Mothers and infants in India have very low levels of vitamin D – April 2012

Vitamin D Status of Low Birth Weight Infants in Delhi: A Comparative Study

Ramesh Agarwal, Deenanath Virmani, Munna Lal Jaipal, Shuchita Gupta, Nandita Gupta, M. Jeeva Sankar, Sunita Bhatia, Anand Agarwal, Veena Devgan, Ashok Deorari, Vinod K. Paul and Investigators of LBW Micronutrient Study Group, Departments of Pediatrics and Endocrinology
All India Institute of Medical Sciences, Department of Pediatrics, Kasturba Hospital and Swami Dayanand Hospital, New Delhi 110029, India
Correspondence: Ramesh Agarwal, Newborn Health Knowledge Centre (NHKC), Department of Pediatrics, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India. Tel: +91-11-26589633, Fax: +91-11-26588633, E-mail: aranag@rediffmail.com

---

Summary by VitaminDWiki

95% of mothers had < 20 ng of vitamin D
87% of low birth weight infants had < 15 ng at birth ( 220 infants includes preterm)
89% of normal weight infants had < 15 ng at birth (119 infants)
61% of low birth weight infants had < 15 ng at age 12 weeks (includes preterm)
72% of normal weight infants had < 15 ng at age 15 weeks
Reminder: In many countries these % would be much higher, as they believe that vitamin D levels should be > 30 ng

---

Objective: To evaluate vitamin D status of preterm and term low birthweight (LBW) and term normal birth weight (NBW; weight???2500?g) infants at birth and in early infancy.

Methods: We enrolled 220 LBW and 119 NBW infants along with their mothers. Blood samples of both infants and mothers were taken within 48?h of birth, and that of infants were repeated at 3 months. Serum levels of calcium, phosphate, alkaline phosphatase, 25 hydroxyvitamin D (25OHD) and parathormone (PTH) were estimated using standard tests.

Our primary outcome was vitamin D deficiency (VDD; serum 25OHD <20?ng/ml in mothers and <15?ng/ml in infants). Other outcomes were raised PTH (>46?pg/ml), raised AlkP (>120?U/l in mothers and 420?U/l in infants), and clinical rickets.

Findings: VDD was present in 186 (87.3%) of LBW and 103 (88.6%) of NBW infants at birth, and in 77 (60.6%) of LBW and 55 (71.6%) of NBW infants at a median corrected age of 12 and 15 weeks, respectively. VDD was almost universal (93–97%) among mothers of both groups. Raised PTH was present in 138 (63.6%) of LBW and 48 (41.4%) of NBW infants at birth, and in 58 (45.7%) of LBW and 38 (49.3%) of NBW infants at follow-up. Clinical rickets was present in 17 (13.4%) of LBW and 4 (4.9%) of NBW infants at 12–14 weeks of corrected age.

Conclusions: High prevalence of VDD in LBW as well as NBW infants with clinical rickets at an early age underlines the need to study the effect of various vitamin D supplementation regimens in these infants to identify the optimal dose.

---

See also VitaminDWiki

• Newborns in sunny Jordan have very low Vitamin D (histogram) – Nov 2013
• 90 % of Indian mothers and infants had less than 20 ng of vitamin D – May 2011
• Rickets in 30 % of infants in India who had low vitamin D – March 2011
• Low D in developing countries – less than 5 ng in some children in China – Oct 2010
• Majority of infant seizures in India due to lack of vitamin D - July 2010
• Recommend 400 IU to prevent rickets – Mar 2010 Turkey
• Vitamin D Levels in Kids are So Low that Rickets is Back with a Vengeance - by Knox
• 16% of exclusively breastfed infants so low on vitamin D that they had rickets – June 2010 India
• Dark Skinned babies probably need vit D supplements to prevent rickets -2001
• Death of Babies in UK due to vitamin D deficiency – Jan 2012
• All items in category Rickets and vitamin D 127 items
• All items in category Infant-Child and Vitamin D 854 items
• Overview Pregnancy and vitamin D which has the following summary
  

  IU	Cumulative Benefit	Blood level	Cofactors	Calcium	$*/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 cofactors	< 750 mg	$3
  6000	Probable: larger benefits for above items Just enough D for breastfed infant More maternal and infant weight		Should have cofactors	< 750 mg	$4