Assessment of Adequacy of Supplementation of Vitamin D in Very Low Birth Weight Preterm Neonates: A Randomized

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N B Mathur1,2, Ashish Saini3, T K Mishra4

  • 1Department of Neonatology, Pediatrics and Biochemistry, Maulana Azad Medical College, New Delhi 110002, India drnbmathur@gmail.com.

Journal of Tropical Pediatrics
|June 22, 2016
PubMed

Insights

Higher vitamin D doses (1000 IU/day) significantly improved bone health and growth in preterm neonates compared to lower doses (400 IU/day). This vitamin D supplementation enhanced serum calcium and 25-hydroxy vitamin D levels while reducing skeletal issues.

Area of Science:

  • Neonatal Medicine
  • Pediatric Endocrinology
  • Nutritional Science

Background:

  • Preterm neonates, especially those with very low birth weight, are at high risk for vitamin D deficiency and associated complications.
  • Maintaining adequate vitamin D levels is crucial for bone mineralization, calcium homeostasis, and overall growth in this vulnerable population.

Purpose of the Study:

  • To compare the efficacy of two different daily doses of vitamin D (400 IU vs. 1000 IU) over a 6-week period in very low birth weight preterm neonates.
  • To evaluate the impact of vitamin D supplementation on serum mineral levels, bone metabolism markers, skeletal hypomineralization, and growth.

Main Methods:

  • A randomized, double-blinded controlled trial was conducted involving 50 very low birth weight preterm neonates.
  • Participants were assigned to receive either 400 IU/day (Group 1) or 1000 IU/day (Group 2) of vitamin D for 6 weeks.
  • Outcome measures included changes in serum calcium, phosphate, alkaline phosphatase (ALP), 25-hydroxy vitamin D (25-OHD), parathormone, incidence of skeletal hypomineralization, and growth parameters.

Main Results:

  • The group receiving 1000 IU/day of vitamin D showed significantly higher mean serum calcium and 25-OHD levels (p < 0.001 for both).
  • Conversely, the 1000 IU/day group exhibited significantly lower mean ALP and parathormone levels (p < 0.001 for both).
  • Skeletal hypomineralization was less frequent, and growth was improved in neonates receiving the higher vitamin D dose.

Conclusions:

  • Vitamin D supplementation at 1000 IU/day is more effective than 400 IU/day in very low birth weight preterm neonates.
  • The higher dose optimizes serum calcium, phosphate, ALP, 25-OHD, and parathormone levels, leading to reduced skeletal hypomineralization and enhanced growth.
  • This suggests that a higher daily intake of vitamin D is beneficial for the bone health and development of preterm infants.
Abstract

Keywords:
pretermsecondary hyperparathyroidismskeletal mineralizationvitamin D supplementation

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