Randomized trial of two doses of vitamin D3 in preterm infants &lt;32 weeks: Dose impact on achieving desired serum 25(OH)D3 in a NICU population

Anderson‐Berry, Ann; Thoene, Melissa; Wagner, Julie; Lyden, Elizabeth; Jones, Glenville; Kaufmann, Martin; Ormer, Matthew Van; Hanson, Corrine

doi:10.1371/journal.pone.0185950

Cited by 37 publications

(30 citation statements)

References 54 publications

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“…There are far fewer data relating 25(OH)D levels and bone mineral content or density in preterm infants or even fracture rates in these infants. Some data suggest a possible benefit for higher 25(OH)D levels on bone mineralization but need confirmation in larger trials and correlation with clinical events and outcomes [11-13]. There are no data indicating that doses of vitamin D of 400 IU daily, or serum 25(OH)D achieved with those doses, are associated with an increased risk of rickets or fractures in any population of preterm or full-term infants.…”

Section: Vitamin D Intake and Functionmentioning

confidence: 99%

Vitamin D in Preterm and Full-Term Infants

Abrams

2020

Ann Nutr Metab

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Vitamin D is necessary for the active (transcellular) absorption of calcium and for skeletal health. Inadequate vitamin D in infants leads to increased risks of poor bone mineralization and ultimately rickets. Rickets is uncommon in full-term infants with a much higher risk in very premature infants. However, the primary cause of rickets in premature infants is a deficiency of calcium and phosphorus, not vitamin D. Available research, as well as most guidelines, recommend an intake of 400 IU daily of vitamin D as adequate for bone health in preterm and full-term infants. Higher doses have not been consistently shown to have specific clinical benefits for healthy infants. There are no strong data to support either routine testing of serum 25-hydroxyvitamin D or targeting high serum 25-hydroxyvitamin D levels (e.g., 30 ng/mL) in healthy preterm or full-term infants. Vitamin D is commonly provided to infants via drops for breastfed babies or via infant formula, although alternative dosing approaches exist for breastfed infants, which some families may prefer. These include the use of drops placed on the mother’s breast, dissolvable doses, and high maternal doses (approximately 6,400 IU daily). Infant formula contains vitamin D, and most infants will reach an intake from formula of about 400 IU daily within the first 2 months of life if they are consuming routine cow milk-based formula. Although vitamin D toxicity is very uncommon, caution should be used to avoid extremely concentrated high doses found in some commercially available drops. Infants with liver or kidney disease may need special attention to vitamin D intake and status. Further research is needed to define the role of vitamin D in non-bone health outcomes of infants and to identify methods to enhance compliance with current recommendations for vitamin D intake in infants.

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Section: Vitamin D Intake and Functionmentioning

confidence: 99%

Vitamin D in Preterm and Full-Term Infants

Abrams

2020

Ann Nutr Metab

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“…In more recent randomized controlled trials, Natarajan et al [17] suggested that 800 IU/day reduced the incidences of vitamin D deficiencies at term CA but showed no improvements in bone mineralization at term and three months CA. Anderson-Berry et al [18] showed greater improvements in serum vitamin D concentrations and bone density measurements of infants born <32 weeks supplemented with 800 IU, compared to 400 IU/day.…”

Section: Discussionmentioning

confidence: 99%

Vitamin and Mineral Supplementation Practices in Preterm Infants: A Survey of Australian and New Zealand Neonatal Intensive and Special Care Units

et al. 2019

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Preterm infants are at increased risk of micronutrient deficiencies as a result of low body stores, maternal deficiencies, and inadequate supplementations. The aim of this survey was to investigate current vitamin and mineral supplementation practices and compare these with published recommendations and available evidence on dosages and long-term outcomes of supplementations in preterm infants. In 2018, a two-part electronic survey was emailed to 50 Australasian Neonatal Dietitians Network (ANDiN) member and nonmember dietitians working in neonatal units in Australia and New Zealand. For inpatients, all units prescribed between 400 and 500 IU/day vitamin D, compared to a recommended intake range of 400–1000 IU/day. Two units prescribed 900–1000 IU/day at discharge. For iron, 83% of respondents prescribed within the recommended intake range of 2–3 mg/kg/day for inpatients. Up to 10% of units prescribed 6 mg/kg/day for inpatients and at discharge. More than one-third of units reported routine supplementations of other micronutrients, including calcium, phosphate, vitamin E, and folic acid. There was significant variation between neonatal units in vitamin and mineral supplementation practices, which may contribute to certain micronutrient intakes above or below recommended ranges for gestational ages or birth weights. The variations in practice are in part due to differences in recommended vitamin and mineral intakes between expert groups and a lack of evidence supporting the recommendations for supplementations.

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“…Vitamin D affects the relationship between endodermal and mesodermal cells that results in alveolar structure and lung maturation. Deficiency of this vitamin, followed by lung non-maturation, may cause the more need for oxygen therapy (14,31).…”

Section: Discussionmentioning

confidence: 99%

Comparison of Serum Vitamin D in the Umbilical Cord of Survived with Not Survived Premature Infants

et al. 2019

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Background: Vitamin D deficiency is associated with prematurity, respiratory problems and infections. These are important causes of death in premature neonates. Objectives: The aim of this study was to compare the vitamin D level in the blood of preterm live neonates discharged with those neonates who did not survive. Methods: In a cross-sectional study, 335 premature infants (less than 34 weeks of gestation) were discharged and 48 infants died. We examined their umbilical cord blood for vitamin D. Results: Eighty-eight percent of our premature neonates had vitamin D deficiency. The mean of vitamin D in the survived neonates was 14.87 ± 10.94 and in those who succumbed their prematurity it was 9.4 ± 6.52 ng/mL (P < 0.01). There was a significant difference between the two groups in terms of the type of delivery, Apgar score of first and fifth minutes, duration of oxygen therapy and gestational age (P < 0.05). Conclusions: The results of this study showed that most premature neonates have a severe vitamin D deficiency, and this deficiency was more pronounced in the dead neonates than in those that survived, despite eliminated the role of gestational age. Measurement of cord blood vitamin D level may help predict the prognosis for premature neonates.

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Randomized trial of two doses of vitamin D3 in preterm infants <32 weeks: Dose impact on achieving desired serum 25(OH)D3 in a NICU population

Cited by 37 publications

References 54 publications

Vitamin D in Preterm and Full-Term Infants

Vitamin D in Preterm and Full-Term Infants

Vitamin and Mineral Supplementation Practices in Preterm Infants: A Survey of Australian and New Zealand Neonatal Intensive and Special Care Units

Comparison of Serum Vitamin D in the Umbilical Cord of Survived with Not Survived Premature Infants

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