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The more preterm the birth, the lower the vitamin D level (both mothers and infants) – Feb 2014

Vitamin D status of early preterm infants and the effects of vitamin D intake during hospital stay

Arch Dis Child Fetal Neonatal Ed 2014;99:F166-F168 doi:10.1136/archdischild-2013-303999
Nagendra Monangi 1, Jonathan L Slaughter 2,3, Adekunle Dawodu 4, Carrie Smith 5, Henry T Akinbi 1
1Neonatal Perinatal Medicine, Perinatal Institute, Cincinnati Children's Hospital Medical Center/University of Cincinnati, Cincinnati, Ohio, USA
2Center for Perinatal Research and Ohio Perinatal Research Network, Nationwide Children's Hospital, Columbus, Ohio, USA
3Department of Pediatrics, The Ohio State University, Columbus, Ohio, USA
4Global Health Center, Cincinnati Children's Hospital Medical Center/University of Cincinnati, Cincinnati, Ohio, USA
5University of Cincinnati Medical Center, Cincinnati, Ohio, USA
Correspondence to: Dr Henry T Akinbi, Division of Neonatology and Pulmonary Biology, 3333 Burnet Ave, Cincinnati, OH 45229-3039, USA; henry.akinbi at cchmc.org

Objectives To evaluate vitamin D (vitD) status in early preterm infants (EPTIs) at birth and during birth hospitalisation on current vitD intake.

Design/methods Serum 25-hydroxyvitamin-D [25(OH)D] concentrations, vitD intake and risk factors for low vitD status were assessed in 120 infants born at ≤32 weeks gestation.

Results Mean (SD) serum 25(OH)D at birth was 46.2 (14.0) nmol/L with lower concentrations in infants born <28 weeks than at 28–32 weeks gestation, p=0.02. Serum 25(OH)D was <50 nmol/L in 63% of mothers, 64% of infants at birth and 35% of infants at discharge. Mean daily vitD intake was 289±96 IU at 4 weeks of age and 60% achieved 400 IU/day intake at discharge.

Conclusions Serum 25(OH)D <50 nmol/L was widespread in parturient women and in EPTIs at birth and at discharge. Optimising maternal vitD status during pregnancy and improving postnatal vitD intake may enhance infant vitD status during hospitalisation.

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IU Cumulative Benefit Blood level CofactorsCalcium $*/month
200 Better bones for mom
with 600 mg of Calcium
6 ng/ml increase Not needed No effect $0.10
400 Less Rickets (but not zero with 400 IU)
3X less adolescent Schizophrenia
Fewer child seizures
20-30 ng/ml Not needed No effect $0.20
2000 2X More likely to get pregnant naturally/IVF
2X Fewer dental problems with pregnancy
8X less diabetes
4X fewer C-sections (>37 ng)
4X less preeclampsia (40 ng vs 10 ng)
5X less child asthma
2X fewer language problems age 5
42 ng/ml Desirable < 750 mg $1
4000 2X fewer pregnancy complications
2X fewer pre-term births
49 ng/ml Should have
< 750 mg $3
6000 Probable: larger benefits for above items
Just enough D for breastfed infant
More maternal and infant weight
Should have
< 750 mg $4