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PEDIATRICS Vol. 111 No. 3 March 2003, pp. 477-482

Clinical Effects of L-Carnitine Supplementation on Apnea and Growth in Very Low Birth Weight Infants

Jonathan Whitfield, MBChB*, Twyala Smith, RD{ddagger}, Heather Sollohub, RD{ddagger}, Lawrence Sweetman, PhD§ and Charles R. Roe, MD§

* Division of Neonatology, Department of Pediatrics
{ddagger} Department of Nutrition Services
§ Institute of Metabolic Disease, Baylor University Medical Center, Dallas, Texas

--> Objective. Systemic carnitine deficiency may present with apnea, hypotonia, and poor growth. Premature infants often manifest these symptoms and are at risk of developing carnitine deficiency because of immaturity of the biosynthetic pathway, lack of sufficient predelivery transplacental transport, and lack of sufficient exogenous supplementation. This study was undertaken to examine the effect of carnitine supplementation in premature infants.

Methods. Eighty preterm infants <1500 g were enrolled in a prospective, double-blind, placebo-controlled study of carnitine supplementation within 96 hours of delivery. Growth, length of hospital stay, and frequency and severity of apnea were the primary outcome measures.

Results. Weight gain and change in length, fronto-occipital head circumference, mid arm circumference, and triceps skinfold thickness were similar between the carnitine-supplemented and placebo groups. The amount and severity of apnea and the overall length of hospitalization were also similar between the 2 groups. The carnitine levels in the supplemented group were significantly higher than in the placebo group at 4 and 8 weeks after study entry.

Conclusion. Although preterm infants <1500 g have low carnitine levels, routine supplementation with carnitine has no demonstrable effect on growth, apnea, or length of hospitalization and thus seems to be unnecessary.

Key Words: carnitine supplementation • very low birth weight infants • apnea • growth

Abbreviations: VLBW, very low birth weight • LOS, length of stay • NICU, neonatal intensive care unit • PCG, pneumocardiogram

Received for publication Mar 5, 2002; Accepted Sep 6, 2002.




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