1
|
Amjadi N, Pooransari P, Mirzamoradi M, Gargari SS, Naeiji Z, Rahmati N, Arbabzadeh T, Torkestani F, Karimi Z. Association of maternal serum vitamin D level with fetal pulmonary artery Doppler indices and neonatal respiratory distress syndrome. JOURNAL OF CLINICAL ULTRASOUND : JCU 2024. [PMID: 38830839 DOI: 10.1002/jcu.23734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Revised: 05/02/2024] [Accepted: 05/20/2024] [Indexed: 06/05/2024]
Abstract
PURPOSE Respiratory distress syndrome (RDS) is potentially fatal in infants. The present study investigated the association of maternal serum vitamin D level with fetal pulmonary artery Doppler indices and neonatal RDS. METHODS This cross-sectional-analytical study was conducted on 260 mothers admitted for delivery. The maternal serum 25-hydroxyvitamin D level was measured and fetal main pulmonary artery Doppler indices were evaluated. The neonate's weight, apgar score, RDS, Umbilical cord arterial pH and neonatal intensive care unit admission were recorded. RESULTS There was a significant relationship between RDS and the low level of vitamin D in the mother's serum. Mothers with low vitamin D had higher fetal pulmonary artery pulsatility index (PI) and peak systolic velocity (PSV) and lower acceleration time (AT) to ejection time (ET) ratio. Also, in neonates with RDS, pulmonary artery PI was higher, and PSV and the ratio of AT to ET were significantly lower than neonates without RDS. Neonates with lower one and 5-min apgar scores were born from mothers with lower vitamin D levels. CONCLUSION Serum levels of vitamin D in pregnant mothers as well as fetal pulmonary artery Doppler indices are correlated to RDS. There is a significant relationship between the serum level of vitamin D in pregnant mothers and fetal pulmonary artery Doppler indices.
Collapse
Affiliation(s)
- Nooshin Amjadi
- Preventive Gynecology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Parichehr Pooransari
- Department of Gynecology and Obstetrics, Shohada-e Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Masoumeh Mirzamoradi
- Department of Gynecology and Obstetrics, Shohada-e Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Soraya Saleh Gargari
- Department of Gynecology and Obstetrics, Mahdiyeh Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Zahra Naeiji
- Department of Gynecology and Obstetrics, Mahdiyeh Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Nayereh Rahmati
- Department of Gynecology and Obstetrics, Mahdiyeh Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Taraneh Arbabzadeh
- Department of Gynecology and Obstetrics, Shohada-e Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Zohreh Karimi
- Department of Gynecology and Obstetrics, Shohada-e Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| |
Collapse
|
2
|
Davis S, Lyles E, Shary JR, Ebeling M, Reed SG, Baatz JE, Hollis BW, Wagner CL. Post Hoc Analysis of National Institute of Child Health and Human Development Vitamin-D Pregnancy Cohort and The Role of Functional Vitamin-D Deficiency in Pregnancy. Am J Perinatol 2024; 41:e2098-e2105. [PMID: 37216969 DOI: 10.1055/a-2097-2098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
OBJECTIVE Our objective was to conduct a secondary, post hoc analysis of the National Institute of Child Health and Human Development (NICHD) vitamin D (vitD) pregnancy study by Hollis et al, which reported on the effect of vitD supplementation in pregnant women and determine the potential interaction between intact parathyroid hormone (iPTH) concentrations, vitD status, and various comorbidities associated with pregnancy. Women with low 25-hydroxy vitamin D (25(OH)D) concentrations and high iPTH concentrations during pregnancy, known as functional vitamin-D deficiency (FVDD), were more likely to acquire complications also affecting their neonates. STUDY DESIGN This post hoc analysis of data collected from a diverse group of pregnant women participating in the NICHD vitD pregnancy study was applied to investigate the applicability of the concept of FVDD in pregnancy (Hemmingway, 2018) in identifying potential risks for certain comorbidities of pregnancy. This analysis defines FVDD as maternal serum 25(OH)D concentrations below 20 ng/mL and iPTH concentrations above 65 pg/mL creating a definitive ratio number, 0.308, to classify mothers as having FVDD prior to delivery (PTD). Statistical analyses were performed using SAS 9.4 (Cary, NC). RESULTS In total, 281 women (85 African American, 115 Hispanic, and 81 Caucasian) with 25(OH)D and iPTH concentrations measured at monthly visits were included in this analysis. No statistically significant association was found between mothers classified as having FVDD at baseline or 1-month PTD and hypertensive disorders of pregnancy, infection, or admittance to the neonatal intensive care unit. When combining all comorbidities of pregnancy in this cohort, results showed those with FVDD at baseline, 24 weeks' gestation, and 1-month PTD were more likely to experience a comorbidity (p = 0.001; p = 0.001; p = 0.004, respectively). Those with FVDD 1-month PTD were 7.1 times (confidence interval [CI]: 1.71-29.81) more likely to have preterm birth (<37 weeks) than women without FVDD. CONCLUSION Participants were more likely to have experienced preterm birth if they met the criteria for FVDD. This study supports the importance of FVDD during pregnancy. KEY POINTS · Functional vitamin D deficiency (FVDD) is defined as the ratio of 25(OH)D divided by iPTH concentration ≤0.308.. · At a minimum, it is recommended that vitamin D status be kept in the healthy range based on current recommendations for pregnant individuals.. · FVDD is a more sensitive predictor of pregnancy risk than 25(OH)D alone.. · FVDD identified those with greater risk of preterm birth in this cohort..
Collapse
Affiliation(s)
- Shellie Davis
- Division of Neonatology, Department of Pediatrics, Medical University of South Carolina, Charleston, South Carolina
| | - Elliott Lyles
- College of Osteopathic Medicine, Edward Via College of Osteopathic Medicine-Carolinas, Spartanburg, South Carolina
| | - Judy R Shary
- Division of Neonatology, Department of Pediatrics, Medical University of South Carolina, Charleston, South Carolina
| | - Myla Ebeling
- Division of Neonatology, Department of Pediatrics, Medical University of South Carolina, Charleston, South Carolina
| | - Susan G Reed
- Division of Neonatology, Department of Pediatrics, Medical University of South Carolina, Charleston, South Carolina
| | - John E Baatz
- Division of Neonatology, Department of Pediatrics, Medical University of South Carolina, Charleston, South Carolina
| | - Bruce W Hollis
- Division of Neonatology, Department of Pediatrics, Medical University of South Carolina, Charleston, South Carolina
| | - Carol L Wagner
- Division of Neonatology, Department of Pediatrics, Medical University of South Carolina, Charleston, South Carolina
| |
Collapse
|
3
|
Liu W, Xu P. The association of serum vitamin D level and neonatal respiratory distress syndrome. Ital J Pediatr 2023; 49:16. [PMID: 36717918 PMCID: PMC9885703 DOI: 10.1186/s13052-023-01415-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 01/10/2023] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND Neonatal respiratory distress syndrome (NRDS) is a critical disease in premature infants. Vitamin D plays an important role in promoting the development of fetal lung structure and the formation of pulmonary surfactants. This study aimed to investigate the correlation between the serum 25(OH)D3 level in the cord blood of premature infants and the prognosis of NRDS. METHODS This retrospective study recruited 82 preterm infants (gestational age 28-36 weeks) diagnosed with NRDS as the NRDS group, and 82 non-NRDS preterm infants as the control group, respectively. The diagnostic efficiency of 25(OH)D3 on NRDS was revealed by receiver operating characteristics curve (ROC) analysis. Enzyme linked immunosorbent assay (ELISA) was performed to evaluate the 25(OH)D3 level in the serum of the cord blood in preterm neonates. The NRDS risk indicators were identified by the multivariate logistic regression analysis. RESULTS Cord blood 25(OH)D3 levels were significantly lower in NRDS preterm infants than control group infants. 25(OH)D3 levels in cord blood can be used to predict NRDS in preterm infants. In addition, 25(OH)D3 levels in cord blood were positively correlated with Apgar score (1 min/5 min) and negatively correlated with oxygen support/CPAP duration in preterm infants with NRDS. 25(OH)D3 in cord blood <57.69 nmol/L (24 ng/ml), gestational age <31 weeks, birth weight <1.86 kg, Apgar score (1 min) <7 and Apgar score (5 min) < 8 were independent risk factors for NRDS. CONCLUSION 25(OH)D3 level is an independent risk factor for NRDS in preterm infants.
Collapse
Affiliation(s)
- Weili Liu
- grid.452270.60000 0004 0614 4777Department of Neonatology, Cangzhou Central Hospital, 16 Xinhua Road, Cangzhou, 061000 Hebei China
| | - Pingping Xu
- grid.452270.60000 0004 0614 4777Department of Neonatology, Cangzhou Central Hospital, 16 Xinhua Road, Cangzhou, 061000 Hebei China
| |
Collapse
|
4
|
Kim YJ, Lim G, Lee R, Chung S, Son JS, Park HW. Association between vitamin D level and respiratory distress syndrome: A systematic review and meta-analysis. PLoS One 2023; 18:e0279064. [PMID: 36701289 PMCID: PMC9879443 DOI: 10.1371/journal.pone.0279064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 11/14/2022] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Growing evidence suggests an association between the vitamin D levels and respiratory outcomes of preterm infants. The objective of this systematic review and meta-analysis was to explore whether premature neonates with a vitamin D deficiency have an increased risk of respiratory distress syndrome (RDS). METHODS We searched PubMed, EMBASE, and the Cochrane Library up through July 20, 2021. The search terms were 'premature infant', 'vitamin D', and 'respiratory distress syndrome'. We retrieved randomized controlled trials and cohort and case-control studies. For statistical analysis, we employed the random-effects model in Comprehensive Meta-Analysis Software ver. 3.3. We employed the Newcastle-Ottawa Scales for quality assessment of the included studies. RESULTS A total of 121 potentially relevant studies were found, of which 15 (12 cohort studies and 3 case-control studies) met the inclusion criteria; the studies included 2,051 preterm infants. We found significant associations between RDS development in such infants and vitamin D deficiency within 24 h of birth based on various criteria, thus vitamin D levels < 30 ng/mL (OR 3.478; 95% CI 1.817-6.659; p < 0.001), < 20 ng/mL (OR 4.549; 95% CI 3.007-6.881; p < 0.001), < 15 ng/mL (OR 17.267; 95% CI 1.084-275.112; p = 0.044), and < 10 ng/ml (OR 1.732; 95% CI 1.031-2.910; p = 0.038), and an even lower level of vitamin D (SMD = -0.656; 95% CI -1.029 to -0.283; p = 0.001). CONCLUSION Although the vitamin D deficiency definitions varied and different methods were used to measure vitamin D levels, vitamin D deficiency or lower levels of vitamin D within 24 h of birth were always associated with RDS development. Monitoring of neonatal vitamin D levels or the maintenance of adequate levels may reduce the risk of RDS.
Collapse
Affiliation(s)
- Yoo Jinie Kim
- Department of Pediatrics, Konkuk University Medical Center, Seoul, Republic of Korea
| | - Gina Lim
- Department of Pediatrics, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Republic of Korea
| | - Ran Lee
- Department of Pediatrics, Konkuk University Medical Center, Seoul, Republic of Korea
- Konkuk University School of Medicine, Seoul, Republic of Korea
| | - Sochung Chung
- Department of Pediatrics, Konkuk University Medical Center, Seoul, Republic of Korea
- Konkuk University School of Medicine, Seoul, Republic of Korea
| | - Jae Sung Son
- Department of Pediatrics, Konkuk University Medical Center, Seoul, Republic of Korea
- Konkuk University School of Medicine, Seoul, Republic of Korea
| | - Hye Won Park
- Department of Pediatrics, Konkuk University Medical Center, Seoul, Republic of Korea
- Konkuk University School of Medicine, Seoul, Republic of Korea
- * E-mail:
| |
Collapse
|
5
|
Corsello A, Milani GP, Giannì ML, Dipasquale V, Romano C, Agostoni C. Different Vitamin D Supplementation Strategies in the First Years of Life: A Systematic Review. Healthcare (Basel) 2022; 10:healthcare10061023. [PMID: 35742074 PMCID: PMC9222934 DOI: 10.3390/healthcare10061023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 05/28/2022] [Accepted: 05/31/2022] [Indexed: 12/04/2022] Open
Abstract
Vitamin D (VD) is an essential micronutrient with multiple functions for human growth, and adequate intake should be guaranteed throughout life. However, VD insufficiency is observed in infants all over the world. Low VD concentration in the breast milk of non-supplemented mothers and low compliance to VD daily supplementation are the main causes of VD insufficiency, especially in the long term. Furthermore, VD supplementation dosages are still debated and differ by country. We conducted a systematic review to compare the most recent evidence on different postnatal VD supplementation strategies, determining whether supplementation given to the mother is as effective as that administered directly to the child, and whether different dosages and administration schedules differ significantly in terms of efficacy and safety. We identified 18 randomized controlled trials (RCTs) addressing the role of infant (n = 961), maternal (n = 652) or combined infant and maternal VD supplementation (n = 260 pairs). In all studies, similar outcomes emerged in terms of efficacy and safety. According to our findings, alternative approaches of VD supplementation may be adopted, especially in cases where the adherence to daily supplementation strategies is poor. This review shows that different dosages and supplementation strategies result in similar VD sufficiency rates. Therefore, international guidelines may be revised in the future to offer multiple and different options of supplementation for specific settings and ages.
Collapse
Affiliation(s)
- Antonio Corsello
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy; (A.C.); (M.L.G.); (C.A.)
| | - Gregorio Paolo Milani
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy; (A.C.); (M.L.G.); (C.A.)
- Pediatric Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
- Correspondence: ; Tel.: +39-349-832-0575
| | - Maria Lorella Giannì
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy; (A.C.); (M.L.G.); (C.A.)
- Neonatal Intensive Care Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Valeria Dipasquale
- Pediatric Gastroenterology and Cystic Fibrosis Unit, Department of Human Pathology in Adulthood and Childhood “G. Barresi”, University of Messina, 98125 Messina, Italy; (V.D.); (C.R.)
| | - Claudio Romano
- Pediatric Gastroenterology and Cystic Fibrosis Unit, Department of Human Pathology in Adulthood and Childhood “G. Barresi”, University of Messina, 98125 Messina, Italy; (V.D.); (C.R.)
| | - Carlo Agostoni
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy; (A.C.); (M.L.G.); (C.A.)
- Pediatric Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| |
Collapse
|
6
|
Gowtham T, Venkatesh S, Palanisamy S, Rathod S. Impact of maternal hypovitaminosis D on birth and neonatal outcome - a prospective cohort study. J Matern Fetal Neonatal Med 2022; 35:9940-9947. [PMID: 35603468 DOI: 10.1080/14767058.2022.2077098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE Vitamin D deficiency in pregnant women is of special concern as mother is the only source of vitamin D for the developing fetus, and maternal hypovitaminosis D has been implicated in a number of maternal and neonatal adverse outcomes. The objective of this study was to assess the association of maternal circulating 25-hydroxy vitamin D3 [25(OH)D] concentration with cord blood 25(OH)D and adverse birth and neonatal outcomes. METHODS This prospective cohort study was conducted in Mahatma Gandhi Medical College and Research Institute (MGMCRI) from January 2020 to December 2020. 121 babies born to mothers with singleton pregnancy tested for serum 25(OH)D level on admission for safe confinement were included in the study and cord blood of the babies were sampled for 25(OH)D. Based on the maternal 25(OH)D level, babies were categorized as those born to mothers with sufficient vitamin D level and those born to mothers with hypovitaminosis D (deficient/insufficient) and primary and secondary outcome was compared between two groups. RESULTS Maternal and cord blood hypovitaminosis D was observed in 65% of mothers and 68.6% of babies, respectively. Maternal vitamin D level was the single most significant predictor of cord blood vitamin D level with five-fold increased risk of cord blood hypovitaminosis D in babies born to mothers with hypovitaminosis D. Birthweight (t = -2.219, p = .028) and preterm birth (aOR = 4.417, 95% CI: 1.03-18.9) was significantly associated with maternal hypovitaminosis D and a trend toward increased risk of LBW (aOR - 2.1, 95%CI: 0.6-7.3), SGA babies (aOR - 1.5, 95% CI: 0.5-4.7), perinatal depression (aOR - 1.5, 95% CI: 0.4-5.8) and neonatal hyperbilirubinemia (aOR = 2.68, 95%CI: 0.942-7.6) was observed. CONCLUSIONS Hypovitaminosis D in pregnant women is a significant health issue affecting both the mother and her baby. Safest dose for supplementation during pregnancy to prevent adverse perinatal outcome needs to be evaluated.
Collapse
Affiliation(s)
- Thirupathi Gowtham
- Department of Pediatrics, Mahatma Gandhi Medical College and Research Institute, Puducherry, India
| | - Soma Venkatesh
- Department of Pediatrics, Mahatma Gandhi Medical College and Research Institute, Puducherry, India
| | - Soundararajan Palanisamy
- Department of Pediatrics, Mahatma Gandhi Medical College and Research Institute, Puducherry, India
| | - Setu Rathod
- Department of Obstetrics and Gynaecology, Mahatma Gandhi Medical College and Research Institute, Puducherry, India
| |
Collapse
|
7
|
Wierzejska RE, Wojda BK. Vitamin D Status during Pregnancy versus the Anthropometric Parameters of Two- and Four-Year-Olds: A Pilot Study. Nutrients 2022; 14:254. [PMID: 35057435 PMCID: PMC8780842 DOI: 10.3390/nu14020254] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 12/27/2021] [Accepted: 01/05/2022] [Indexed: 12/26/2022] Open
Abstract
Apart from being associated with a well-documented risk for adverse pregnancy outcomes, maternal deficiency of vitamin D may also negatively affect the physical development of their children. The aim of the study was to evaluate the relationship between maternal as well as umbilical cord blood levels of vitamin D and the weight and height values of two- and four-year-olds. The study was conducted in a group of 52 'mother-child' pairs. On the day of the delivery, total 25(OH)D concentration in blood was measured using immunological tests (LIAISON). Weight and height values were obtained from the database of routine health checks for children aged two and four, which are obligatory in Poland. Multiple regression analysis was used for statistical analysis. No association was detected between maternal-neonatal concentrations of vitamin D and weight and height values of the investigated two- and four-year-olds despite extreme differences in maternal (4.0-37.7 ng/mL) and neonatal (5.9-46.6 ng/mL) concentrations and the fact that vitamin D deficiency was detected in almost 54% of the mothers and 37% of the newborns. Therefore, no relationship between maternal-fetal vitamin D concentrations and the anthropometric parameters of the investigated children up to the age of four was found.
Collapse
Affiliation(s)
- Regina Ewa Wierzejska
- Department of Nutrition and Nutritional Value of Food, National Institute of Public Health NIH—National Research Institute, Chocimska St. 24, 00-791 Warsaw, Poland;
| | | |
Collapse
|
8
|
OUP accepted manuscript. Nutr Rev 2022; 80:2225-2236. [DOI: 10.1093/nutrit/nuac023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
|
9
|
Vierucci F, Fusani L, Saba A, Minucciani T, Belluomini MP, Domenici R, Bracco GL, Vaccaro A, Federico G. Gestational vitamin D 3 supplementation and sun exposure significantly influence cord blood vitamin D status and 3-epi-25-hydroxyvitamin D 3 levels in term newborns. Clin Chim Acta 2022; 524:59-68. [PMID: 34838794 DOI: 10.1016/j.cca.2021.11.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 11/19/2021] [Accepted: 11/22/2021] [Indexed: 12/19/2022]
Abstract
BACKGROUND AND AIMS High prevalence of hypovitaminosis D is worldwide reported among pregnant women and newborns. We assessed cord blood 25-hydroxyvitamin D3 [25(OH)D3] and 3-epi-25-hydroxyvitamin D3 (C3-epimer) levels in relation to assumed maternal risk factors for hypovitaminosis D. METHODS We enrolled 246 term newborns during summer. 175/246 mothers were supplemented with a daily variable dosage (200-1,000 IU) of vitamin D3 during pregnancy. Cord blood 25(OH)D3 and C3-epimer concentrations were analyzed by high performance liquid chromatography tandem mass spectrometry. RESULTS Median cord blood 25(OH)D3 levels were 23.4 ng/mL (16.9-28.8). The prevalences of vitamin D sufficiency (≥ 30.0 ng/mL), insufficiency (20.0-29.9 ng/mL), and deficiency (< 20.0 ng/mL) were 19.9%, 45.9%, and 34.2%, respectively. Non-Caucasian ethnicity, housewife life, weight excess, negligible sun exposure and absent gestational vitamin D supplementation were associated with both reduced cord blood 25(OH)D3 and C3-epimer levels. C3-epimer/25(OH)D3 ratio was 15.1% (13.6%-18.4%) and it was not related to any of the assumed risk factors for hypovitaminosis D. CONCLUSIONS Cord blood vitamin D deficiency was common, particularly in newborns from mother not receiving vitamin D supplementation and with poor sun exposure. C3-epimer levels were high in cord blood, causing possible misclassification of vitamin D status if they were not distinguished from 25(OH)D3 concentrations.
Collapse
Affiliation(s)
| | - Lara Fusani
- Pediatric Unit, University-Hospital of Pisa, Pisa, Italy.
| | - Alessandro Saba
- Laboratory of Endocrinology, University of Pisa, Pisa, Italy.
| | | | | | | | - Gian Luca Bracco
- Obstetrics and Gynecology Unit, San Luca Hospital, Lucca, Italy.
| | | | | |
Collapse
|
10
|
Luo X, Wu F, Wang C, Wen C. Analysis of Development Trends of the Research Hotspots of Vitamin D in Children. Front Pediatr 2022; 10:899844. [PMID: 35601441 PMCID: PMC9120835 DOI: 10.3389/fped.2022.899844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Accepted: 04/06/2022] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVE Using multivariate statistics and social network analysis techniques, we present a realistic and intuitive visualization of the research hotspots and development trends of vitamin D in children. METHODS The Medical Subject Headings (MeSH) term "vitamin D" was used to search all the publications (the study subjects were 0-18 years old) included in PubMed by time period. The subject terms for each development stage were extracted, the high-frequency subject terms were extracted using the Bibliographic Items Co-occurrence Matrix Builder (BICOMB), and a core subject term co-occurrence matrix was established. The Netdraw function of Ucinet 6.0 software was used to complete the social network drawing of the core subject term co-occurrence matrix to form a co-word network diagram composed of core subject terms. RESULTS Prior to 1979, there were 890 papers with 1,899 core subject terms; from 2010 to 2020, there were 3,773 papers with 12,682 core subject terms. Before 1979, the research direction of vitamin D in children focused on vitamin D in the classical regulation of calcium and phosphorus metabolism. From 1980 to 1989, studies focused on vitamin D metabolites and therapeutic drugs such as "calcitriol" and "calcifediol." From 1990 to 1999, studies focused on "calcitriol" and its association with "psoriasis," "chronic renal failure," and "dermatological drugs." From 2000 to 2009, studies focused on "vitamin D" and "vitamin D deficiency." From 2010 to 2020, studies focused on "vitamin D3" and its association with "vitamins," "bone mineral density protectants," "asthma," "obesity," "pregnancy complications" and "fetal blood." CONCLUSION Since 2010, the research direction of vitamin D in children has been growing rapidly, and the overall development trend is good. Studies extend from the study of the skeletal effect of vitamin D to the study of its extraskeletal effect and the investigation of mechanisms of its association with related diseases.
Collapse
Affiliation(s)
- Xuemei Luo
- Department of Pediatrics, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Feifeng Wu
- Department of Pediatrics, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Cheng Wang
- Department of Pediatrics, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Chuan Wen
- Department of Pediatrics, The Second Xiangya Hospital, Central South University, Changsha, China
| |
Collapse
|
11
|
Vitamin D Status and Factors Associated with Vitamin D Deficiency during the First Year of Life in Preterm Infants. Nutrients 2021; 13:nu13062019. [PMID: 34208333 PMCID: PMC8231173 DOI: 10.3390/nu13062019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 06/05/2021] [Accepted: 06/09/2021] [Indexed: 12/19/2022] Open
Abstract
We aimed to investigate the changes in vitamin D levels and factors associated with vitamin D deficiency (VDD) during the first year of life in Korean preterm infants. We enrolled 333 preterm infants who were born at Kyungpook National University Children’s Hospital between March 2013 and December 2019. 25-hydroxyvitamin D (25-OHD) levels and medical records were collected at birth, 6 months, and 12 months of age. The mean gestational age was 33.4 ± 2.3 weeks and mean 25-OHD levels at birth were 18.2 ± 13.5 ng/mL. The incidence of VDD was 82.8%, 30.6%, and 27.0% at birth, 6 months, and 12 months, respectively. The incidence of severe VDD (25-OHD < 10 ng/mL) was 31.5%, 1.5%, and 0%, at birth, 6 months, and 12 months, respectively. Among infants with severe VDD, the deficiency persisted in 49.6% at 6 months, and 35.3% at 12 months. The strongest predictor of VDD during follow-up was 25-OHD concentration at birth. Vitamin D supplementation at 400 IU/day did not affect vitamin D levels during the first year of life. Therefore, it is important to prevent neonatal VDD through maternal vitamin D supplementation during pregnancy. Further research is needed to determine the optimal vitamin D supplementation dose for Korean preterm infants.
Collapse
|
12
|
Ilardi L, Proto A, Ceroni F, Morniroli D, Martinelli S, Mosca F, Giannì ML. Overview of Important Micronutrients Supplementation in Preterm Infants after Discharge: A Call for Consensus. Life (Basel) 2021; 11:331. [PMID: 33920163 PMCID: PMC8069002 DOI: 10.3390/life11040331] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Revised: 04/07/2021] [Accepted: 04/07/2021] [Indexed: 01/10/2023] Open
Abstract
Preterm infants have a lower level of nutrient body stores and immature body systems, resulting in a higher risk of malnutrition. Imbalanced complementary feeding could lead to further risk of nutritional deficits and excesses. However, evidence on their nutritional requirements following hospital discharge is limited. When planning complementary feeding, appropriate micronutrient intake should be considered for their critical role in supporting various body functions. This narrative review summarizes the need for iron, zinc, vitamin D, calcium, phosphate and long-chain polyunsaturated fatty acids (LCPUFAs) supplementation in preterm infants during complementary feeding. Regarding iron and vitamin D, the scientific community is reaching an agreement on supplementation in some categories of prematures. On the contrary, there is still not enough evidence to detail possible recommendations for LCPUFAs, zinc, calcium and phosphorus supplementation. However, these micronutrients are paramount for preterms' health: LCPUFAs can promote retinal and brain development while calcium and phosphorus supplementation is essential to prevent preterms' metabolic bone disease (MBD). Waiting for a consensus on these micronutrients, it is clear how the knowledge of the heterogeneity of the prematures population can help adjust the nutritional planning regarding the growth rate, comorbidities and comprehensive clinical history of the preterm infant.
Collapse
Affiliation(s)
- Laura Ilardi
- Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda, 20162 Milan, Italy; (L.I.); (A.P.); (S.M.)
| | - Alice Proto
- Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda, 20162 Milan, Italy; (L.I.); (A.P.); (S.M.)
| | - Federica Ceroni
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy; (F.C.); (F.M.)
| | - Daniela Morniroli
- Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, NICU, 20122 Milan, Italy;
| | - Stefano Martinelli
- Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda, 20162 Milan, Italy; (L.I.); (A.P.); (S.M.)
| | - Fabio Mosca
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy; (F.C.); (F.M.)
- Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, NICU, 20122 Milan, Italy;
| | - Maria Lorella Giannì
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy; (F.C.); (F.M.)
- Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, NICU, 20122 Milan, Italy;
| |
Collapse
|
13
|
Yates N, Gunn AJ, Bennet L, Dhillon SK, Davidson JO. Preventing Brain Injury in the Preterm Infant-Current Controversies and Potential Therapies. Int J Mol Sci 2021; 22:1671. [PMID: 33562339 PMCID: PMC7915709 DOI: 10.3390/ijms22041671] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 02/03/2021] [Accepted: 02/05/2021] [Indexed: 12/12/2022] Open
Abstract
Preterm birth is associated with a high risk of morbidity and mortality including brain damage and cerebral palsy. The development of brain injury in the preterm infant may be influenced by many factors including perinatal asphyxia, infection/inflammation, chronic hypoxia and exposure to treatments such as mechanical ventilation and corticosteroids. There are currently very limited treatment options available. In clinical trials, magnesium sulfate has been associated with a small, significant reduction in the risk of cerebral palsy and gross motor dysfunction in early childhood but no effect on the combined outcome of death or disability, and longer-term follow up to date has not shown improved neurological outcomes in school-age children. Recombinant erythropoietin has shown neuroprotective potential in preclinical studies but two large randomized trials, in extremely preterm infants, of treatment started within 24 or 48 h of birth showed no effect on the risk of severe neurodevelopmental impairment or death at 2 years of age. Preclinical studies have highlighted a number of promising neuroprotective treatments, such as therapeutic hypothermia, melatonin, human amnion epithelial cells, umbilical cord blood and vitamin D supplementation, which may be useful at reducing brain damage in preterm infants. Moreover, refinements of clinical care of preterm infants have the potential to influence later neurological outcomes, including the administration of antenatal and postnatal corticosteroids and more accurate identification and targeted treatment of seizures.
Collapse
Affiliation(s)
- Nathanael Yates
- The Queensland Brain Institute, University of Queensland, St Lucia, QLD 4072, Australia;
- School of Human Sciences, University of Western Australia, Crawley, WA 6009, Australia
| | - Alistair J. Gunn
- The Department of Physiology, University of Auckland, Auckland 1023, New Zealand; (A.J.G.); (L.B.); (S.K.D.)
| | - Laura Bennet
- The Department of Physiology, University of Auckland, Auckland 1023, New Zealand; (A.J.G.); (L.B.); (S.K.D.)
| | - Simerdeep K. Dhillon
- The Department of Physiology, University of Auckland, Auckland 1023, New Zealand; (A.J.G.); (L.B.); (S.K.D.)
| | - Joanne O. Davidson
- The Department of Physiology, University of Auckland, Auckland 1023, New Zealand; (A.J.G.); (L.B.); (S.K.D.)
| |
Collapse
|
14
|
Zang R, Zhang Y, Zhang H, Zhang X, Lv Y, Li D. Association Between Vitamin D Level and Neonatal Respiratory Distress Syndrome: A Systematic Review and Meta-Analysis. Front Pediatr 2021; 9:803143. [PMID: 35127597 PMCID: PMC8815315 DOI: 10.3389/fped.2021.803143] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 12/10/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND In recent years, vitamin D in the occurrence of lung diseases has gradually become a hot topic. Although the role of vitamin D in normal lung development has been confirmed, the correlation between vitamin D level and neonatal respiratory distress syndrome (NRDS) is not clear. OBJECTIVE To evaluate the association between vitamin D level and NRDS. METHODS We performed a comprehensive search of the following electronic databases: PubMed, Embase, Cochrane Library, Web of Science, and China National Knowledge Infrastructure (CNKI). Literature screening and quality assessment were performed according to inclusion and exclusion criteria. The Newcastle-Ottawa Scale was used to assess the methodological components of each study, and Stata 15.1 software to perform the Meta-analysis. RESULTS A total of nine case-control studies were included, with 653 infants with NRDS and 501 infants without NRDS. The Meta-analysis showed no heterogeneity across all studies(I2=0.0%, P=0.583). The fixed-effect model showed that 25 hydroxy vitamin D level of children in the NRDS group was significantly lower than that of the non-NRDS group(SMD = -0.51, 95%CI: -0.63 to -0.39, p ≤ 0.05). CONCLUSION This systematic review and meta-analysis study suggests that vitamin D deficiency is very likely to be a high-risk factor of NRDS, and reasonable vitamin D supplementation during pregnancy and after birth is of great significance.
Collapse
Affiliation(s)
- Rina Zang
- Department of Neonatology, Affiliated Hospital of Inner Mongolia Medical University, Huhhot, China
| | - Yayu Zhang
- Department of Neonatology, Affiliated Hospital of Inner Mongolia Medical University, Huhhot, China
| | - Hanshuo Zhang
- Department of Neonatology, Affiliated Hospital of Inner Mongolia Medical University, Huhhot, China
| | - Xueyi Zhang
- Department of Neonatology, Affiliated Hospital of Inner Mongolia Medical University, Huhhot, China
| | - Yuening Lv
- Department of Neonatology, Affiliated Hospital of Inner Mongolia Medical University, Huhhot, China
| | - Dan Li
- Department of Neonatology, Affiliated Hospital of Inner Mongolia Medical University, Huhhot, China
| |
Collapse
|