title: Vitamin D nutritional status in preterm infants and response to supplementation.
abstract: Little is known about vitamin D status in preterm infants and their response to supplementation. To investigate this, we assessed serum 25-hydroxyvitamin D (25OHD) levels using RIA in a consecutive sample of stable preterm very low birth weight (VLBW) infants (born ≤ 32 weeks gestation or birth weight ≤ 1·5 kg), and we explored associated factors. Serum 25OHD level was first assessed once infants were tolerating feeds (n 274). If this first 25OHD level was below 50 nmol/l (20 ng/ml), which is the level associated with covering requirements in terms of skeletal health in the majority, then we recommended prolonged augmented vitamin D intake ( ≥ 10 μg (400 IU) daily) from a combination of fortified feeds and vitamin supplements and follow-up re-assessment at approximately 6 weeks corrected age (n 148). The first assessment, conducted at a median for chronological age of 18 (interquartile range (IQR) 11-28) d, found that 78 % had serum 25OHD levels below 50 nmol/l. Multivariable analysis demonstrated that the determinants of serum 25OHD levels were duration of vitamin D supplementation and gestational age at birth (r 2 0·215; P< 0·001). At follow-up, after a median of 104 (IQR 78-127) d, 87 % achieved levels ≥ 50 nmol/l and 8 % had levels >125 nmol/l, a level associated with potential risk of harm. We conclude that low 25OHD levels are an issue for preterm VLBW infants, warranting early nutritional intervention. In infants with serum 25OHD levels < 50 nmol/l, a vitamin D intake of ≥ 10 μg (400 IU) daily achieves target levels in the majority; however, further work is needed to determine the exact dose to safely meet target levels without overcorrection.
authors.affiliation: Department of Neonatology, National Maternity Hospital, Holles Street, Dublin 2, Republic of Ireland. rmccarthy@nmh.ie
authors.forename: Roberta A
authors.initials: RA
authors.lastname: McCarthy
authors.forename: Malachi J
authors.initials: MJ
authors.lastname: McKenna
authors.forename: Oyinkansola
authors.initials: O
authors.lastname: Oyefeso
authors.forename: Ogenna
authors.initials: O
authors.lastname: Uduma
authors.forename: Barbara F
authors.initials: BF
authors.lastname: Murray
authors.forename: Jennifer J
authors.initials: JJ
authors.lastname: Brady
authors.forename: Mark T
authors.initials: MT
authors.lastname: Kilbane
authors.forename: John F
authors.initials: JF
authors.lastname: Murphy
authors.forename: Anne
authors.initials: A
authors.lastname: Twomey
authors.forename: Colm P
authors.initials: CP
authors.lastname: O' Donnell
authors.forename: Nuala P
authors.initials: NP
authors.lastname: Murphy
authors.forename: Eleanor J
authors.initials: EJ
authors.lastname: Molloy
mesh_terms: D050071:Bone Density Conservation Agents / Q000008:administration & dosage / Q000097:blood / Q000627:therapeutic use; D004032:Diet; D019587:Dietary Supplements; D005260:Female; D005527:Food, Fortified; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature / Q000097:blood*; D019102:Infant, Very Low Birth Weight / Q000097:blood*; D008297:Male; D015596:Nutrition Assessment; D009751:Nutritional Requirements; D009752:Nutritional Status; D014807:Vitamin D / Q000008:administration & dosage / Q000031:analogs & derivatives / Q000097:blood / Q000627:therapeutic use*; D014808:Vitamin D Deficiency / Q000097:blood / Q000517:prevention & control*; D014815:Vitamins / Q000008:administration & dosage / Q000097:blood / Q000627:therapeutic use
chemical_list: D050071:Bone Density Conservation Agents; D014815:Vitamins; D014807:Vitamin D; C104450:25-hydroxyvitamin D