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Is vitamin d deficiency a risk factor for respiratory distress syndrome?
Fevzi Ataseven1, Canan Aygün2, Ali Okuyucu3
1Specialist, Ondokuz Mayıs University Medical Faculty, Division of Neonatology Department of Pediatrics, Samsun, Turkey.
Insights
Severe vitamin D deficiency in preterm infants is linked to a higher risk of respiratory distress syndrome (RDS). Addressing maternal vitamin D status may help reduce RDS incidence in newborns.
Area of Science:
- Neonatal Health
- Nutritional Science
- Pediatric Respiratory Medicine
Background:
- Existing research links maternal vitamin D (25-hydroxyvitamin D or 25(OH)D) to fetal lung development.
- However, the specific role of vitamin D deficiency as a risk factor for respiratory distress syndrome (RDS) in preterm infants remains uninvestigated.
Purpose of the Study:
- To determine if 25-hydroxyvitamin D (25(OH)D) deficiency is a risk factor for developing respiratory distress syndrome (RDS) in preterm newborns.
Main Methods:
- A cohort of 152 preterm infants (29-35 weeks gestational age) was studied.
- Serum 25(OH)D levels were measured within 24 hours of birth using liquid chromatography-tandem mass spectrometry.
- Demographic data and RDS diagnoses were collected for all participants.
Main Results:
- A high prevalence of vitamin D deficiency was observed: 64% had severe deficiency (≤10 ng/mL), 33% moderate (10-20 ng/mL), and 3% mild (20-30 ng/mL). No infants had normal 25(OH)D levels.
- Respiratory distress syndrome (RDS) occurred more frequently in infants with severe vitamin D deficiency (28%) compared to those with mild-moderate deficiency (14%) (p < 0.05).
- Serum 25(OH)D levels did not correlate with gestational age.
Conclusions:
- The study highlights a significant burden of vitamin D deficiency in preterm infants, with no participants exhibiting normal levels.
- Severe vitamin D deficiency was associated with an increased incidence of respiratory distress syndrome (RDS) in preterm infants.
- Evaluating and supplementing maternal vitamin D status could be a crucial strategy to mitigate RDS risk, complementing antenatal steroids.
Background:
Previous studies have shown the relationship between in utero lung development and vitamin D [25(OH)D], but there have been no studies to investigate whether vitamin D deficiency is a risk factor for respiratory distress syndrome (RDS) in preterm babies.
Objectives:
In this study, we investigated if 25(OH)D deficiency is a risk factor for RDS.
Methods:
One hundred fifty-two preterm newborns, born at 29 - 35 weeks gestational age, were included in the study following informed consent from the parents. Peripheral blood samples were collected within the first 24 hours of life and 25(OH)D levels were measured by liquid chromatography-tandem mass spectrometry. Demographic characteristics of the babies and the diagnosis of RDS were recorded.
Results:
In 64 % of preterm infants, 25(OH)D levels were compatible with severe deficiency (≤ 10 ng/mL), 33 % with moderate deficiency (10 - 20 ng/mL), and 3 % with mild deficiency (20 - 30 ng/mL). In none of the babies was a normal 25(OH)D level observed. Serum 25(OH)D levels were not correlated with gestational age. Respiratory distress syndrome was more common in preterm babies with severe (28 %) compared to mild-moderate 25(OH)D deficiency (14 %) (p < 0.05).
Conclusions:
None of the preterm infants in this study had normal vitamin D level, which underlined the burden of vitamin D deficiency in pregnant women and their offspring. RDS was more common in severely vitamin D-deficient preterms. Determination of vitamin D status of the mothers and appropriate supplementation might be a valuable strategy to reduce RDS, in addition to antenatal steroids. Besides, since vitamin D is a regulatory factor in many organs during fetal development, long-term effects of in utero vitamin D deficiency warrant further studies.
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