Randomized controlled trial comparing two doses of daily vitamin D supplementation in preterm neonates

Dina Jamal Abdelmoez Abdelmegeed Basta; Hanna Mohamed Aboulghar; Aliaa Adel Ali; Dina Mohamed Akmal; Heba Nabil Amin Baz

doi:10.53730/ijhs.v6nS1.4760

Authors

Dina Jamal Abdelmoez Abdelmegeed Basta
deena-gamal@hotmail.com
Department of Pediatrics, Faculty of Medicine, Cairo University, Cairo, Egypt
Hanna Mohamed Aboulghar Department of Pediatrics, Faculty of Medicine, Cairo University, Cairo, Egypt
Aliaa Adel Ali Department of Pediatrics, Faculty of Medicine, Cairo University, Cairo, Egypt
Dina Mohamed Akmal Department of Pediatrics, Faculty of Medicine, Cairo University, Cairo, Egypt
Heba Nabil Amin Baz Department of Clinical and Chemical Pathology, Faculty of Medicine, Cairo University, Cairo, Egypt

Keywords:

anthropometry, calcium, NICU outcomes, preterm neonates, vitamin D supplementation

Abstract

Vitamin D supplementation is recommended for preterm infants. The study aimed to compare the effect of 400 versus 1000 IU of daily oral vitamin D3 doses on vitamin D levels and anthropometric measurements of two groups of newborns. A Randomized controlled trial included eighty successive preterm neonates with a gestational age of ?32 weeks who were randomly allocated to receive 400 or 1000 IU/day of vitamin D. Data were processed using the Statistical Package for Social Science version 23. Vitamin D concentrations at 40 weeks postconceptual age were significantly higher in the 1000 IU (16.26 ± 7.92 ng/ml) when compared to the 400 IU group (12.87 ± 6.15 ng/ml). Serum Calcium showed a highly significant rise in the 1000 IU group when compared with the 400 IU group (9.18 ± 1.76 mg/dL vs. 8.69 ± 0.77 mg/dL, p<0.001). Significant progression in length at follow-up in the 1000 IU group compared with the 400 IU group (42.0 ± 3.45 cm vs 39.93 ± 1.60 cm, p<0.001). Conclusion: 1000 IU/day of vitamin D supplementation in preterm infants ?32 weeks gestation age effectively decreases the prevalence of vitamin D deficiency and leads to higher concentrations of 25(OH) vitamin D at 40 weeks PCA.

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References

Abrams, S. A. (2007). In utero physiology: role in nutrient delivery and fetal development for calcium, phosphorus, and vitamin D. The American journal of clinical nutrition, 85(2), 604S-607S.

Abrams, S. A., Bhatia, J. J., Corkins, M. R., De Ferranti, S. D., Golden, N. H., & Silverstein, J. (2013). Calcium and vitamin D requirements of enterally fed preterm infants. Pediatrics, 131(5), e1676-e1683.

Agostoni, C., Buonocore, G., Carnielli, V. P., De Curtis, M., Darmaun, D., Decsi, T., ... & ESPGHAN Committee on Nutrition. (2010). Enteral nutrient supply for preterm infants: commentary from the European Society of Paediatric Gastroenterology, Hepatology and Nutrition Committee on Nutrition. Journal of pediatric gastroenterology and nutrition, 50(1), 85-91.

Anderson-Berry, A., Thoene, M., Wagner, J., Lyden, E., Jones, G., Kaufmann, M., ... & Hanson, C. (2017). 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. PLoS One, 12(10), e0185950.

Apgar, V., & James, L. S. (1962). Further observations on the newborn scoring system. American journal of Diseases of Children, 104(4), 419-428.

Backström, M. C., Mäki, R., Kuusela, A. L., Sievänen, H., Koivisto, A. M., Ikonen, R. S., ... & Mäki, M. (1999). Randomised controlled trial of vitamin D supplementation on bone density and biochemical indices in preterm infants. Archives of Disease in Childhood-Fetal and Neonatal Edition, 80(3), F161-F166.

Ballard, J. L., Novak, K. K., & Driver, M. (1979). A simplified score for assessment of fetal maturation of newly born infants. The Journal of pediatrics, 95(5 Pt 1), 769-774.

Bozkurt, O., Uras, N., Sari, F. N., Atay, F. Y., Sahin, S., Alkan, A. D., ... & Oguz, S. S. (2017). Multi-dose vitamin d supplementation in stable very preterm infants: prospective randomized trial response to three different vitamin D supplementation doses. Early Human Development, 112, 54-59. https://doi.org/10.1016/j.earlhumdev.2017.07.016

Cloherty, J. P., Eichenwald, E. C., & Stark, A. R. (Eds.). (2008). Manual of neonatal care. Lippincott Williams & Wilkins.

Fettah, N. D., Zenciro?lu, A., Dilli, D., Beken, S., & Okumu?, N. (2015). Is higher 25-hydroxyvitamin D level preventive for respiratory distress syndrome in preterm infants?. American journal of perinatology, 32(03), 247-250.

Hewison, M. (2011). Antibacterial effects of vitamin D. Nature Reviews Endocrinology, 7(6), 337-345.

Koo, W. W., Sherman, R., Succop, P., Krug-Wispe, S., Tsang, R. C., Steichen, J. J., ... & Oestreich, A. E. (1989). Fractures and rickets in very low birth weight infants: conservative management and outcome. Journal of pediatric orthopedics, 9(3), 326-330.

Mathur, N. B., Saini, A., & Mishra, T. K. (2016). Assessment of adequacy of supplementation of vitamin D in very low birth weight preterm neonates: a randomized controlled trial. Journal of Tropical Pediatrics, 62(6), 429-435.

Maxwell, C. S., Carbone, E. T., & Wood, R. J. (2012). Better newborn vitamin D status lowers RSV-associated bronchiolitis in infants. Nutrition reviews, 70(9), 548-552.

Natarajan, C. K., Sankar, M. J., Agarwal, R., Pratap, O. T., Jain, V., Gupta, N., ... & Sreenivas, V. (2014). Trial of daily vitamin D supplementation in preterm infants. Pediatrics, 133(3), e628-e634.

Onwuneme, C., Martin, F., McCarthy, R., Carroll, A., Segurado, R., Murphy, J., ... & Molloy, E. (2015). The association of vitamin D status with acute respiratory morbidity in preterm infants. The Journal of pediatrics, 166(5), 1175-1180. https://doi.org/10.1016/j.jpeds.2015.01.055

Pittard, W. B., Geddes, K. M., Hulsey, T. C., & Hollis, B. W. (1991). How much vitamin D for neonates?. American Journal of Diseases of Children, 145(10), 1147-1149.

Rigo, J., Mohamed, M. W., & De Curtis, M. (2006). Disorders of calcium, phosphorus and magnesium metabolism. Neonatal-Perinatal medicine: disease of the fetus and infanth, 8, 1492-1523.

Rigo, J., Pieltain, C., Salle, B., & Senterre, J. (2007). Enteral calcium, phosphate and vitamin D requirements and bone mineralization in preterm infants. Acta Paediatrica, 96(7), 969-974.

Tarby, T. J., & Volpe, J. J. (1982). Intraventricular hemorrhage in the premature infant. Pediatric Clinics of North America, 29(5), 1077-1104.

Terek, D., Özcan, G., Ergin, F., Koroglu, Ö. Z. G. E., Yalaz, M., AKISÜ, M., & Kültürsay, N. (2018). Vitamin D deficiency in premature infants and its effects on neonatal prognosis. Journal of Pediatric Research, 5(1).

Tergestina, M., Rebekah, G., Job, V., Simon, A., & Thomas, N. (2016). A randomized double-blind controlled trial comparing two regimens of vitamin D supplementation in preterm neonates. Journal of Perinatology, 36(9), 763-767.

Vachharajani, A. J., Mathur, A. M., & Rao, R. (2009). Metabolic bone disease of prematurity. NeoReviews, 10(8), e402-e411.

Yang, L. R., Li, H., Zhang, T., & Zhao, R. C. (2018). Relationship between vitamin D deficiency and necrotizing enterocolitis in preterm infants. Zhongguo Dang dai er ke za zhi= Chinese Journal of Contemporary Pediatrics, 20(3), 178-183.

Yang, Y., Li, Z., Yan, G., Jie, Q., & Rui, C. (2018). Effect of different doses of vitamin D supplementation on preterm infants–an updated meta-analysis. The Journal of Maternal-Fetal & Neonatal Medicine, 31(22), 3065-3074.