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Vitamin D status of low birth weight infants in Delhi: a comparative study
Ramesh Agarwal1, Deenanath Virmani, Munna Lal Jaipal
1All India Institute of Medical Sciences, Department of Pediatrics, Kasturba Hospital and Swami Dayanand Hospital, New Delhi 110029, India. aranag@rediffmail.com
Insights
Vitamin D deficiency is highly prevalent in both low birthweight and normal birthweight infants, as well as their mothers. This widespread deficiency necessitates further research into optimal vitamin D supplementation for infants.
Area of Science:
- Neonatal Health
- Nutritional Biochemistry
- Pediatric Endocrinology
Background:
- Vitamin D deficiency (VDD) is a growing concern in maternal and infant health.
- Low birthweight (LBW) infants and even normal birthweight (NBW) infants are at risk.
- Maternal vitamin D status significantly impacts infant vitamin D levels.
Purpose of the Study:
- To assess vitamin D status in preterm and term LBW infants compared to term NBW infants.
- To evaluate vitamin D levels at birth and in early infancy.
- To determine the prevalence of vitamin D deficiency (VDD) and related biochemical markers.
Main Methods:
- Enrolled 220 LBW and 119 NBW infants with their mothers.
- Collected blood samples from mothers and infants at birth and infants at 3 months.
- Measured serum calcium, phosphate, alkaline phosphatase, 25-hydroxyvitamin D (25OHD), and parathormone (PTH).
Main Results:
- High VDD prevalence at birth (87.3% LBW, 88.6% NBW) and in infancy (60.6% LBW, 71.6% NBW).
- Mothers exhibited near-universal VDD (93-97%).
- Elevated PTH and clinical rickets were observed in a significant proportion of infants, particularly LBW.
Conclusions:
- Early-life VDD is common in both LBW and NBW infants.
- The high incidence of VDD and rickets highlights the urgent need for effective supplementation strategies.
- Further studies are required to determine optimal vitamin D dosage regimens for these vulnerable infants.
Objective:
To evaluate vitamin D status of preterm and term low birthweight (LBW) and term normal birth weight (NBW; weight ≥ 2500 g) infants at birth and in early infancy.
Methods:
We enrolled 220 LBW and 119 NBW infants along with their mothers. Blood samples of both infants and mothers were taken within 48 h of birth, and that of infants were repeated at 3 months. Serum levels of calcium, phosphate, alkaline phosphatase, 25 hydroxyvitamin D (25OHD) and parathormone (PTH) were estimated using standard tests. Our primary outcome was vitamin D deficiency (VDD; serum 25OHD <20 ng/ml in mothers and <15 ng/ml in infants). Other outcomes were raised PTH (>46 pg/ml), raised AlkP (>120 U/l in mothers and 420 U/l in infants), and clinical rickets.
Findings:
VDD was present in 186 (87.3%) of LBW and 103 (88.6%) of NBW infants at birth, and in 77 (60.6%) of LBW and 55 (71.6%) of NBW infants at a median corrected age of 12 and 15 weeks, respectively. VDD was almost universal (93-97%) among mothers of both groups. Raised PTH was present in 138 (63.6%) of LBW and 48 (41.4%) of NBW infants at birth, and in 58 (45.7%) of LBW and 38 (49.3%) of NBW infants at follow-up. Clinical rickets was present in 17 (13.4%) of LBW and 4 (4.9%) of NBW infants at 12-14 weeks of corrected age.
Conclusions:
High prevalence of VDD in LBW as well as NBW infants with clinical rickets at an early age underlines the need to study the effect of various vitamin D supplementation regimens in these infants to identify the optimal dose.
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