Severe vitamin D deficiency in preterm infants: possibly no association with clinical outcomes?

Matějek, Tomáš; Zemánková, J; Maláková, Jana; Čermáková, Eva; Skálová, Sylva; Palička, Vladimír

doi:10.1080/14767058.2020.1762560

Cited by 11 publications

(11 citation statements)

References 40 publications

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“…16 A study found that vitamin D levels in the umbilical cord did not increase or decrease the risk of RDS (OR 1.044; 95%CI 0.349 to 0.88; P=0.0771). 17 Our study did not find a correlation between vitamin D deficiency and RDS. The RDS group had younger gestational age therefore leading this group to a higher risk of RDS.…”

Section: Discussioncontrasting

confidence: 69%

Vitamin D and T- regulator cells are not independent factors for RDS in premature neonates

Marsubrin¹,

Firmansyah²,

Rohsiswatmo³

et al. 2021

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Background The high morbidity and mortality of premature neonates remain significant problem in Indonesia with respiratory distress syndrome (RDS) as one of the most common problem. Vitamin D plays an important role in lung maturity. Vitamin D deficiency causes epithelial cell inflammation, leading to a higher risk of RDS. Previous studies suggest that T regulatory cells (Treg) in inflammatory diseases, such as RDS in neonates, are possibly linked to vitamin D deficiency. Objective To determine the role of vitamin D on RDS and Treg cells in very premature or very low birth weight neonates. Methods A prospective cohort study conducted on premature neonates in Neonatology Division, Department of Child Health, Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia. Umbilical cord blood samples were collected to evaluate total vitamin D 25-OH levels and Treg cells. Subjects with RDS were evaluated until the end of the observation period. Results The mean umbilical cord vitamin D level was 15.79 (SD 6.9) ng/mL, and 53% of the subjects were found to be deficient. As much as 65.1% of neonates had RDS. The mean Treg level was 11.38 (SD 2.45)%. No significant correlation was observed between vitamin D level and the occurrence of RDS (RR 0.87; 95%CI 0.56 to 1.34; P=0.53); vitamin D level and the dysregulation of Treg cells (RR 1.30; 95%CI 0.76 to 2.21; P=0.31) as well as between Treg dysregulation and RDS (RR 1.11; 95%CI 0.70 to 1.75; P=0.64). However, we found that RDS group had a lower gestational age and higher presentation of dysregulation Treg. Conclusion In very premature or very low birth weight neonates, no association between occurence of RDS and vitamin D deficiency as well as Treg cell dysregulation.

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Section: Discussioncontrasting

confidence: 69%

Vitamin D and T- regulator cells are not independent factors for RDS in premature neonates

Marsubrin¹,

Firmansyah²,

Rohsiswatmo³

et al. 2021

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“…In addition, Dogan et al (18) have confirmed that higher serum vitamin D levels in preterm infants can prevent NRDS. However, in contrast to this, in the latest prospective cohort study, when the cut-off value of 10 ng/ml was used, it was not found that the vitamin D status of preterm infants was related to NRDS, that is, the serum vitamin D level of preterm infants neither increased nor decreased the incidence of NRDS, which was contrary to the results of the above studies (21). Therefore, their relevance is still very controversial.…”

Section: Discussionmentioning

confidence: 77%

Association Between Vitamin D Level and Neonatal Respiratory Distress Syndrome: A Systematic Review and Meta-Analysis

Zang

Zhang

et al. 2022

Front. Pediatr.

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BackgroundIn recent years, vitamin D in the occurrence of lung diseases has gradually become a hot topic. Although the role of vitamin D in normal lung development has been confirmed, the correlation between vitamin D level and neonatal respiratory distress syndrome (NRDS) is not clear.ObjectiveTo evaluate the association between vitamin D level and NRDS.MethodsWe performed a comprehensive search of the following electronic databases: PubMed, Embase, Cochrane Library, Web of Science, and China National Knowledge Infrastructure (CNKI). Literature screening and quality assessment were performed according to inclusion and exclusion criteria. The Newcastle–Ottawa Scale was used to assess the methodological components of each study, and Stata 15.1 software to perform the Meta-analysis.ResultsA total of nine case-control studies were included, with 653 infants with NRDS and 501 infants without NRDS. The Meta-analysis showed no heterogeneity across all studies(I2=0.0%, P=0.583). The fixed-effect model showed that 25 hydroxy vitamin D level of children in the NRDS group was significantly lower than that of the non-NRDS group(SMD = −0.51, 95%CI: −0.63 to −0.39, p ≤ 0.05).ConclusionThis systematic review and meta-analysis study suggests that vitamin D deficiency is very likely to be a high-risk factor of NRDS, and reasonable vitamin D supplementation during pregnancy and after birth is of great significance.

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“…Studies that evaluated the influence of vitamin D status on early respiratory outcome of very preterm infants have shown conflicted findings (15,(26)(27)(28). The makers used to define RDS severity and vitamin D deficiency varied between the studies.…”

Section: Discussionmentioning

confidence: 99%

“…The makers used to define RDS severity and vitamin D deficiency varied between the studies. Some of them have found a high rate of RDS and markers of severe respiratory disease while others did not (15,(26)(27)(28)(29)(30). Onwuneme C et al have found in a population of very preterm infants (GA <32 weeks) an association between vitamin D deficiency at birth [25(OH)D levels < 30 nmol/L] and clinical signs of acute respiratory morbidity with higher oxygen needs and a greater rate of MV in the delivery room and during the neonatal period (15).…”

Section: Discussionmentioning

confidence: 99%

Low Vitamin D Levels at Birth and Early Respiratory Outcome in Infants With Gestational Age Less Than 29 Weeks

et al. 2022

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BackgroundVitamin D (VitD) is involved in lung development but its influence on respiratory distress syndrome of extremely preterm (EPT) infants have been little investigated. In this study, we examined the influence of low vitamin D status at birth on early respiratory outcomes of this vulnerable infant population.MethodsCord blood 25(OH)D levels ≤ 75 nmol/L were considered as Low vitamin D levels. Stepwise logistic regression and classification regression-tree analyses were used and the primary outcome was the combined outcome of death or mechanical ventilation need by the end of the first week (death or MV DoL7) as a marker od RDS severity.ResultsThe mean (SD) GA and birth weight were 26 (1.4) weeks and 801 (212) gr, respectively; 81/109 (74%) infants had low 25(OH)D levels. Infants with low VitD levels had 25% higher initial FiO2 levels (p < 0.05) and were more likely to be mechanically ventilated on DoL7 (36 vs. 7%, p < 0.05). Adjusted for gestational age, they had 10-fold higher odds of death or MV DoL7 (p < 0.01). By regression tree analysis, the rate of death or MV DoL7 increased from 18 to 71% in infants with GA < 26 weeks and with cord blood 25(OH)D levels higher and lower than 74 nmol/L, respectively (p < 0.05).ConclusionLow vitamin D levels at birth are associated with early adverse respiratory outcomes in infants with GA less 29 weeks. Further largest studies are needed to confirm this association.

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Severe vitamin D deficiency in preterm infants: possibly no association with clinical outcomes?

Cited by 11 publications

References 40 publications

Vitamin D and T- regulator cells are not independent factors for RDS in premature neonates

Vitamin D and T- regulator cells are not independent factors for RDS in premature neonates

Association Between Vitamin D Level and Neonatal Respiratory Distress Syndrome: A Systematic Review and Meta-Analysis

Low Vitamin D Levels at Birth and Early Respiratory Outcome in Infants With Gestational Age Less Than 29 Weeks

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