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[Neonatal vitamin D status and calcium-phosphorus homeostasis in the third week of life]
Justyna Czech-Kowalska1, Anna Dobrzanska, Joanna Janowska
1Klinika Patologii Noworodka, Instytut Pomnik Centrum Zdrowia Dziecka, Al. Dzieci Polskich 20, 04-736 Warszawa, Poland. justynakowalska@poczta.fm
Insights
Newborns in their third week of life often have low vitamin D levels, especially if breastfed. Early vitamin D supplementation is recommended as it doesn't affect calcium-phosphorus balance.
Area of Science:
- Neonatal Medicine
- Endocrinology
- Nutritional Science
Background:
- Vitamin D is crucial for calcium and phosphorus homeostasis.
- Neonatal vitamin D status is influenced by maternal factors and infant feeding practices.
- Hypovitaminosis D is a common concern in newborns.
Purpose of the Study:
- To assess vitamin D status and calcium-phosphorus homeostasis in term newborns.
- To evaluate the impact of maternal supplementation and feeding methods on neonatal vitamin D levels.
- To determine if hypovitaminosis D affects calcium-phosphorus balance in early infancy.
Main Methods:
- Serum calcidiol (25OHD), calcium, phosphorus, and alkaline phosphatase were measured in 56 term neonates.
- Urinary calcium/creatinine and phosphorus/creatinine ratios, and tubular phosphate reabsorption rate (TRP) were analyzed.
- Infants were categorized based on 25OHD levels (normal vs. hypovitaminosis D) and feeding type (breastfed vs. formula-fed).
Main Results:
- Mean 25OHD concentration was 15.23 ng/ml; 37.5% of neonates had hypovitaminosis D (25OHD < 11 ng/ml).
- Breastfed infants had significantly lower 25OHD levels (11.2 ng/ml) compared to formula-fed infants (18.5 ng/ml).
- No significant differences in serum calcium, phosphorus, alkaline phosphatase, or urinary Ca/creatinine and TRP were observed between groups. Urinary P/creatinine ratio differed between groups.
Conclusions:
- Neonatal vitamin D status at 3 weeks is not strongly dependent on maternal supplementation during pregnancy.
- Breastfed infants are at higher risk for hypovitaminosis D, suggesting the need for earlier vitamin D supplementation.
- Hypovitaminosis D in the third week of life does not appear to influence basic calcium-phosphorus homeostasis parameters.
Aim:
Assessment of vitamin D status and calcium -phosphorus homeostasis in term newborns before routine supplementation.
Material And Method:
Calcidiol (25OHD), calcium, phosphorus and alkaline phosphatase in serum and Ca (urine)/creatinine (urine) ratio (mg/mg), P (urine)/creatinine (urine) ratio (mg/mg) and tubular phosphate reabsorption rate (TRP= [1-(P(urine) / P(serum). creatinine serum/urine)].100%) in 3rd week of life in 56 appropriate for gestational age term neonates was measured. First group contains 35 newborns (62.5%) with normal 25OHD values and second group 21 newborns (37.5%) with hypovitaminosis D (25OHD < 11 ng/ml).
Result:
Mean 25OHD concentration was 15.23 ng/ml + 8.57 ng/ml. Maternal vitamin D supplementation (10 ug/day) for more than 4 months of pregnancy was similar in both groups (55.9% vs. 52.4%) (p>0.05). There were 51.43% breastfed newborns in group one and 85.71% in group two (p=0.009). Median 25OHD concentration in breastfed newborns was 11.2 ng/ml and 18.5 ng/ml in formula fed babies (p=0.017). There were no statistical differences between groups in calcium (2.44 vs. 2.41 mmol/l), phosphorus (2.27 vs. 2.22 mmol/l) and alkaline phosphatase (261 vs. 266 U/L) blood concentration and Ca (urine)/creatinine (urine) ratio (0,34 vs. 0,25mg/mg) and TRP (86% vs. 88%) (p>0.05). The P (urine) /creatinine (urine) ratio in the first group was 2.3mg/mg and 1.42 mg/mg in the second group (p=0.048).
Conclusions:
Neonatal vitamin D stores in the 3rd week of life are not more dependent on maternal vitamin D supplementation during pregnancy. Breastfed infants are at greater risk of hypovitaminosis D than formula fed infants, therefore earlier vitamin D supply should be considered. The hypovitaminosis D has no influence on basic parameters of Ca-P homeostasis in the 3rd week of life.
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