Questioning the adequacy of standardized vitamin D supplementation protocol in very low birth weight infants: a prospective cohort study

Hatice Sarıdemir; Ozge Surmeli Onay; Ozge Aydemir; Ayse Neslihan Tekin

doi:10.1515/jpem-2021-0390

Article

Questioning the adequacy of standardized vitamin D supplementation protocol in very low birth weight infants: a prospective cohort study

Hatice Sarıdemir , Ozge Surmeli Onay , Ozge Aydemir and Ayse Neslihan Tekin

Published/Copyright: August 20, 2021

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From the journal Journal of Pediatric Endocrinology and Metabolism Volume 34 Issue 12

Abstract

Objectives

Preterm infants are at increased risk for vitamin D deficiency (VDD). We aimed to assess the adequacy of standardized vitamin D supplementation protocol in very low birth weight (VLBW) infants. Additionally, vitamin D status of mother/infant couples and the associations between vitamin D status at birth and morbidities of the infants were investigated.

Methods

In this single-center, prospective cohort study blood samples were collected from 55 mothers just before delivery and from their infants at birth and on the 30th day of life (DOL) for 25 hydroxy vitamin D (25OHD) measurements. Vitamin D was initiated in dose of 160 IU/kg by parenteral nutrition on the first DOL and oral vitamin D supplementation (400 IU/day) was administered when enteral feedings reached 50% of total intake or on the 15th DOL.

Results

The median 25OHD levels of the infants were 16.12 (9.14–20.50) in cord blood and 36.32 (31.10–44.44) in venous blood on the 30th DOL (p<0.01). In 98% of the VLBW infants 25OHD reached sufficient levels on the 30th DOL. None of the mothers had sufficient vitamin D levels (25OHD >30 ng/mL). Maternal 25OHD levels were correlated with the 25OHD levels of the infants in cord blood (r=0.665, p<0.001). There was a significant difference in mean cord 25OHD levels between winter (13.65 ± 5.69 ng/mL) and summer seasons (19.58 ± 11.67 ng/mL) (p=0.021). No association was found between neonatal morbidity and vitamin D status.

Conclusions

The results clearly show that by utilizing the current supplementation protocol, the majority of VLBW infants with deficient/insufficient serum 25OHD levels reached sufficient levels on the 30th DOL. Furthermore, vitamin D levels in mother/infant couples were found to be highly correlated.

Keywords: neonatal intensive care unit; preterm; very low birth weight infant; vitamin D; vitamin D supplementation

Corresponding author: Ayse Neslihan Tekin, MD, Professor, Department of Pediatrics, Division of Neonatology Eskisehir Osmangazi University Faculty of Medicine, Eskisehir, Turkey, Phone: +90 542 4217254, Fax: +90 222 2391975, E-mail: neslihan801@gmail.com

Hatice Sarıdemir and Ayse Neslihan Tekin shared first authorship.

Acknowledgements

This study was Hatice Sarıdemir’s Thesis in Pediatrics, and Ayse Neslihan Tekin served as the Thesis advisor.

Research funding: None declared.
Author contributions: H.S. and A.N.T. equally contributed to the conception and design of the research, acquisition and analysis of the data; O.S.O. contributed to design, acquisition, analysis, interpretation of data and drafted manuscript. O.A. contributed to the acquisition, analysis and interpretation of the data. All authors critically revised the manuscript, agree to be fully accountable for ensuring the integrity and accuracy of the work, and read and approved the final manuscript.
Competing interests: Authors state no conflict of interest.
Informed consent: An informed consent was obtained after the participants had received a detailed introduction to the study.
Ethical approval: The Institutional Ethics Committee approved the study (No. 10-28.06.2018).

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Received: 2021-06-08

Accepted: 2021-08-02

Published Online: 2021-08-20

Published in Print: 2021-12-20

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Articles in the same Issue

https://doi.org/10.1515/jpem-2021-0390

Keywords for this article

neonatal intensive care unit; preterm; very low birth weight infant; vitamin D; vitamin D supplementation