Clinical efficacy of different supplemental doses of vitamins A and D in preventing bronchopulmonary dysplasia in preterm infants: A network meta-analysis based on randomized controlled trials.

BACKGROUND

Bronchopulmonary dysplasia (BPD) is a prevalent and severe chronic respiratory condition in preterm infants, with vitamin deficiency recognized as a contributing factor. Although vitamins A and D are known to play protective roles in lung development, the optimal supplementation doses for BPD prevention remain unclear.

METHODS

Search PubMed, Ovid, the Cochrane Library, Web of Science, CNKI, and Wanfang from database inception to November 30, 2024, identifying randomized controlled trials that investigated the role of vitamins A and D in the prevention of BPD in preterm infants. Data were extracted for network meta-analysis. Patient demographic data, the incidence of BPD, mortality, and mechanical ventilation duration were analyzed.

RESULTS

In our analysis, encompassing 20 studies with 4357 patients, we observed that high-dose vitamin D (HDVD, ≥800 IU/d) demonstrated the most notable reduction in the incidence of BPD; low-dose vitamin A (LDVA, <3330 IU/d) exhibited the lowest mortality; high-dose vitamin A (≥3330 IU/d) had the shortest mechanical ventilation duration.

CONCLUSION

Current scholarly literature suggests that HDVD (≥800 IU/d) supplementation may be the most effective regimen for preventing BPD in preterm infants, followed by LDVA (<3330 IU/d). No statistically significant differences in mortality were observed among any of the supplementation strategies or placebo. High-dose vitamin A (≥3330 IU/d) was associated with a shorter duration of mechanical ventilation. Consequently, to prevent BPD in preterm infants, supplementation with HDVD (≥800 IU/d) and LDVA (<3330 IU/d) may be considered.