The relationship between umbilical cord blood vitamin A levels and late preterm infant morbidities: A prospective cohort study

Abstract Background: Low plasma vitamin A levels increases the risk of neonates’ morbidity. However, the relationship between umbilical cord blood (UCB) vitamin A levels and late-preterm infant (LPI) consequences is inconclusive. Herein, we attempted to clarify the association between UCB vitamin A levels and LPI morbidities.Methods: We conducted a prospective cohort study of 208 LPI (from 34+0 to 36+6 weeks gestational age) between January 1, 2014 and June 30, 2015. UCB specimens were collected shortly after birth, and vitamin A levels were determined by enzyme-linked immunosorbent assay. Jaundice, sepsis, respiratory distress syndrome, bronchopulmonary dysplasia, necrotizing enterocolitis, and death were recorded.Results: Prevalence of low UCB vitamin A level <0.7 μmol/L was 37.5% in LPI. Cesarean section was an independent risk factor of UCB vitamin A level < 0.7 μmol/L. Nevertheless, UCB vitamin A levels did not correlate with gestational age, birthweight, and gender. UCB vitamin A level < 0.7 μmol/L was not an independent risk factor for hospitalization, oxygen supplementation, hyperbilirubinemia, sepsis and respiratory distress syndrome. However, cesarean section, gestational age < 35 weeks and birthweight < 2500 g were independent risk factors for hospitalization and RDS. In addition, cesarean section increased the risk of oxygen supplementation, while gestational age < 35 weeks increased the risk of hyperbilirubinemia. Conclusions: Cesarean section delivery is an independent risk factor of low UCB vitamin A levels, and increases the risk of RDS. On the basis of our results, there is no association between low vitamin A levels and morbidity of late-preterm infants, including hyperbilirubinemia, sepsis and respiratory distress syndrome. Trial registration: Not applicable.