Background. This study aimed to assess whether the serum levels of vitamin A, vitamin D and vitamin E are associated with respiratory distress syndrome (RDS) in preterm infants.

Methods. This retrospective research included 179 neonates born before 35 weeks of gestation in Jiaxing Maternity and Child Health Care Hospital from January 2020 to December 2020. Depending on whether or not they had RDS, participants were classified into the RDS group (59 neonates) and the control group (120 neonates). The 1:1 propensity score matching (PSM) analysis was performed to balance the baseline confounding factors and then the groups were compared in terms of serum vitamin levels and RDS morbidity.

Results. A total of 34 pairs of preterm infants were involved after PSM. There were significant differences in vitamin D level (12.13 (8.44-17.85) ng/mL vs. 16.84 (10.75-25.83) ng/mL), vitamin D deficiency rate (85.3% vs. 55.9%), as well as vitamin A level (134.91 (105.01-156.74) ng/mL vs. 152.46 (120.06-200.00) ng/mL) in the two groups. However, the vitamin A deficiency rate, vitamin E status, as well as vitamin E deficiency rate did not differ significantly between the two groups. Logistic analysis showed that a low level of vitamin D was an independent risk factor for RDS in preterm neonates (OR 0.917, 95%CI 0.851-0.989).

Conclusions. Low serum vitamin D levels may contribute to the development of RDS in preterm infants, but no significant effect of serum vitamin A and vitamin E levels was found.

Keywords: propensity score matching, respiratory distress syndrome, vitamin A, vitamin D, vitamin E