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Three Part Question

In [pre term infants] does [prophylactic vitamin E ]prevent [anaemia of Prematurity and reduce the need for transfusion?]

Clinical Scenario

In certain neonatal units there is the practice of supplementing vitamin E in therapeutic doses in order to prevent anaemia of prematurity.

Search Strategy

[vitamin E] or [anemia of prematurity] limited to human and english

Search Outcome

Medline search came out with 89 results of which 3 were found to be relevant

Relevant Paper(s)

Author, date and country	Patient group	Study type (level of evidence)	Outcomes	Key results	Study Weaknesses
Brion LP, Bell EF, Raghuveer TS. 2003 USA	Preterm less than 37 wks and 2500 gm	Cochrane review of randomised control trials and semi randomised control trials	Vitmain E supplementation significantly increased haemoglobin but it did not affect the need of transfusion		Too many variable relating to this search
Pathak A, Roth P, Piscitelli J, Johnson L 2003 USA	30 infant ,32 weaks or 1250 gm	Randomised, double blind, placebo controlled trial	Oral vitamin E supplementation at 50 IU/day does not increase the response of preterm infants to erythropoietin and iron		only 30 infants are studied
Zipursky A,Brown EJ, Watts J, Milner , RandC, Blanchette VS, Bell EF,Paes B 1987 USA	178 infants <1500gm	Randomized, controlled, and blinded trial.	At 6 weeks of age, there was no significant difference between the supplemented and un supplemented

Comment(s)

There was some evidence(1)mostly based on evidence from 1980's, that vitamin E administration will increase haemoglobin in preterm infants and but there is no evidence that Vitamin E supplementation will reduce the need for transfusion But recent evidence shows there is no significant difference in haemoglobin in both groups

Clinical Bottom Line

There is no role of prophylatic Vitamin E in preterm babies for prevention of anemia of prematurity

References

1. Brion LP, Bell EF, Raghuveer TS. Vitamin E supplementation for prevention of morbidity and mortality in preterm infants. cochrane data base
2. Pathak A, Roth P, Piscitelli J, Johnson L Effects of vitamin E supplementation during erythropoietin treatment of the anaemia of prematurity Archives of disease in childhood. Fetal and neonatal edition
3. Zipursky A,Brown EJ, Watts J, Milner , RandC, Blanchette VS, Bell EF,Paes B Oral vitamin E supplementation for the prevention of anemia in premature infants: a controlled trial paediatrics