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Multi-dose vitamin d supplementation in stable very preterm infants: Prospective randomized trial response to three different vitamin D supplementation doses
Early Human Development. Volume 112, September 2017, Pages 54–59
ttps://doi.org/10.1016/j.earlhumdev.2017.07.016
Ozlem Bozkurt, dr_kalyoncu at hotmail.com, Nurdan Uras, Fatma Nur Sari, Funda Yavanoglu Atay, Suzan Sahin, Ayse Dogan Alkan, Fuat Emre Canpolat, Serife Suna Oguz
Highlights
- There is no consensus regarding the adequate dose of supplementation for preterm infants.
- Vitamin D supplementation of 1000 IU/d in very preterm infants effectively decreases the prevalence of vitamin D deficiency.
- The clinical importance of biochemically sufficient levels of vitamin D need to be further assessed.
Background
Preterm newborns are born with lower vitamin D stores. Although vitamin D supplementation is recommended there is no consensus regarding the adequate dose of supplementation for preterm infants.
Aims
To assess the effect of three different doses of vitamin D supplementation (400, 800 and 1000 IU/d) in preterm infants ≤ 32 weeks gestation on the prevalence of vitamin D deficiency and 25(OH) D levels at 36 weeks postmenstrual age (PMA).
Study design: Prospective randomized trial.
Subjects: 121 preterm infants with gestational age of 24–32 weeks were randomly allocated to receive 400, 800 or 1000 IU/d vitamin D.
Outcome measures
Serum concentration of 25(OH) D and the prevalence of vitamin D deficiency at 36 weeks PMA. Vitamin D deficiency was defined as serum 25(OH) D concentrations < 20 ng/ml.
Results
Of the 121 infants 72% had deficient vitamin D levels before supplementation. The average 25(OH) vitamin D concentrations at 36 weeks PMA were significantly higher in 800 IU (40 ± 21.4 ng/ml) and 1000 IU group (43 ± 18.9 ng/ml) when compared to 400 IU group (29.4 ± 13 ng/ml). The prevalence of vitamin D deficiency (2.5 vs 22.5; RR: 0.09; CI:0.01–0.74) and insufficiency (30 vs 57.5; RR:0.32; CI:0.13–0.80) was significantly lower in 1000 IU group when compared to 400 IU group at 36 weeks PMA.
Conclusion
1000 IU/d of vitamin D supplementation in preterm infants ≤ 32 weeks gestation age effectively decreases the prevalence of vitamin D deficiency and leads to higher concentrations of 25(OH) vitamin D at 36 weeks PMA
Trial registration Clinical Trials.gov: NCT02941185.
800 IU provided benefits to premies, 400 IU did not - RCT 2017
Randomized trial of two doses of vitamin D3 in preterm infants <32 weeks: Dose impact on achieving desired serum 25(OH)D3 in a NICU population
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