Supplement preterm infants with vitamin D if less than 80 ng – RCT

Monitored Supplementation of Vitamin D in Preterm Infants: A Randomized Controlled Trial

Nutrients 2021, 13(10), 3442; https://doi.org/10.3390/nu13103442

Alicja Kołodziejczyk-Nowotarska ORCID,Renata Bokiniec andJoanna Seliga-Siwecka *

Department of Neonatology and Neonatal Intensive Care, Medical University of Warsaw, 00-315 Warsaw, Poland

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Appropriate supplementation of vitamin D can affect infections, allergy, and mental and behavioral development. This study aimed to assess the effectiveness of monitored vitamin D supplementation in a population of preterm infants. 109 preterm infants (24 0/7–32 6/7 weeks of gestation) were randomized to receive 500 IU vitamin D standard therapy (n = 55; approximately 800–1000 IU from combined sources) or monitored therapy (n = 54; with an option of dose modification). 25-hydroxyvitamin D [25(OH)D] concentrations were measured at birth, 4 weeks of age, and 35, 40, and 52 ± 2 weeks of post-conceptional age (PCA). Vitamin D supplementation was discontinued in 23% of infants subjected to standard treatment due to increased potentially toxic 25(OH)D concentrations (>90 ng/mL) at 40 weeks of PCA. A significantly higher infants’ percentage in the monitored group had safe vitamin D levels (20−80 ng/mL) at 52 weeks of PCA (p = 0.017). We observed increased vitamin D levels and abnormal ultrasound findings in five infants. Biochemical markers of vitamin D toxicity were observed in two patients at 52 weeks of PCA in the control group. Inadequate and excessive amounts of vitamin D can lead to serious health problems. Supplementation with 800–1000 IU of vitamin D prevents deficiency and should be monitored to avoid overdose.

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“Eighty percent of calcium and phosphorus placental transfer occurs between 24–40 weeks of gestation; hence, preterm infants are especially prone to adverse effects of VDD, including MBD and low bone mineral status ^[21,34,35].”

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