Questioning the adequacy of standardized vitamin D supplementation protocol in very low birth weight infants: a prospective cohort study

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Hatice Sarıdemir ◽  
Ozge Surmeli Onay ◽  
Ozge Aydemir ◽  
Ayse Neslihan Tekin
Keyword(s):  
Vitamin D ◽  
Cohort Study ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Prospective Cohort ◽  
Very Low Birth Weight ◽  
Vitamin D Supplementation ◽  
Vitamin D Status ◽  
Vlbw Infants ◽  
Vitamin D Levels

Abstract Objectives Preterm infants are at increased risk for vitamin D deficiency (VDD). We aimed to assess the adequacy of standardized vitamin D supplementation protocol in very low birth weight (VLBW) infants. Additionally, vitamin D status of mother/infant couples and the associations between vitamin D status at birth and morbidities of the infants were investigated. Methods In this single-center, prospective cohort study blood samples were collected from 55 mothers just before delivery and from their infants at birth and on the 30th day of life (DOL) for 25 hydroxy vitamin D (25OHD) measurements. Vitamin D was initiated in dose of 160 IU/kg by parenteral nutrition on the first DOL and oral vitamin D supplementation (400 IU/day) was administered when enteral feedings reached 50% of total intake or on the 15th DOL. Results The median 25OHD levels of the infants were 16.12 (9.14–20.50) in cord blood and 36.32 (31.10–44.44) in venous blood on the 30th DOL (p<0.01). In 98% of the VLBW infants 25OHD reached sufficient levels on the 30th DOL. None of the mothers had sufficient vitamin D levels (25OHD >30 ng/mL). Maternal 25OHD levels were correlated with the 25OHD levels of the infants in cord blood (r=0.665, p<0.001). There was a significant difference in mean cord 25OHD levels between winter (13.65 ± 5.69 ng/mL) and summer seasons (19.58 ± 11.67 ng/mL) (p=0.021). No association was found between neonatal morbidity and vitamin D status. Conclusions The results clearly show that by utilizing the current supplementation protocol, the majority of VLBW infants with deficient/insufficient serum 25OHD levels reached sufficient levels on the 30th DOL. Furthermore, vitamin D levels in mother/infant couples were found to be highly correlated.

Mortality and Management of Surgical Necrotizing Enterocolitis in Very Low Birth Weight Neonates: A Prospective Cohort Study

2014 ◽  
Vol 218 (6) ◽  
pp. 1148-1155 ◽  
Author(s):  
Melissa A. Hull ◽  
Jeremy G. Fisher ◽  
Ivan M. Gutierrez ◽  
Brian A. Jones ◽  
Kuang Horng Kang ◽  
...  
Keyword(s):  
Cohort Study ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Necrotizing Enterocolitis ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Very Low Birth Weight

The role of Vitamin D in the prevention of pregnancy complications and childhood diseases in the first year of life

2021 ◽  
Vol 20 (5) ◽  
pp. 114-123
Author(s):  
E.V. Shikh ◽  
◽  
A.A. Makhova ◽  
Zh.M. Sizova ◽  
N.V. Shikh ◽  
...  
Keyword(s):  
Vitamin D ◽  
Birth Weight ◽  
Preterm Birth ◽  
Low Birth Weight ◽  
Pregnant Women ◽  
Pregnancy Complications ◽  
Vitamin D Supplementation ◽  
Childhood Diseases ◽  
Vitamin D Levels ◽  
First Year Of Life

Vitamin D status during pregnancy has an impact on fetal growth and development and plays an important role in the prevention of pregnancy complications. Fetal vitamin D supplementation is completely dependent on maternal status, which explains the high correlation between 25(OH)D concentrations in maternal and umbilical cord blood. Adequate vitamin D supplementation in pregnant women is associated with a decreased risk of preterm birth and low birth weight. Most newborns, regardless of gestational age, have insufficient vitamin D levels. Thus, the problem of Vitamin D supplementation is relevant not only for pregnant women, but also for newborns. Research studies of recent years have aimed at comparing the efficacy of Vitamin D dosing to prevent pregnancy complications. Doses higher than 4000 IU have virtually no effect on the risk of preeclampsia compared with doses of 4000 IU or less. Administration of Vitamin D in doses less than 2000 IU per day reduces the risk of low birth weight, intrauterine or neonatal mortality. Doses higher than 2000 IU have no additional benefit. Recommendations for vitamin D supplementation based on objective pharmacokinetic characteristics should be developed. Key words: pregnancy, vitamin D, doses, preterm birth, gestational diabetes, preeclampsia

scholarly journals Factors Associated With Improvements in Mortality and Morbidity Rates of Very-Low-Birth-Weight Infants: A Cohort Study

2018 ◽  
Vol 5 ◽  
pp. 2333794X1876536
Author(s):  
Giancarlo Mari ◽  
Zoran Bursac ◽  
Patricia Jean Goedecke ◽  
Ramasubbareddy Dhanireddy
Keyword(s):  
Cohort Study ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Outcome Measures ◽  
Very Low Birth Weight ◽  
Mortality Rates ◽  
Health Science ◽  
Science Center ◽  
Vlbw Infants ◽  
Antenatal Steroids

Objective. The objective of this study was to determine factors contributing to improvements in infant mortality rates (IMR) and composite morbidity-mortality in very-low-birth-weight (VLBW) infants after initiating a new perinatal program in 2009 at Regional One Health (ROH). VLBW infants account for 67% of infant deaths. Design. This is a pre-/postintervention cohort study of prospectively gathered data. Population. VLBW infants delivered at ROH during the 2004 to 2015 study period. Setting. ROH is a Regional Perinatal Center affiliated with the University of Tennessee Health Science Center. Methods. We studied 2364 consecutive VLBW infants. Multivariate models were applied to determine factors contributing significantly to the reduction in the outcome measures as well as trends over time. Main Outcome Measures. Primary outcomes were IMR and composite morbidity-mortality rates. Standardized, risk-adjusted mortality and composite morbidity ratios were also reported as defined by the Vermont Oxford Network. Results. Mortality declined from 15.5% in Pre-Implementation to 13.1% in Post-Implementation ( P = .093), corresponding to an 18% reduction in odds. The combined factors of composite morbidity-mortality rate decreased from 55.7% in Pre-Implementation to 43.9% in Post-Implementation ( P < .0001), representing a 38% reduction in odds. Standardized, risk-adjusted mortality and composite morbidity ratios improved during the study period from 20% above to 20% below the expected rate. Increases in the administration of antenatal steroids, surfactant administration, cesarean delivery, and perhaps other programmatic changes that were observational and unaccounted in the model were associated with improvements in outcome measures. Conclusions. Decreased mortality and composite morbidity-mortality in VLBW infants delivered at ROH were found following the initiation of a new perinatal program.

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