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Is there a potential link between vitamin D and pulmonary morbidities in preterm infants?
Yang Yang1, Yun Feng1, Xu Chen1
1Department of Neonates, Children's Hospital of Nanjing Medical University, Nanjing, China.
Insights
Low vitamin D levels in preterm infants are linked to respiratory distress syndrome and bronchopulmonary dysplasia, especially in those born at or before 30 weeks. Appropriate vitamin D may aid lung development in premature babies.
Area of Science:
- Neonatology
- Pediatric Pulmonology
- Nutritional Science
Background:
- The association between vitamin D and pulmonary complications in premature infants remains unclear.
- Preterm birth poses significant risks for respiratory morbidity.
Purpose of the Study:
- To investigate the relationship between vitamin D levels and pulmonary morbidities in preterm infants.
- To determine if vitamin D deficiency is associated with respiratory distress syndrome (RDS) or bronchopulmonary dysplasia (BPD) in this population.
Main Methods:
- Retrospective analysis of clinical data and blood samples from 106 preterm infants within 24 hours of admission.
- Comparison of vitamin D concentrations between infants with and without RDS and BPD, stratified by gestational age.
Main Results:
- Significantly lower vitamin D levels were observed in infants with RDS, particularly those born at or before 30 weeks gestation.
- Infants with BPD showed significantly decreased vitamin D concentrations in both the ≤30 weeks and 30-34 weeks gestational age groups.
- Lower vitamin D levels correlated with increased duration of mechanical ventilation and oxygen support in the ≤30 weeks group.
- Vitamin D levels were significantly lower in non-surviving infants compared to survivors at discharge.
Conclusions:
- Vitamin D deficiency is associated with RDS and BPD in preterm infants, especially those born extremely prematurely (≤30 weeks).
- The findings suggest a potential role for vitamin D in promoting lung maturation and improving outcomes in premature infants.
- Further large-scale, multi-center randomized controlled trials are warranted to confirm these associations and establish optimal vitamin D supplementation strategies.
Background:
There hasn't been conclusive proof about the association between vitamin D and pulmonary morbidities of prematurity.
Methods:
106 preterm infants were retrospectively included into this study. Clinical data and blood samples of all the patients were collected within 24 h of admission.
Results:
(1) Respiratory distress syndrome (RDS) patients were mainly concentrated in "≤30 weeks" stage when compared with other two gestational age groups. The only significant decrease of vitamin D concentration between RDS and non-RDS patients reflected in "≤30 weeks" stage (RDS vs. non-RDS: 29.48 ± 13.06 vs. 40.47 ± 20.52 nmol/l). (2) Bronchopulmonary dysplasia (BPD) patients were also concentrated in "≤30 weeks" stage. Vitamin D concentration showed significant difference both in "≤30 weeks" stage and "30-34 weeks" stage (≤30 weeks stage, BPD vs. non-BPD: 33.20 ± 16.51 vs. 39.21 ± 16.65 nmol/l; 30-34 weeks stage, BPD vs. non-BPD: 30.36 ± 15.50 vs. 41.21 ± 20.40 nmol/l). (3) Though vitamin D concentration in mechanical ventilation (MV) group was lower than non-MV group, there're no significant differences. (4) Vitamin D concentration in dead cases was significant lower than survival patients at discharge. (5) It showed a good correlation between vitamin D concentration and serum Ca, serum P, duration of MV and duration of oxygen support in "≤30 weeks" stage.
Conclusion:
The significant decrease of vitamin D concentration between RDS and non-RDS patients only reflected in "≤30 weeks" stage. And significant decrease of vitamin D concentration in BPD patients was both showed in "≤30 weeks" stage and "30-34 weeks" stage, which is consistent with "duration of oxygen support". However, the overall effect did not show any difference in all preterm infants. It seems that the appropriate concentration of vitamin D is beneficial to lung maturation of human. Certainly, large sample, multi-center randomized controlled trials are necessary.
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