Preemies with low Vitamin D are 14 percent more like to have expensive gut problems (necrotizing enterocolitis) – March 2017

Maternal/neonatal vitamin D deficiency: a new risk factor for necrotizing enterocolitis in preterm infants?

Journal of Perinatology , (23 March 2017) | doi:10.1038/jp.2017.18
M Cetinkaya, T Erener-Ercan, T Kalayci-Oral, A Babayiğit, B Cebeci, S Y Semerci and G Buyukkale

Objective:
The objective of the study was to investigate the possible association between maternal/neonatal 25-hydroxy vitamin D (25-OHD) levels and development of necrotizing enterocolitis (NEC).

Study Design:
One hundred and forty-five preterm infants less than or equal to 36 weeks of gestation were enrolled. 25-OHD levels were determined in maternal/neonatal blood samples that were obtained at the time of admission to the neonatal intensive care unit.

Results:
Of the 145 enrolled patients, 26 (18%) developed NEC. Maternal/neonatal 25-OHD levels in the NEC group were significantly lower than those of the no-NEC group (P=0.001 and 0.004, respectively). In univariate logistic regression analysis, both maternal/neonatal vitamin D levels were a significant predictor of NEC (odds ratio (OR): 0.92 and 0.89; P<0.001 and P<0.005, respectively). However, multivariate logistic regression analysis revealed that only maternal vitamin D level was a significant predictor of NEC (OR: 0.86, P<0.0009).

Conclusion:
This is the first study to propose a possible association between maternal/neonatal 25-OHD levels and subsequent development of NEC in preterm infants.

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See also web

• Necrotizing enterocolitis Wikipedia
  "Rates were almost three times higher for black populations than for white populations" (Note: blacks hasve lower vitamin D levels
• Part 1. Current Controversies in the Understanding of Necrotizing Enterocolitis Medscape 2003
  "The incidence of NEC varies. It is stated most often as 1% to 7% of all neonatal intensive care unit (NICU) admissions, or 1 to 3 per 1,000 live births"
• Costs of necrotizing enterocolitis and cost-effectiveness of exclusively human milk-based products in feeding extremely premature infants Feb 2017
  NEC medical + surgical cost = $270,000
• Necrotizing Enterocolitis Risk April 2012
  "Necrotizing enterocolitis is a costly disease, accounting for nearly 20% of NICU costs annually."
  "Necrotizing enterocolitis survivors requiring surgery often stay in the NICU more than 90 days and are among those most likely to stay more than 6 months"
  "Although 90% of infants who develop NEC are born premature, full-term and near-term infants also develop the disease"
  "It is estimated that nearly 12% of infants born weighing less than 1500 g will develop NEC; of those, about 30% will not survive."
   Download the PDF from VitaminDWiki

VitaminDWiki Calculation:
Vitamin D does not appear to be a cost-effective way to prevent NEC

1. 1 in 1,000 live births get NEC (see web above)
2. $100,000 = Conservative cost of NEC
   thus NEC only adds $100 to the average cost of birth
3. 14% less NEC if high good level of vitamin D (study on this page)
   Thus adding Vitamin D would only reduce the averagecost of birth due to NEC by $14
   This calculation does not consider the decrease in extreme premie births by vitamin D
   This calculation does not consider adding Vitamin D to premie after birth but before NEC starts

See also VitaminDWiki

• Infant-Child category listing has 844 items along with related searches
• Stunting OR “low birth weight” OR LBW OR preemie OR preemies OR preterm 777 items as of March 2017
• Preterm births are VERY costly – Feb 2017
• Children in Intensive Care need Vitamin D loading dose of 10000 IU per kg (nearing a consensus) - Oct 2016
• 5 out of 6 children who died in pediatric critical care unit had low vitamin D – May 2014

Healthy pregnancies need lots of vitamin D has the following summary

Problem	Vit. D Reduces	Evidence
0. Chance of not conceiving	3.4 times	Observe
1. Miscarriage	2.5 times	Observe
2. Pre-eclampsia	3.6 times	RCT
3. Gestational Diabetes	3 times	RCT
4. Good 2nd trimester sleep quality	3.5 times	Observe
5. Premature birth	2 times	RCT
6. C-section - unplanned	1.6 times	Observe
Stillbirth - OMEGA-3	4 times	RCT - Omega-3
7. Depression AFTER pregnancy	1.4 times	RCT
8. Small for Gestational Age	1.6 times	meta-analysis
9. Infant height, weight, head size      within normal limits		RCT
10. Childhood Wheezing	1.3 times	RCT
11. Additional child is Autistic	4 times	Intervention
12.Young adult Multiple Sclerosis	1.9 times	Observe
13. Preeclampsia in young adult	3.5 times	RCT
14. Good motor skills @ age 3	1.4 times	Observe
15. Childhood Mite allergy	5 times	RCT
16. Childhood Respiratory Tract visits	2.5 times	RCT

RCT = Randomized Controlled Trial

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