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Observational Study
. 2022 May 24;14(11):2189.
doi: 10.3390/nu14112189.

Ascorbic Acid and the Premature Infant

Nayef Chahin  1 , Miheret S Yitayew  1 , Alicia Richards  2 , Brielle Forsthoffer  2 , Jie Xu  1 , Karen D Hendricks-Muñoz  1
Affiliations
Observational Study

Ascorbic Acid and the Premature Infant

Nayef Chahin et al. Nutrients. .

Abstract

Little information exists about the plasma target nutritional needs of the >15 million premature infants <37 weeks gestation. Investigating ascorbic acid’s (AscA) role in infant health, our study details the relationship of infant characteristics and maternal health on infant plasma AscA level (pAscA) during postnatal development. Furthermore, we determined pAscA influence during the first week of life (EpAscA) with later infant morbidities. We hypothesize that pAscA is influenced by gestational organ immaturity, as well as maternal factors, with EpAscA associated with greater morbidity risk. We conducted a prospective longitudinal observational study of pAscA, demographics and hospital course detailed in infants ≤34 weeks. Sixty-three subjects were included, with >200 urine and plasma data points analyzed. Maternal smoking, exposure to magnesium sulfate (MgSO4) and advancing gestational and postnatal age were associated with lower pAscA. Non-white infants and those ≤30 weeks that developed bronchopulmonary dysplasia or retinopathy of prematurity had lower pAscA. Prenatal smoking, MgSO4, birth gestational age and race negatively influence pAscA. These results show prenatal and postnatal developmental factors influencing initial pAscA and metabolism, potentially setting the stage for organ health and risk for disease. Assessment of dietary targets may need adjustment in this population.

Keywords: ascorbic acid; premature nutrition; prematurity; vitamin C.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Measured plasma ascorbic-acid levels (mg/dL) per day of life in preterm infants ≤34 weeks with and without BPD. Infants who developed BPD had significantly lower pAscA levels at birth and these remained low throughout the study period compared to those who did not develop BPD (p = 0.0003, 95% CI = −0.36, 2.76). BPD = bronchopulmonary dysplasia, pAscA = plasma ascorbic acid.
Figure 2
Figure 2
Measured plasma ascorbic-acid levels (mg/dL) per day of life in preterm infants ≤34 weeks with and without ROP. Infants who developed any ROP had significantly lower pAscA levels at birth and these remained low throughout the study period compared to those who did not develop ROP (p = 0.029, 95% CI: −0.43, 2.63). ROP = retinopathy of prematurity, pAscA= plasma ascorbic acid.
Figure 3
Figure 3
Measured plasma ascorbic-acid levels (mg/dL) in relation to corrected gestational age (weeks). Plasma ascorbic-acid levels were significantly lower with advancing preterm infant maturity outside the maternal womb (corrected gestational age) regardless of gestational age at birth (p < 0.027).
Figure 4
Figure 4
Measured plasma ascorbic-acid levels (mg/dL) in relation to gestational age at birth (weeks). With increased gestational age at birth, plasma ascorbic-acid levels were significantly lower (p < 0.001).
See this image and copyright information in PMC

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