Vitamin D nutritional status in preterm infants and response to supplementation.

Hdl Handle:
http://hdl.handle.net/10147/299502
Title:
Vitamin D nutritional status in preterm infants and response to supplementation.
Authors:
McCarthy, Roberta A; McKenna, Malachi J; Oyefeso, Oyinkansola; Uduma, Ogenna; Murray, Barbara F; Brady, Jennifer J; Kilbane, Mark T; Murphy, John F; Twomey, Anne; O' Donnell, Colm P; Murphy, Nuala P; Molloy, Eleanor J
Affiliation:
Department of Neonatology, National Maternity Hospital, Holles Street, Dublin 2, Republic of Ireland. rmccarthy@nmh.ie
Citation:
Vitamin D nutritional status in preterm infants and response to supplementation. 2013, 110 (1):156-63 Br. J. Nutr.
Journal:
The British journal of nutrition
Issue Date:
14-Jul-2013
URI:
http://hdl.handle.net/10147/299502
DOI:
10.1017/S0007114512004722
PubMed ID:
23182428
Abstract:
Little is known about vitamin D status in preterm infants and their response to supplementation. To investigate this, we assessed serum 25-hydroxyvitamin D (25OHD) levels using RIA in a consecutive sample of stable preterm very low birth weight (VLBW) infants (born ≤ 32 weeks gestation or birth weight ≤ 1·5 kg), and we explored associated factors. Serum 25OHD level was first assessed once infants were tolerating feeds (n 274). If this first 25OHD level was below 50 nmol/l (20 ng/ml), which is the level associated with covering requirements in terms of skeletal health in the majority, then we recommended prolonged augmented vitamin D intake ( ≥ 10 μg (400 IU) daily) from a combination of fortified feeds and vitamin supplements and follow-up re-assessment at approximately 6 weeks corrected age (n 148). The first assessment, conducted at a median for chronological age of 18 (interquartile range (IQR) 11-28) d, found that 78 % had serum 25OHD levels below 50 nmol/l. Multivariable analysis demonstrated that the determinants of serum 25OHD levels were duration of vitamin D supplementation and gestational age at birth (r 2 0·215; P< 0·001). At follow-up, after a median of 104 (IQR 78-127) d, 87 % achieved levels ≥ 50 nmol/l and 8 % had levels >125 nmol/l, a level associated with potential risk of harm. We conclude that low 25OHD levels are an issue for preterm VLBW infants, warranting early nutritional intervention. In infants with serum 25OHD levels < 50 nmol/l, a vitamin D intake of ≥ 10 μg (400 IU) daily achieves target levels in the majority; however, further work is needed to determine the exact dose to safely meet target levels without overcorrection.
Item Type:
Article
Language:
en
Keywords:
NEONATE; NUTRITION
MeSH:
Bone Density Conservation Agents; Diet; Dietary Supplements; Female; Food, Fortified; Gestational Age; Humans; Infant, Newborn; Infant, Premature; Infant, Very Low Birth Weight; Male; Nutrition Assessment; Nutritional Requirements; Nutritional Status; Vitamin D; Vitamin D Deficiency; Vitamins
ISSN:
1475-2662

Full metadata record

DC FieldValue Language
dc.contributor.authorMcCarthy, Roberta Aen_GB
dc.contributor.authorMcKenna, Malachi Jen_GB
dc.contributor.authorOyefeso, Oyinkansolaen_GB
dc.contributor.authorUduma, Ogennaen_GB
dc.contributor.authorMurray, Barbara Fen_GB
dc.contributor.authorBrady, Jennifer Jen_GB
dc.contributor.authorKilbane, Mark Ten_GB
dc.contributor.authorMurphy, John Fen_GB
dc.contributor.authorTwomey, Anneen_GB
dc.contributor.authorO' Donnell, Colm Pen_GB
dc.contributor.authorMurphy, Nuala Pen_GB
dc.contributor.authorMolloy, Eleanor Jen_GB
dc.date.accessioned2013-08-22T10:49:52Z-
dc.date.available2013-08-22T10:49:52Z-
dc.date.issued2013-07-14-
dc.identifier.citationVitamin D nutritional status in preterm infants and response to supplementation. 2013, 110 (1):156-63 Br. J. Nutr.en_GB
dc.identifier.issn1475-2662-
dc.identifier.pmid23182428-
dc.identifier.doi10.1017/S0007114512004722-
dc.identifier.urihttp://hdl.handle.net/10147/299502-
dc.description.abstractLittle is known about vitamin D status in preterm infants and their response to supplementation. To investigate this, we assessed serum 25-hydroxyvitamin D (25OHD) levels using RIA in a consecutive sample of stable preterm very low birth weight (VLBW) infants (born ≤ 32 weeks gestation or birth weight ≤ 1·5 kg), and we explored associated factors. Serum 25OHD level was first assessed once infants were tolerating feeds (n 274). If this first 25OHD level was below 50 nmol/l (20 ng/ml), which is the level associated with covering requirements in terms of skeletal health in the majority, then we recommended prolonged augmented vitamin D intake ( ≥ 10 μg (400 IU) daily) from a combination of fortified feeds and vitamin supplements and follow-up re-assessment at approximately 6 weeks corrected age (n 148). The first assessment, conducted at a median for chronological age of 18 (interquartile range (IQR) 11-28) d, found that 78 % had serum 25OHD levels below 50 nmol/l. Multivariable analysis demonstrated that the determinants of serum 25OHD levels were duration of vitamin D supplementation and gestational age at birth (r 2 0·215; P< 0·001). At follow-up, after a median of 104 (IQR 78-127) d, 87 % achieved levels ≥ 50 nmol/l and 8 % had levels >125 nmol/l, a level associated with potential risk of harm. We conclude that low 25OHD levels are an issue for preterm VLBW infants, warranting early nutritional intervention. In infants with serum 25OHD levels < 50 nmol/l, a vitamin D intake of ≥ 10 μg (400 IU) daily achieves target levels in the majority; however, further work is needed to determine the exact dose to safely meet target levels without overcorrection.en_GB
dc.language.isoenen
dc.rightsArchived with thanks to The British journal of nutritionen_GB
dc.subjectNEONATEen_GB
dc.subjectNUTRITIONen_GB
dc.subject.meshBone Density Conservation Agents-
dc.subject.meshDiet-
dc.subject.meshDietary Supplements-
dc.subject.meshFemale-
dc.subject.meshFood, Fortified-
dc.subject.meshGestational Age-
dc.subject.meshHumans-
dc.subject.meshInfant, Newborn-
dc.subject.meshInfant, Premature-
dc.subject.meshInfant, Very Low Birth Weight-
dc.subject.meshMale-
dc.subject.meshNutrition Assessment-
dc.subject.meshNutritional Requirements-
dc.subject.meshNutritional Status-
dc.subject.meshVitamin D-
dc.subject.meshVitamin D Deficiency-
dc.subject.meshVitamins-
dc.titleVitamin D nutritional status in preterm infants and response to supplementation.en_GB
dc.typeArticleen
dc.contributor.departmentDepartment of Neonatology, National Maternity Hospital, Holles Street, Dublin 2, Republic of Ireland. rmccarthy@nmh.ieen_GB
dc.identifier.journalThe British journal of nutritionen_GB
dc.description.fundingNo fundingen
dc.description.provinceLeinsteren
dc.description.peer-reviewpeer-reviewen

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