Randomized trial of two doses of vitamin D3 in preterm infants <32 weeks: Dose impact on achieving desired serum 25(OH)D3 in a NICU population.
PLoS One. 2017 Oct 10;12(10):e0185950. doi: 10.1371/journal.pone.0185950. eCollection 2017.
Anderson-Berry A1, Thoene M2, Wagner J3, Lyden E4, Jones G5, Kaufmann M5, Van Ormer M1, Hanson C6.
- Note: 400 IU and 800 IU had virtually same Vitamin D levels after 4 weeks, but 800 IU preemies has much better bone density
- Preemies need 1,000 IU of vitamin D – RCT Sept 2017
- Premature infants (30 weeks) who got 800-1000 IU of vitamin D were much healthier – March 2017
- Monthly vitamin D dosing is better than daily dosing for children and elderly (more likely to be taken) – June 2017
Also, monthly dosing gets Vitamin D levels up in days, instead of a month or two
Recommendations for vitamin D supplementation for preterm infants span a wide range of doses. Response to vitamin D supplementation and impact on outcomes in preterm infants is not well understood.
Evaluate serum 25(OH)D3 concentration changes after 4 weeks in response to two different doses of vitamin D3 supplementation in a population of premature infants and quantify the impact on NICU outcomes.
32 infants born at 24-32 weeks gestation were prospectively randomized to receive 400 or 800 IU/day vitamin D3 supplementation. Serum 25(OH)D3 levels were measured every 4 weeks. The Wilcoxon signed rank test was used to compare serum levels of 25(OH)D3 at 4 weeks and each subsequent time point. A p-value of <0.05 was considered statistically significant.
Serum 25(OH)D3 levels at birth were 41.9 and 42.9 nmol/l for infants in the 400 IU group and 800 IU group, respectively (p = 0.86). Cord 25(OH)D3 concentrations significantly correlated with gestational age (r = 0.40, p = 0.04). After 4 weeks of D3 supplementation, median 25(OH)D3 levels increased in both groups (84.6 vs. 105.3 nmol/l for 400 vs. 800 IU/day respectively, with significantly more improvement in the higher dose (p = 0.048). Infants in the 400 IU group were significantly more likely to have dual energy x-ray absorptiometry (DEXA) bone density measurements <10 percentile (56% vs 16%, p = 0.04).
Improvement in 25(OH)D3 levels at 4 weeks, bone density, and trends towards improvement in linear growth support consideration of a daily dose of 800 IU of vitamin D for infants <32 weeks cared for in the NICU.
PMID: 29016653 DOI: 10.1371/journal.pone.0185950