Vitamin D Status in Mothers and Preterm Infants

Background: Given the high prevalence of vitamin D(vitD) deficiency in preterm infants on total parentral nutrition(TPN) and the negative effects of this deficiency, the vitD status and the risk factors of vitD deficiency should be evaluated and studied in order to prevent the deficiency of vitD and its complications. Methods: This study was a cross sectional study in which 25(OH)D, calcium(Ca), phosphorus(P), and alkaline phosphatase(Alk) levels were measured in infants of GA<37 weeks receiving TPN in the first 24 hours after birth and two weeks after receiving TPN. Maternal 25(OH)D, Ca, P, and Alk levels were also measured in the first 24 hours after delivery. Moreover, the relationship between neonatal and maternal vitD, Ca, P, and Alk was measured before and after TPN. Inclusion criteria: infants with no asphyxia, that were expected to undergo TPN for two weeks. Infants did not receive corticosteroids and anticonvulsants. Mothers did not receive medication during pregnancy. Results: The mean of 25(OH) D level in infants was significantly decreased after 2 weeks, therefore, the mean at birth, in the group of GA30 weeks before and after TPN was 49.44+32.12 ng/ml and 34.99+23.15ng/m and in the group of GA> 30 weeks before and after TPN was 33.64–16.24ng/ml and 26.26+9.86ng/ml, respectively The neonatal vitD status at birth and at two weeks of age had a strong, direct and significant relationship with maternal vitD at the time of delivery, but the neonatal P, Ca and Alk level had a direct and significant correlation with maternal P, Ca and Alk level only at the time of birth, and unlike vitD, this relationship decreased significantly after two weeks. Conclusion: It seems that the cause of this significant decrease in vitD status cannot be attributed to vitD deficiency in mothers only; rather this decrease is relevant to the lack of fat-soluble vitamins such as vitD in TPN solutions available in our country. The main recommendation of the present study is that by adding fat-soluble vitamins to TPN from the first days of life, the deficiency of these vitamins in preterm infants on TPN and its complications can be prevented.

کلیدواژه ها:

vitamin D deficency ، hypocalcemia ، premature infant ، preterm neonate ، total parentral nutrition ، TPN