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Serum Calcium Normal Range in 1,000 Term Newborns
Lucie Levaillant1,2, Agnès Linglart3,4, Emmanuelle Letamendia5
1AP-HP, Hôpital Bicêtre Paris-Saclay, service d'endocrinologie et diabète de l'enfant, Centre de référence des maladies rares du métabolisme du calcium et du phosphate, filière OSCAR, DMU 3 SEA, Le Kremlin-Bicêtre, France, lucielevaillant49@gmail.com.
Insights
Neonatal serum calcium levels at 3 days of life range from 2.06 to 2.73 mmol/L. Maternal vitamin D status significantly impacts newborn calcium levels, highlighting the importance of supplementation.
Area of Science:
- Neonatal physiology
- Endocrinology
- Calcium metabolism
Background:
- Serum calcium levels in newborns decrease sharply after birth due to the cessation of maternal-fetal calcium transfer.
- Maternal vitamin D levels are a known factor influencing neonatal serum calcium.
- The study investigates neonatal calcium levels in relation to French vitamin D supplementation guidelines.
Purpose of the Study:
- To determine the normal range of neonatal serum calcium.
- To assess the impact of maternal vitamin D supplementation during pregnancy on neonatal serum calcium.
- To identify factors influencing serum calcium maintenance in newborns.
Main Methods:
- A prospective cohort study involving 1,002 mother-newborn dyads.
- Data collected from two centers near Paris, France, between April 2012 and July 2014.
- Analysis of maternal and cord blood 25-hydroxyvitamin D [25(OH)D] concentrations.
Main Results:
- Neonatal serum calcium at 3 days of life ranged from 2.06 to 2.73 mmol/L (mean 2.45 mmol/L).
- No significant difference in serum calcium was observed between infants of supplemented and non-supplemented mothers.
- Maternal and cord blood 25(OH)D concentrations were crucial for maintaining neonatal serum calcium.
Conclusions:
- The established normal range for neonatal serum calcium (2.06–2.73 mmol/L) is wider than the adult range.
- These findings aid physicians in diagnosing neonatal hypo- or hypercalcemia.
- The study underscores the importance of vitamin D supplementation and adequate 25(OH)D status for neonatal calcium homeostasis.
Introduction:
Serum calcium rapidly declines at birth because of the sudden interruption of the maternal-fetal calcium influx. Several factors are known to influence serum calcium in the first days of life, including circulating concentrations of maternal vitamin D. Objective was to establish the normal range variations of neonatal serum calcium according to the current French vitamin D supplementation during pregnancy, i.e., 100,000 IU of cholecalciferol during the third trimester.
Methods:
We included in our prospective cohort study 1,002 mother-newborn dyads recruited from April 2012 to July 2014 in two centers located in the neighborhoods of Paris, France.
Results:
Total serum calcium at 3 days of life in neonates varied from 2.06 mmol/L to 2.73 mmol/L [2.5 and 97.5 percentiles], with a mean of 2.45 mmol/L. Serum calcium was similar between babies born from vitamin D-supplemented mothers and those born from non-supplemented ones. In univariate and multivariable analyses, we demonstrated the importance of maternal and cord blood 25(OH)D concentrations for newborn serum calcium maintenance.
Conclusion:
We established that the expected serum calcium in neonates ranges between 2.06 mmol/L and 2.73 mmol/L which is significantly wider than the adult range. This finding should help physicians in the diagnosis of hypo- or hypercalcemia. In addition, our study supports the importance of vitamin D supplementation and 25(OH)D status for neonatal serum calcium maintenance.
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