title: Vitamin D status and adequacy of standard supplementation in preterm neonates from South India.
abstract: OBJECTIVE
  The aim of this study was to assess vitamin D status of preterm babies at birth and adequacy of daily supplementation with vitamin D.
  
  
  METHODS
  This prospective cohort study recruited 111 preterm babies, 25 to 32 weeks' gestation from a tertiary care perinatal center in south India. Cord blood was assayed for serum calcium, phosphate, alkaline phosphatase, and 25-hydroxyvitamin D (25(OH)D). All of the babies were fed unfortified breast-milk and supplemented daily with calcium, phosphate, and 400 IU of vitamin D. At 6 weeks serum calcium, phosphate, alkaline phosphatase, parathyroid hormone, and 25(OH)D levels were estimated.
  
  
  RESULTS
  Of 111 preterm babies recruited, a total of 90 (81%) of the preterm babies were followed up until 6 weeks. The median (interquartile range) vitamin D level in the preterm group was 34.7 (25.6-50.1) and 19.3 (13.9-27.1) ng/mL at birth and 6 weeks, respectively. Using a cutoff value of <20 ng/mL to determine vitamin D insufficiency (VDI), it was observed that 12.6% of the babies were vitamin D insufficient at birth. This increased to 52.2% at 6 weeks despite the recommended supplementation with vitamin D (P < 0.001).
  
  
  CONCLUSIONS
  The prevalence of VDI was not high at birth; however, a large proportion of preterm babies were vitamin D insufficient at 6 weeks despite being supplemented with vitamin D 400 IU/day. The recommended vitamin D supplementation of 400 IU appears to be inadequate to prevent VDI, and hence randomized controlled trials looking at higher doses of vitamin D supplementation are needed.
authors.affiliation: *Department of Neonatology †Department of Clinical Biochemistry ‡Department of Biostatistics, Christian Medical College, Vellore, Tamil Nadu, India.
authors.forename: Mintoo
authors.initials: M
authors.lastname: Tergestina
authors.forename: Arun
authors.initials: A
authors.lastname: Jose
authors.forename: Santhanam
authors.initials: S
authors.lastname: Sridhar
authors.forename: Victoria
authors.initials: V
authors.lastname: Job
authors.forename: Grace
authors.initials: G
authors.lastname: Rebekah
authors.forename: Kurien A
authors.initials: KA
authors.lastname: Kuruvilla
authors.forename: Niranjan
authors.initials: N
authors.lastname: Thomas
mesh_terms: D000469:Alkaline Phosphatase / Q000097:blood; D002118:Calcium / Q000097:blood; D015331:Cohort Studies; D019587:Dietary Supplements; D005312:Fetal Blood / Q000737:chemistry; D005865:Gestational Age; D006801:Humans; D007194:India / Q000453:epidemiology; D007231:Infant, Newborn; D007234:Infant, Premature / Q000097:blood*; D007235:Infant, Premature, Diseases / Q000097:blood* / Q000453:epidemiology; D010281:Parathyroid Hormone / Q000097:blood; D010710:Phosphates / Q000097:blood; D011446:Prospective Studies; D014807:Vitamin D / Q000031:analogs & derivatives* / Q000097:blood; D014808:Vitamin D Deficiency / Q000097:blood* / Q000453:epidemiology; D014815:Vitamins / Q000008:administration & dosage*
chemical_list: D010281:Parathyroid Hormone; D010710:Phosphates; D014815:Vitamins; D014807:Vitamin D; C104450:25-hydroxyvitamin D; D000469:Alkaline Phosphatase; D002118:Calcium