Vitamin A as an add-on treatment for neonatal respiratory distress syndrome: a clinical study

Objective To investigate the clinical efficacy of vitamin A supplementation in the treatment of neonatal respiratory distress syndrome (NRDS) . Methods A total of 72 NRDS children who stayed in our hospital from January 2016 to May 2017 were randomly divided into the study group (n=36) and NRDS control group (n=36) . Another contemporary group of preterm infants was recruited as non-NRDS control group (n=36) . Both the study group and the NRDS control group received routine treatment, ie bovine pulmonary surfactant, while the study group was additionally given vitamin A supplement. Prior to and at 7 days of the treatment, blood gas analysis was performed for the two groups of children. The treatment efficacy was evaluated at 7 days of treatment. Meanwhile, serum levels of transforming growth factor-β1 (TGF-β1) and bone morphogenetic protein-7 (BMP-7) were detected at 0, 1, 3, and 7 days after birth in the three groups. Results Evaluation of treatment efficacy at 7 days showed that the effective rates in the study group and the NRDS control group were 66.67% (24/36) and 44.44% (16/36) respectively, with statistically significant difference between two groups (χ2=−2.039, P=0.041) . At 7 days of treatment, the study group had significantly higher arterial oxygen partial pressure (PaO2) and blood pH, and significantly lower arterial carbon dioxide partial pressure (PaCO2) , compared with the NRDS control group (all P< 0.05) . The levels of serum TGF-β1 and BMP-7 were significantly higher in the NRDS control group than those in the study group and non-NRDS control group, while in the study group than those in the non-NRDS control group (all P<0.001) . At 7 days of treatment, the study group and the NRDS control group showed remarkable decline in levels of serum TGF-β1 and BMP-7 from their peak values (all P<0.05) . Conclusion Supplemental vitamin A added on bovine pulmonary surfactant may help elevate the clinical efficacy and improve the prognosis in NRDS. Key words: Vitamin A; Pulmonary surfactants; Respiratory distress syndrome, newborn; Transforming growth factor-β1; Bone morphogenetic protein-7