Neonatal hypocalcaemia due to maternal vitamin D deficiency: a preventable and underestimated condition

Area of Science:

• Neonatal Medicine
• Endocrinology
• Nutritional Science

Background:

• Neonatal hypocalcaemia (NH) is a prevalent metabolic disorder in preterm and high-risk infants, potentially life-threatening.
• Early-onset NH can be clinically silent, presenting with subtle or no immediate symptoms.
• Maternal health status significantly influences neonatal calcium homeostasis.

Purpose of the Study:

• To present a case of refractory early-onset neonatal hypocalcaemia secondary to severe maternal vitamin D deficiency.
• To highlight the critical role of maternal vitamin D status in neonatal calcium balance.
• To emphasize the importance of early recognition and intervention for maternal and neonatal hypovitaminosis D.

Main Methods:

• Case report of a premature infant with refractory early-onset neonatal hypocalcaemia.
• Biochemical assessment of the infant, including calcium, magnesium, and vitamin D levels.
• Evaluation of the mother for vitamin D deficiency and secondary hyperparathyroidism.

Main Results:

• The infant presented with persistent biochemical abnormalities requiring significant supplementation (calcium, magnesium, high-dose vitamin D).
• Severe maternal vitamin D deficiency and secondary hyperparathyroidism were confirmed.
• Neonatal vitamin D levels were found to be critically dependent on maternal stores.

Conclusions:

• Maternal hypovitaminosis D is a significant and preventable risk factor for neonatal hypocalcaemia.
• The prevalence of vitamin D deficiency in pregnant women is underestimated globally.
• Early detection and management of vitamin D deficiency in pregnant women are essential for preventing neonatal complications.