Vitamin D Deficiency Prevalence in Late Neonatal Hypocalcemia: A Multicenter Study

Abstract

Objective: Late neonatal hypocalcemia (LNH) is a common metabolic problem associated with hypoparathyroidism, high phosphate intake and vitamin D deficiency, often presenting with seizures. In this cross-sectional study, we aimed to evaluate the role of vitamin D deficiency in LNH in Turkey and to describe the characteristics of affected newborns. Methods: Conducted with a cross-sectional design and with the participation of 61 neonatal centers from December 2015 to December 2016, the study included term neonates with LNH (n=96) and their mothers (n=93). Data were registered on the FAVOR Web Registry System. Serum samples of newborns and mothers were analyzed for calcium, phosphate, magnesium, albumin, alkaline phosphatase, intact parathyroid hormone (iPTH) and 25 hydroxyvitamin D [25(OH)D] levels. Results: The median (range) onset time of hypocalcemia was 5.0 (4.0-8.0) days of age, with a male preponderance (60.4%). The median (range) serum 25(OH)D levels of the neonates and their mothers were 6.3 (4.1-9.05) and 5.2 (4.7-8.8) ng/mL, respectively. The prevalence of vitamin D deficiency (<12 ng/mL) was high in both the neonates (86.5%) and mothers (93%). Serum 25(OH)D levels of the infants and mothers showed a strong correlation (p<0.001). While the majority (93.7%) of the neonates had normal/high phosphorus levels, iPTH levels were low or inappropriately normal in 54.2% of the patients. Conclusion: Vitamin D deficiency prevalence was found to be high in LNH. Efforts to provide vitamin D supplementation during pregnancy should be encouraged. Evaluation of vitamin D status should be included in the workup of LNH.

Mediation Effect of Social Distancing on Neonatal Vitamin D Status and Related Clinical Outcomes during the Coronavirus Disease-19 Pandemic

“…Among neonatal morbidities, hypocalcemia was significantly associated with neonatal vitamin D deficiency ( Table 3 and Table 4 ), consistent with previous studies [ 9 , 10 ]. A lower rate of respiratory illness was seen during SD than B-SD ( Table 1 ), but it was not related to neonatal vitamin D deficiency in the study ( Table 3 ), unlike previous reports [ 11 , 12 , 13 , 14 ].…”

“…Like previous studies, the results also showed that maternal vitamin D status could affect neonatal vitamin D levels, and maternal supplementation could improve the vitamin D level of the mother and her offspring [ 5 , 6 , 28 ]. Multiple roles of vitamin D in neonates have been reported besides its fundamental function in bone health, and its deficiency has been associated with many adverse health effects in neonates, including respiratory, infectious, and metabolic diseases [ 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 ]. Although more evidence on routine vitamin D supplementation to pregnant women is necessary, supplementation during pregnancy may help to reduce neonatal vitamin D deficiency without significant side effects [ 29 ].…”

“…Vitamin D plays a fundamental role in promoting various physiological functions, including the immune system, and prenatal and postnatal lung growth, as well as calcium and phosphorus homeostasis in neonates [ 7 , 8 ]. Vitamin D deficiency in neonates is related to diverse morbidities, such as late-onset hypocalcemia, sepsis, and respiratory illness, including respiratory distress syndrome (RDS) and transient tachypnea of newborn (TTN) in both preterm and term newborn infants [ 9 , 10 , 11 , 12 , 13 , 14 , 15 ].…”