Almost all newborns in India have less than 20 ng of vitamin D – Nov 2012

Vitamin D Status of Low Birth Weight Infants in Delhi: A Comparative Study

Ramesh Agarwal, Deenanath Virmani, Munna Lal Jaipal, Shuchita Gupta, Nandita Gupta, M. Jeeva Sankar, Sunita Bhatia, Anand Agarwal, Veena Devgan, Ashok Deorari, Vinod K. Paul, Investigators of LBW Micronutrient Study Group, Departments of Pediatrics and Endocrinology
All India Institute of Medical Sciences, Department of Pediatrics, Kasturba Hospital and Swami Dayanand Hospital, New Delhi 110029, India
Correspondence: Ramesh Agarwal, Newborn Health Knowledge Centre (NHKC), Department of Pediatrics, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India. Tel: +91-11-26589633, Fax: +91-11-26588633, E-mail: <[email protected]>.

Objective: To evaluate vitamin D status of preterm and term low birthweight (LBW) and term normal birth weight (NBW; weight ≥ 2500 g) infants at birth and in early infancy.

Methods: We enrolled 220 LBW and 119 NBW infants along with their mothers. Blood samples of both infants and mothers were taken within 48 h of birth, and that of infants were repeated at 3 months. Serum levels of calcium, phosphate, alkaline phosphatase, 25 hydroxyvitamin D (25OHD) and parathormone (PTH) were estimated using standard tests. Our primary outcome was vitamin D deficiency (VDD; serum 25OHD <20 ng/ml in mothers and <15 ng/ml in infants). Other outcomes were raised PTH (>46 pg/ml), raised AlkP (>120 U/l in mothers and 420 U/l in infants), and clinical rickets.

Findings: VDD was present in 186 (87.3%) of LBW and 103 (88.6%) of NBW infants at birth, and in 77 (60.6%) of LBW and 55 (71.6%) of NBW infants at a median corrected age of 12 and 15 weeks, respectively. VDD was almost universal (93–97%) among mothers of both groups. Raised PTH was present in 138 (63.6%) of LBW and 48 (41.4%) of NBW infants at birth, and in 58 (45.7%) of LBW and 38 (49.3%) of NBW infants at follow-up.

Clinical rickets was present in

• 17 (13.4%) of LBW and
• 4 (4.9%) of NBW infants

at 12–14 weeks of corrected age.

Conclusions: High prevalence of VDD in LBW as well as NBW infants with clinical rickets at an early age underlines the need to study the effect of various vitamin D supplementation regimens in these infants to identify the optimal dose.
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Note: about 1/4 of ALL infants in India had rickets.

Seems like India could eliminate the huge cost of rickets by giving (for free) 400 IU of vitamin D to all infants

See also Vitamin D Life

• 16% of exclusively breastfed infants so low on vitamin D that they had rickets – June 2010 India
• Black Sudanese children 350X more likely to have rickets than other Australians – April 2012
• Turkey gave 400 IU vitamin D to needy infants and reduced Rickets by 60X - 2011
• All items in category Rickets and vitamin D 119 items
• All items in category Infants/children and vitamin D 606 items
• Black Sudanese children 350X more likely to have rickets than other Australians – April 2012
• 90 % of Indian mothers and infants had less than 20 ng of vitamin D – May 2011
• Mothers and infants in India have very low levels of vitamin D – April 2012