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Respiratory distress after preterm birth is more likely if low vitamin D – review April 2015

The impact of vitamin D on fetal and neonatal lung maturation. A systematic review.

Am J Physiol Lung Cell Mol Physiol. 2015 Apr 1;308(7):L587-602. doi: 10.1152/ajplung.00117.2014. Epub 2015 Jan 16.
Lykkedegn S1, Sorensen GL2, Beck-Nielsen SS1, Christesen HT3.
1Hans Christian Andersen Children's Hospital, Odense University Hospital, Odense, Denmark; Clinical Institute, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark;
2Institute of Molecular Medicine, Department of Cardiovascular and Renal Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark.
3Hans Christian Andersen Children's Hospital, Odense University Hospital, Odense, Denmark; Clinical Institute, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark; henrik.christesen at rsyd.dk.

Respiratory distress syndrome (RDS) and bronchopulmonary dysplasia (BPD) are major complications to preterm birth. Hypovitaminosis D is prevalent in pregnancy. We systematically reviewed the evidence of the impact of vitamin D on lung development, surfactant synthesis, RDS, and BPD searching PubMed, Embase, and Cochrane databases with the terms vitamin D AND (surfactant OR lung maturation OR lung development OR respiratory distress syndrome OR fetal lung OR prematurity OR bronchopulmonary dysplasia). Three human studies, ten animal studies, two laboratory studies, and one combined animal and laboratory study were included. Human evidence was sparse, allowing no conclusions. BPD was not associated with vitamin D receptor polymorphism in a fully adjusted analysis. Animal and laboratory studies showed substantial positive effects of vitamin D on the alveolar type II cell, fibroblast proliferation, surfactant synthesis, and alveolarization. These data support the hypothesis of hypovitaminosis D as a frequent, modifiable risk factor of RDS and BPD, which should be tested in randomized controlled trials on pregnant women, those with threatening preterm delivery, or in the preterm neonates. Future experimental and ]human studies should aim to identify optimal time windows, vitamin D doses, and cut-off levels for 25-hydroxyvitamin D in interventions against RDS, BPD, and later adverse respiratory outcomes.

Copyright © 2015 the American Physiological Society.

PMID: 25595644
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See also VitaminDWiki

items in BOTH of categories: infants and Breathing

See also Vitamin D Council

  • The role of vitamin D in respiratory distress among newborns Aug 2015
    "RDS develops in about 1% of all newborn infants and is the leading cause of death in preterm infants."
    "The incidence decreases with advancing gestational age, from about 50% in babies born at 26–28 weeks, to about 25% at 30–31 weeks."
    "In a cohort study, the researchers found that 28% of the infants with 25(OH)D <10 ng/ml had RDS compared to 14% of the infants with higher 25(OH)D. RDS was reduced 3.34 times in newborns with higher vitamin D levels."
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