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

• Published in: Nutrients 2021-09, Vol.13 (10), p.3442
• Main Authors: Kołodziejczyk-Nowotarska, Alicja, Bokiniec, Renata, Seliga-Siwecka, Joanna
• Format: Article
• Language: English
• Subjects: 25-Hydroxyvitamin D; Age; Biochemical markers; Bone diseases; Calciferol; Caregivers; Clinical trials; Creatinine; Gallbladder diseases; Health problems; Hypercalcemia; Hypersensitivity; Infants; Intensive care; metabolic bone disease; Metabolism; Neonatal nursing; Neonates; Newborn babies; Nutrition; osteopenia; Overdose; Parenteral nutrition; Performance evaluation; Premature babies; prematurity; rickets; Toxicity; Ultrasonic imaging; Vitamin D; Vitamin deficiency
• ISSN: 2072-6643; 2072-6643
• DOI: 10.3390/nu13103442

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.