Vitamin D deficiency associated with dilated cardiomyopathy in early infancy caused by maternal cholestasis

Area of Science:

• Pediatrics
• Neonatology
• Maternal-Fetal Medicine

Background:

• Vitamin D deficiency is common in breastfed infants due to low levels in breast milk.
• Infants fed formula are generally protected from vitamin D deficiency.
• Severe vitamin D deficiency can lead to serious health issues like hypocalcemic seizures and dilated cardiomyopathy.

Purpose of the Study:

• To report a case of vitamin D deficiency in an infant fed formula.
• To investigate the underlying causes of vitamin D deficiency in this infant.
• To highlight the importance of maternal health in preventing infant vitamin D deficiency.

Main Methods:

• Case report of a 1-month-old infant presenting with hypocalcemic seizures and dilated cardiomyopathy.
• Evaluation of infant's feeding history, including formula intake.
• Assessment of maternal health conditions during pregnancy and postpartum, including hyperemesis, cholestasis, and sunlight exposure.

Main Results:

• The infant developed hypocalcemic seizures and dilated cardiomyopathy attributed to vitamin D deficiency.
• Despite adequate formula intake, the infant's deficiency stemmed from maternal vitamin D deficiency.
• Maternal factors identified included severe hyperemesis, insufficient sunlight exposure, and fat-soluble vitamin malabsorption due to cholestasis.

Conclusions:

• Maternal vitamin D deficiency can impact infants even when fed formula.
• Maternal conditions such as hyperemesis, cholestasis, and limited sun exposure are critical risk factors.
• Close monitoring of maternal health during pregnancy and postpartum is essential for preventing fetal and infant vitamin D deficiency.