Prophylactic effect of low dose vitamin D in osteopenia of prematurity: a clinical trial study

Area of Science:

• Neonatal Nutrition
• Pediatric Endocrinology
• Preventive Medicine

Background:

• Osteopenia of prematurity (OOP) is a growing concern with increased survival rates of premature newborns.
• Early diagnosis and prevention are crucial for managing rickets of prematurity.
• Vitamin D plays a vital role in bone health for preterm infants.

Purpose of the Study:

• To compare the prophylactic efficacy of two low doses of vitamin D (200 IU/day vs. 400 IU/day) in preventing rickets of prematurity.
• To evaluate the impact of vitamin D dosage on clinical, biochemical, and radiological indicators of rickets.
• To determine the optimal low-dose vitamin D regimen for preterm infants.

Main Methods:

• A randomized clinical trial involving 60 preterm newborns (birth weight < 2000 g, gestational age < 37 weeks).
• Infants were divided into two groups: one receiving 200 IU/day vitamin D, the other 400 IU/day.
• Measurements included serum calcium, phosphate, alkaline phosphatase, 25-hydroxy vitamin D, physical examination, and wrist X-rays at 6-8 weeks of life.

Main Results:

• No significant differences were observed between the 200 IU/day and 400 IU/day vitamin D groups.
• Both dosages demonstrated comparable outcomes in biochemical markers, radiological findings, and clinical presentation of rickets.
• Serum 25-hydroxy vitamin D levels were adequate in both groups, indicating effective vitamin D status.

Conclusions:

• A low daily dose of 200 IU of vitamin D is adequate for the prevention of osteopenia of prematurity.
• The higher dose of 400 IU/day did not offer additional benefits in preventing rickets of prematurity in this cohort.
• This finding supports the use of a 200 IU/day vitamin D regimen for routine prophylaxis in preterm infants.