Clinical indicative roles of vitamins A, D and E in preterm and term neonates with respiratory distress syndrome

Abstract

Neonatal respiratory distress syndrome (NRDS) is a leading cause of neonatal mortality, and commonly occurs in preterm neonates. Vitamins are closely related with lung development. The purpose of this study was to evaluate the clinical predictive value of umbilical cord serum vitamins A, D and E for NRDS onset in both preterm and term infants. A total of 150 NRDS neonates, including 114 preterm and 36 term cases, were included in this study. The levels of vitamins A, D and E in the umbilical cord serum of NRDS neonates were measured using electrochemiluminescence method. The predictive value of vitamins was evaluated using logistics regression analysis and receiver operating characteristic curves. Vitamins A, D and E levels were significantly reduced in NRDS neonates and served as risk factors for the onset of NRDS with certain predictive accuracy, which manifested by the area under the curve (AUC) value (0.885 for vitamins A, 0.875 for vitamins D, 0.720 for vitamins E). Additionally, in the 114 preterm cases, decreased vitamins A, D and E were also independently associated with NRDS occurrence. For term NRDS neonates, only vitamins A and D were determined as two risk factors for disease onset. Overall, vitamins A, D and E levels were lower in NRDS compared with normal control neonates, and vitamins A and D played as predictive indicators for NRDS onset in both preterm and term neonates, while relationship between vitamins E and NRDS was only found in preterm neonates.