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Author Spotlight: Studying the Impact of Maternal Dietary Deficiencies on Long-Term Offspring Health Outcomes
Published on: June 28, 2024
Questioning the adequacy of standardized vitamin D supplementation protocol in very low birth weight infants: a
Hatice Sarıdemir1, Ozge Surmeli Onay1, Ozge Aydemir1
1Department of Pediatrics, Division of Neonatology, Eskisehir Osmangazi University Faculty of Medicine, Eskisehir, Turkey.
Insights
A standardized vitamin D supplementation protocol effectively increased vitamin D levels in very low birth weight (VLBW) infants by 30 days. Maternal vitamin D status significantly correlated with infant levels, highlighting the importance of maternal vitamin D sufficiency.
Area of Science:
- Neonatology
- Nutritional Science
- Pediatric Endocrinology
Background:
- Preterm infants, particularly very low birth weight (VLBW) infants, exhibit a higher susceptibility to vitamin D deficiency (VDD).
- Maternal vitamin D status is a critical determinant of neonatal vitamin D levels.
- Optimal vitamin D levels are essential for infant growth and development, impacting bone health and immune function.
Purpose of the Study:
- To evaluate the efficacy of a standardized vitamin D supplementation protocol in achieving adequate vitamin D levels in VLBW infants.
- To investigate the relationship between maternal and infant vitamin D status at birth.
- To explore potential associations between neonatal vitamin D status and infant morbidities.
Main Methods:
- A single-center, prospective cohort study involving 55 mother-infant dyads.
- Measurement of serum 25-hydroxyvitamin D (25OHD) levels in mothers before delivery and in infants at birth and 30 days of life (DOL).
- Administration of vitamin D via parenteral nutrition (160 IU/kg/day) on DOL 1, followed by oral supplementation (400 IU/day) starting on DOL 15 or when enteral feedings reached 50%.
Main Results:
- Infant 25OHD levels significantly increased from a median of 16.12 ng/mL at birth to 36.32 ng/mL by 30 DOL (p<0.01).
- The supplementation protocol achieved sufficient 25OHD levels (>30 ng/mL) in 98% of VLBW infants by 30 DOL.
- Maternal 25OHD levels were strongly correlated with cord blood 25OHD levels (r=0.665, p<0.001), and no maternal participants achieved sufficient levels.
- Seasonal variations influenced cord blood 25OHD levels, with lower levels observed in winter.
Conclusions:
- The current vitamin D supplementation protocol is effective in correcting vitamin D deficiency/insufficiency in VLBW infants by 30 DOL.
- Maternal vitamin D status is a significant predictor of infant vitamin D levels at birth.
- Further research may be warranted to optimize maternal vitamin D supplementation to improve neonatal stores and long-term outcomes.
Objectives:
Preterm infants are at increased risk for vitamin D deficiency (VDD). We aimed to assess the adequacy of standardized vitamin D supplementation protocol in very low birth weight (VLBW) infants. Additionally, vitamin D status of mother/infant couples and the associations between vitamin D status at birth and morbidities of the infants were investigated.
Methods:
In this single-center, prospective cohort study blood samples were collected from 55 mothers just before delivery and from their infants at birth and on the 30th day of life (DOL) for 25 hydroxy vitamin D (25OHD) measurements. Vitamin D was initiated in dose of 160 IU/kg by parenteral nutrition on the first DOL and oral vitamin D supplementation (400 IU/day) was administered when enteral feedings reached 50% of total intake or on the 15th DOL.
Results:
The median 25OHD levels of the infants were 16.12 (9.14-20.50) in cord blood and 36.32 (31.10-44.44) in venous blood on the 30th DOL (p<0.01). In 98% of the VLBW infants 25OHD reached sufficient levels on the 30th DOL. None of the mothers had sufficient vitamin D levels (25OHD >30 ng/mL). Maternal 25OHD levels were correlated with the 25OHD levels of the infants in cord blood (r=0.665, p<0.001). There was a significant difference in mean cord 25OHD levels between winter (13.65 ± 5.69 ng/mL) and summer seasons (19.58 ± 11.67 ng/mL) (p=0.021). No association was found between neonatal morbidity and vitamin D status.
Conclusions:
The results clearly show that by utilizing the current supplementation protocol, the majority of VLBW infants with deficient/insufficient serum 25OHD levels reached sufficient levels on the 30th DOL. Furthermore, vitamin D levels in mother/infant couples were found to be highly correlated.
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