Severe vitamin D deficiency in preterm infants: maternal and neonatal clinical features

Abstract

PurposeWe investigated the vitamin D status of preterm infants to determine the incidence of vitamin D deficiency.MethodsA total of 278 preterm infants delivered at Kyungpook National University Hospital between January 2013 and May 2015 were enrolled. The serum concentrations of calcium, phosphorous, alkaline phosphatase, and 25-hydroxyvitamin D (25-OHD) were measured at birth. We collected maternal and neonatal data such as maternal gestational diabetes, premature rupture of membranes, maternal preeclampsia, birth date, gestational age, and birth weight.ResultsMean gestational age was 33+5±2+2 weeks of gestation and mean 25-OHD concentrations were 10.7±6.4 ng/mL. The incidence of vitamin D deficiency was 91.7%, and 51.1% of preterm infants were classified as having severe vitamin D deficiency (25-OHD<10 ng/mL). The serum 25-OHD concentrations did not correlate with gestational age. There were no significant differences in serum 25-OHD concentrations or incidence of severe vitamin D deficiency among early, moderate, and late preterm infants. The risk of severe vitamin D deficiency in twin preterm infants was significantly higher than that in singletons (odds ratio, 1.993; 95% confidence interval [CI], 1.137-3.494, P=0.016). In the fall, the incidence of severe vitamin D deficiency decreased 0.46 times compared to that in winter (95% CI, 0.227-0.901; P=0.024).ConclusionMost of preterm infants (98.9%) had vitamin D insufficiency and half of them were severely vitamin D deficient. Younger gestational age did not increase the risk of vitamin D deficiency, but gestational number was associated with severe vitamin D deficiency.

Vitamin D Deficiency in Premature Infants and Its Effects on Neonatal Prognosis

“…Burris et al (18) did not see any linear correlation between vitamin D level and gestational week. Park et al (20) reported insignificant correlation of vitamin D levels with gestational age and birth weight.…”

“…Park et al (20) found vitamin D level as 10.7±6.4 ng/mL in a study of 278 cases with a mean gestational age of 33±2 weeks. In the cohort of Park et al (20) 91% of newborn babies have vitamin D deficiency and there is severe vitamin D deficiency in 51%. In our study the mean vitamin D level was higher and vitamin D deficiency rates were lower when compared to the above studies (19,20).…”

“…In the cohort of Park et al (20) 91% of newborn babies have vitamin D deficiency and there is severe vitamin D deficiency in 51%. In our study the mean vitamin D level was higher and vitamin D deficiency rates were lower when compared to the above studies (19,20). In our study, vitamin D levels were not related to gestational age and birth weight.…”

“…In our cases with intrauterine growth restriction vitamin D level was ≤20 ng/mL in 60% of cases (p<0.05). Low maternal vitamin D levels during pregnancy also have been shown to be associated with increased risk of specific conditions including gestational diabetes, preeclampsia and poor fetal growth (20). Park et al (20) reported insignificant correlation of vitamin D levels with premature rupture of membranes and preeclampsia, and a small correlation with gestational age.…”

Maternal Anemia and Vitamin D deficiency: associations with neonatal hemoglobin levels and the vitamin D status

“…1,2 The results from previous studies indicated that the vitamin D levels in Korean preterm infants were lower than those in infants in Northern European countries. 3,4 Vitamin D deficiency remains a common micronutrient disorder despite of encouragement to vitamin D supplements. Vitamin D plays an important role in calcium and bone metabolism, and potential associations between vitamin D and immune modulators, erythropoiesis, and iron homeostasis have been reported.…”