Document Type : original article

Authors

1 Neonatal Research Center, Mofid Children's Hospital, Faculty of Medicine, Shahid Beheshti University of medical Sciences, Tehran, Iran.

2 Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran

3 Imam Ali hospital, zahedan University medical university, Zahedan, Iran

4 Pediatric Gastroenterology, Hepatology and Nutrition Research Center, Research Institute for Children & rsquo;s Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran

10.22038/ijp.2024.64592.4898

Abstract

Background: This study was conducted to evaluate the impact of two different dosages of vitamin D (400 units versus 800 units) on achieving normal serum levels in premature infants.
Methods: In this randomized clinical trial, premature infants aged between 28 and 34 weeks, with a weight range of 1000 to 2000 grams, were randomly assigned to two groups: one receiving 400 units and the other 800 units of oral vitamin D drops daily.
Results: The results indicated that alterations in calcium and alkaline phosphatase (ALP) levels were not statistically significant. However, it was observed that the mean level of phosphorus within the first 24 hours and at the two-week mark was significantly lower in the group administered 800 units compared to those receiving 400 units (P < 0.05). Repeated measures ANOVA revealed that the overall changes in phosphorus levels were not statistically significant, suggesting that the observed differences at 24 hours and two weeks can be attributed to baseline variations between the groups. Additionally, it was found that vitamin D levels in infants receiving 800 units were significantly elevated at both the second and fourth weeks when compared to those receiving 400 units (P < 0.001).
Conclusion: The findings from this study demonstrate that infants receiving a high dosage of 800 units of vitamin D exhibited significantly higher vitamin D levels at both the second and fourth weeks compared to those receiving the standard dosage of 400 units.

Keywords

  1. . Jobe AH. Vitamin D for extremely preterm infants. The Journal of pediatrics. 2016; 174:1-3.

    1. Benedik E. Sources of vitamin D for humans. International Journal for Vitamin and Nutrition Research. 2021.
    2. Lange NE, Litonjua A, Hawrylowicz CM, Weiss S. Vitamin D, the immune system and asthma. Expert review of clinical immunology. 2009; 5:693-702.
    3. Phokela SS, Peleg S, Moya FR, Alcorn JL. Regulation of human pulmonary surfactant protein gene expression by 1α, 25-dihydroxyvitamin D3. American Journal of Physiology-Lung Cellular and Molecular Physiology. 2005; 289:L617-L26.
    4. Renzaho AM, Halliday JA, Nowson C. Vitamin D, obesity, and obesity-related chronic disease among ethnic minorities: a systematic review. Nutrition. 2011; 27:868-79.
    5. Kaur J, Ferguson SL, Freitas E, Miller R, Bemben D, Knehans A, et al. Association of vitamin d status with chronic disease risk factors and cognitive dysfunction in 50–70 year old adults. Nutrients. 2019; 11:141.
    6. Abrams SA, Nutrition Co, Bhatia JJ, Abrams SA, Corkins MR, de Ferranti SD, et al. Calcium and vitamin D requirements of enterally fed preterm infants. Pediatrics. 2013; 131:e1676-e83.
    7. Agostoni C, Buonocore G, Carnielli V, De Curtis M, Darmaun D, Decsi T, et al. Enteral nutrient supply for preterm infants: commentary from the European Society of Paediatric Gastroenterology, Hepatology and Nutrition Committee on Nutrition. Journal of pediatric gastroenterology and nutrition. 2010; 50:85-91.
    8. Cashman KD. Vitamin D deficiency: defining, prevalence, causes, and strategies of addressing. Calcified tissue international. 2020:1-16.
    9. Darlow BA, Graham P, Rojas‐Reyes MX. Vitamin A supplementation to prevent mortality and short‐and long‐term morbidity in very low birth weight infants. Cochrane database of systematic reviews. 2016.
    10. Abbasian M, Chaman R, Amiri M, Ajami ME, Jafari-Koshki T, Rohani H, et al. Vitamin D deficiency in pregnant women and their neonates. Global Journal of Health Science. 2016; 8:83.
    11. Burris HH, Van Marter LJ, McElrath TF, Tabatabai P, Litonjua AA, Weiss ST, et al. Vitamin D status among preterm and full-term infants at birth. Pediatric research. 2014; 75:75-80.
    12. Natarajan CK, Sankar MJ, Agarwal R, Pratap OT, Jain V, Gupta N, et al. Trial of daily vitamin D supplementation in preterm infants. Pediatrics. 2014; 133:e628-e34.
    13. Wagner CL, Greer FR, Breastfeeding So, Nutrition Co. Prevention of rickets and vitamin D deficiency in infants, children, and adolescents. Pediatrics. 2008; 122:1142-52.
    14. Abrams SA. Vitamin D in Preterm and Full-Term Infants. Annals of Nutrition and Metabolism. 2020; 76:6-14.
    15. Fort P, Salas AA, Nicola T, Craig CM, Carlo WA, Ambalavanan N. A comparison of 3 vitamin D dosing regimens in extremely preterm infants: a randomized controlled trial. The Journal of pediatrics. 2016; 174:132-8. e1.
    16. Agarwal N, Faridi M, Aggarwal A, Singh O. Vitamin D Status of term exclusively breastfed infants and their mothers from India. Acta Paediatrica. 2010; 99:1671-4.
    17. Backström M, Mäki R, Kuusela A, Sievänen H, Koivisto A, Ikonen R, et al. Randomised controlled trial of vitamin D supplementation on bone density and biochemical indices in preterm infants. Archives of Disease in Childhood-Fetal and Neonatal Edition. 1999; 80:F161-F6.
    18. Dawodu A, Nath R. High prevalence of moderately severe vitamin D deficiency in preterm infants. Pediatrics International. 2011; 53:207-10.
    19. Medicine Io. Dietary reference intakes for calcium and vitamin D: National Academies Press; 2011.
    20. Grant CC, Stewart AW, Scragg R, Milne T, Rowden J, Ekeroma A, et al. Vitamin D during pregnancy and infancy and infant serum 25-hydroxyvitamin D concentration. Pediatrics. 2014; 133:e143-e53.
    21. Volpe JJ. Perinatal brain injury: from pathogenesis to neuroprotection. Mental retardation and developmental disabilities research reviews. 2001; 7:56-64.
    22. Zipitis CS, Akobeng AK. Vitamin D supplementation in early childhood and risk of type 1 diabetes: a systematic review and meta-analysis. Archives of disease in childhood. 2008; 93:512-7.
    23. Camargo Jr CA, Rifas-Shiman SL, Litonjua AA, Rich-Edwards JW, Weiss ST, Gold DR, et al. Maternal intake of vitamin D during pregnancy and risk of recurrent wheeze in children at 3 y of age. The American journal of clinical nutrition. 2007; 85:788-95.
    24. Marjamäki L, Niinistö S, Kenward M, Uusitalo L, Uusitalo U, Ovaskainen M-L, et al. Maternal intake of vitamin D during pregnancy and risk of advanced beta cell autoimmunity and type 1 diabetes in offspring. Diabetologia. 2010; 53:1599-607.
    25. Morley R, Carlin JB, Pasco JA, Wark JD. Maternal 25-hydroxyvitamin D and parathyroid hormone concentrations and offspring birth size. The Journal of Clinical Endocrinology & Metabolism. 2006; 91:906-12.
    26. Belderbos ME, Houben ML, Wilbrink B, Lentjes E, Bloemen EM, Kimpen JL, et al. Cord blood vitamin D deficiency is associated with respiratory syncytial virus bronchiolitis. Pediatrics. 2011; 127:e1513-e20.
    27. Namgung R, Tsang RC. Factors affecting newborn bone mineral content: in utero effects on newborn bone mineralization. Proceedings of the Nutrition Society. 2000; 59:55-63.
    28. Morrison NA, Qi JC, Tokita A, Kelly PJ, Crofts L, Nguyen TV, et al. Prediction of bone density from vitamin D receptor alleles. Nature. 1994; 367:284-7.
    29. Carpenter TO, Zhang JH, Parra E, Ellis BK, Simpson C, Lee WM, et al. Vitamin D binding protein is a key determinant of 25‐hydroxyvitamin D levels in infants and toddlers. Journal of Bone and Mineral Research. 2013; 28:213-21.
    30. Cho SY, Park H-K, Lee HJ. Efficacy and safety of early supplementation with 800 IU of vitamin D in very preterm infants followed by underlying levels of vitamin D at birth. Italian journal of pediatrics. 2017; 43:1-8.
    31. Hein G, Richter D, Manz F, Weitzel D, Kalhoff H. Development of nephrocalcinosis in very low birth weight infants. Pediatric Nephrology. 2004; 19:616-20.