Necrotizing Enterocolitis of Newborn Clinical Trial
Official title:
The Effect of Co-administered β-Carotene, Vitamin D3, Zinc and Antenatal Steroid Therapy on Hyaline Membrane Disease and Feeding Intolerance in Premature Neonates
Hyaline membrane disease, now commonly called respiratory distress syndrome (RDS), and feeding intolerance, which can lead to necrotizing enterocolitis (NEC), are two key morbidities found in premature neonates which resulted in high mortality rate in Indonesia. Cochrane meta-analysis proved that antenatal steroid therapy can reduce the morbidity and mortality rate of premature neonates. But there is still different outcomes and severity of disease in preterm newborn receiving the same dose of antenatal steroid therapy. This raises questions whether there are other factors influencing the development and maturity of lung and gut in preterm newborn, aside from steroid therapy. Vitamin A, D and zinc are already known for their function in fetal lung and gut development. To our best of knowledge, no study has evaluated the effect of these vitamins levels on HMD and feeding intolerance in premature neonates. Therefore, the aim of this study want to evaluate the effect of antenatal steroid therapy versus co-administered β-carotene, vitamin D3, zinc and antenatal steroid therapy on the presence and severity of HMD and feeding intolerance in premature neonates.
This study is a randomized controlled trial and held in Cipto Mangunkusumo Hospital.
Pregnant women 28-34 weeks of gestational age, who fulfill the inclusion criteria, divide
into two groups. Subjects from both groups receive the hospital protocol of preterm birth, 4
doses of 6 mg of dexamethasone, intravenous 12 hours apart to support lung maturation.
Subjects in intervention group receive oral single-dose beta-carotene 25,000 IU, oral
single-dose vitamin D3 50,000 IU and oral zinc 50 mg/day for 3 days. The maternal dan cord
blood sample are obtained for zinc, vitamin A and 25(OH)D levels before and after
intervention. After the premature neonates was born, observation will be done for maximum
period of 4 weeks. The presence and severity of HMD and feeding intolerance or NEC will be
recorded. Neonates showing any signs of HMD and/or abdominal distension will need to undergo
additional chest/abdominal x-ray procedures.
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