Vitamin D supplementation and T Cell Regulation In Preterm Infants: A Randomized Controlled Trial.
J Pediatr Gastroenterol Nutr. 2019 Jul 22. doi: 10.1097/MPG.0000000000002448.
Aly H1, Mohsen L2, Bhattacharjee I1, Malash A2, Atyia A2, Elanwary S2, Hawary RE3.
1 Department of Neonatology, Cleveland Clinic Children's, Cleveland, Ohio.
2 Department of Pediatrics, Faculty of Medicine, Cairo University, Cairo, Egypt.
3 Clinical and Chemical Pathology Department, Faculty of Medicine, Cairo University, Cairo, Egypt.
Infants born 28-33 weeks gestation
After consuming 100 ml/kg they were given 400 or 800 IU of Vitamin D
| 400 IU | 800 IU | |
| Treg @ 4 weeks | 2 | 74 |
| Days in hospital | 25 | 22 |
- Newborn Vitamin D - single 50,000 IU is better than daily – RCT Sept 2016
- A loading dose gets the vitamin D levels up months sooner than daily dosing
- Preterm babies have low vitamin D, but recover in 6 weeks with 800 IU supplementation – Jan 2019
- Preemies getting 800 IU of vitamin D were 3X less likely to have low bone density 4 weeks later – RCT Oct 2017
- 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
- No preemie had even 30 ng of vitamin D, lower D associated with more Respiratory Distress – Aug 2013
- Third study found that Infants needed 1600 IU of vitamin D – JAMA RCT May 2013
- Vitamin D, immunity and microbiome – Dec 2014
The objective of this study was to evaluate the effect of two different doses of vitamin D on the expression of T regulatory cells (Treg) in premature infants. A double blinded randomized controlled trial was conducted on preterm infants born with gestational age (GA) between 28 and 33weeks. Subjects were randomly assigned to receive 400 or 800 IU/day of vitamin D3 when they achieved 100 ml/kg of enteral feeds. Percent increase in Treg cell counts were measured by flow cytometry at enrollment, and after one and four weeks of oral vitamin D supplementation at the allotted doses in both groups. Short-term morbidity and mortality outcomes were also assessed. A total of 40 infants were enrolled, 20 in each group. The change in Treg count (%) was significantly less in the low-dose vitamin D3 supplementation group after one week (1.9 ± 5.5 vs 60 ± 5.6, p = 0.0005) and after four weeks (1.8 ± 5.7 vs 73.7 ± 5.6, p = 0.0028). The two groups did not differ in anthropometric measurements, duration of oxygen and respiratory support, and mortality. Length of hospital stay was longer in the low-dose group (24.9 ± 5.14 vs 22 ± 3.49, p = 0.04). Oral vitamin D supplementation has a dose and time dependent effect on percentage of Treg in infants born prematurely. The 800 IU dose of vitamin D3 did not have apparent short-term side effects. Larger studies are needed to explore the effect of vitamin D3 dosing on length of hospital stay.