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Craniotabes in Newborns and the Role of Maternal Vitamin D Deficiency: A Case Series
Rita M Pita1, Marta O Martins1, Ana Ferraz1
1Neonatology Department, Maternidade Daniel de Matos, Unidade Local de Saúde de Coimbra, Coimbra, PRT.
Insights
Maternal vitamin D deficiency can cause newborn craniotabes (soft skull bones). Supplementation normalized levels and resolved symptoms, underscoring the importance of prenatal vitamin D for infant bone health.
Area of Science:
- Neonatology
- Pediatric Endocrinology
- Nutritional Science
Background:
- Craniotabes, or soft skull bones in newborns, is often linked to in utero vitamin D deficiency.
- It can be associated with rickets, congenital syphilis, and osteogenesis imperfecta.
Observation:
- Four term infants presented with craniotabes at birth.
- All cases showed maternal and infant vitamin D deficiency (serum 25-hydroxyvitamin D < 20 ng/mL).
- One infant experienced a skull fracture and neonatal stroke.
Findings:
- Oral cholecalciferol supplementation normalized vitamin D levels in all infants.
- Skull softening resolved in all cases following treatment.
- These findings confirm the efficacy of vitamin D supplementation for craniotabes.
Implications:
- Highlights the critical role of maternal vitamin D in fetal bone development.
- Emphasizes the need for clinical vigilance and diagnostic testing for complications.
- Increases awareness of craniotabes as a sign of vitamin D deficiency in neonates.
Abstract:
Craniotabes is characterized by the softening of skull bones in newborns. It can be associated with conditions like rickets, congenital syphilis, and osteogenesis imperfecta. In otherwise healthy newborns, craniotabes is often linked to in utero vitamin D deficiency. We report four cases of term infants diagnosed with craniotabes at birth. For all cases, laboratory tests confirmed vitamin D deficiency with serum 25-hydroxyvitamin D levels below 20 ng/mL, alongside maternal vitamin D deficiency. While three cases showed no complications, one newborn had a skull fracture and a neonatal stroke. All infants were supplemented with oral cholecalciferol, resulting in the normalization of serum 25-hydroxyvitamin D levels and resolution of the skull softening. These cases highlight the critical role of maternal vitamin D levels in fetal bone development and the potential risks of its deficiency. Although craniotabes associated with maternal vitamin D deficiency is a known condition among neonatologists, these cases help to increase awareness of this diagnosis. We highlight the need for thorough clinical examination, along with complementary diagnostic tests, to identify any related complications.
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