Serum Vitamin D Deficiency in NICU Hospitalized Neonates and Its Association with Neonatal Outcomes
Vitamin D deficiency in NICU hospitalized neonates
Abstract
Objective: Vitamin D deficiency is a major health problem in all age groups. In the present study, we aimed to determine the prevalence of vitamin D deficiency in neonates hospitalized in an intensive care unit (NICU) and its association with clinical neonatal outcomes.
Materials and methods: A prospective cross-sectional study was carried out on all neonates hospitalized in the NICU of Children's Medical Center over a period of one year (January–December 2018). Immediately on admission, a serum sample for vitamin D measurement was obtained with another routine blood sampling. Demographic and clinical data including sex, gestational age, the season of birth, serum levels of vitamin D and calcium, the causes of hospitalization, age at admission and neonatal outcomes including length of hospital stay and mortality during hospitalization were assessed.
Results: One hundred neonates entered the study. Vitamin D deficiency and insufficiency were present in 95% of neonates. There was a significant association between vitamin D status and birth during winter (p=0.014); hypocalcemia (p=0.025) and older age at NICU admission (p<0.001). The mean value of vitamin D in term neonates was significantly lower than in preterm neonates (p=0.031). There were no correlations between length of hospital stay and neonatal mortality rate with vitamin D status (p=0.876).
Conclusion: Vitamin D deficiency and insufficiency were highly prevalent among NICU patients. Maternal vitamin D supplementation during pregnancy may prevent or reduce the risk of low levels of vitamin D in neonates.
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2. Kim I, Kim SS, Song JI, Yoon SH, Park GY, Lee YW. Association between vitamin D level at birth and respiratory morbidities in very-low-birth-weight infants. Korean J Pediatr 2019; 62: 166-72.
3. Eremkina AK, Mokrysheva NG, Pigarova EA, Mirnaya SS. Vitamin D: effects on pregnancy, maternal, fetal and postnatal outcomes. Ter Arkh 2018; 90:115-7.
4. Baqai S, Siraj A,Imran R. Association of vitamin-D insufficiency during pregnancy with maternal & perinatal morbidity and mortality. Pak Armed Forces Med J 2020; 70: 323-7.
5. Thomas DJ, Khan HU, Paul S, Jaidev MD, Hegde P.
A study on vitamin D levels in preterm and term neonates and their mothers. International Journal of Contemporary Pediatrics 2020; 7: 387-92.
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A Stratified Randomized Vitamin D Supplementation Controlled Trial. JMIR Res Protoc 2017; 6: e54.
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10. Mirzaei F, Amiri Moghadam T, Arasteh P. Comparison of serum 25-hydroxy vitamin D levels between mothers with small for gestational age and appropriate for gestational age newborns in Kerman. Iran J Reprod Med 2015; 13: 203-8.
11. Khuri-Bulos N, Lang RD, Blevins M, Kudyba K, Lawrence L, Davidson M, et al. Vitamin D Deficiency among Newborns in Amman, Jordan. Glob J Health Sci 2013; 6:162-71.
12. Tanbakuchi B, Taheri F, Zardast M, Ramazani A. Effect of Vitamin D Supplementation on Vitamin D Levels of Term and Preterm Neonates and their Mothers: A Clinical Trial Study. International Journal of Pediatrics 2019; 7: 10311-22.
13. Azim A, Ahmed A, Yadav S, Baronia AK, Gurjar M, Godbole MM, et al. Prevalence of vitamin D deficiency in critically ill patients and its influence on outcome: experience from a tertiary care centre in North India (an observational study). J Intensive Care 2013; 1: 14.
14. Venkatram S, Chilimuri S, Adrish M, Salako A, Patel M, Diaz-Fuentes G. Vitamin D deficiency is associated with mortality in the medical intensive care unit. Crit Care 2011; 15: R292.
15. Arnson Y, Grinzauz I, Itzhaky D, Amital H. Vitamin D deficiency is associated with poor outcomes and increased mortality in severely ill patients. QJM 2012; 105: 633-9.
16. McNally JD, Nama N, O’Hearn K, Sampson M, Amrein K, Iliriani K, et al. Vitamin D deficiency in critically ill children: a systematic review and meta-analysis. Crit Care 2017; 21: 287.
17. Madden K, Feldman HA, Smith EM, Gordon CM, Keisling SM, Sullivan RM, et al. Vitamin D Deficiency in Critically Ill Children. Pediatrics 2012; 130: 421-8.
18. Rippel C, South M, Butt ww, Shekerdermian LS. Vitamin D status in critically ill children. Intensive Care Med 2012; 38: 2055-62
19. Hebbar KB, Wittkamp M, Alvarez JA, McCracken CE, Tangpricha V. Vitamin D Deficiency in Pediatric Critical Illness. J Clin Transl Endocrinol 2014; 1:170–5.
20. Ringe JD, Kipshoven C. Vitamin D-insufficiency. An estimate of the situation in Germany. Dermatoendocrinol 2012; 4: 72-80.
21. Chiruvolu A, Engle WD, Sendelbach D, Manning MD, Jackson GL. Serum calcium values in term and late-preterm neonates receiving gentamicin. Pediatr Nephrol 2008; 23: 569-74.
22. Bhimji KM, Naburi H, Aboud S, Manji K. Vitamin D status and associated factors in neonates in a resource constrained setting. Int J pediatr 2018: 9614975.
23. Chacham S, Rajput S, Gumurkar S, Mirza A, Saxena V, Daksinamurthy S, et al. Prevalence of Vitamin D Deficiency Among Infants in Northern India: A Hospital Based Prospective Study. Cureus 2020; 12: e11353.
24. Maghbooli Z, Hossein-Nezhad A, Shafaei AR, Karimi F, Madani FS, Larijani B. Vitamin D status in mothers and their newborns in Iran. BMC Pregnancy Childbirth 2007; 7: 1.
25. Al-Wassia H, Abo-Ouf N. Prevalence of vitamin D deficiency in mother–infant pairs in a tertiary hospital in the west coast of Saudi Arabia. Journal of Clinical Neonatology 2016; 5: 243-6.
26. Munshi UK, Graziano PD, Meunier K, Ludke J, Rios A. Serum 25 Hydroxy Vitamin D Levels in Very Low Birth Weight Infants Receiving Oral Vitamin D Supplementation. J Pediatr Gastroenterol Nutr 2018; 66: 676-9.
27. Panda M, McIntosh J, Chaudhari T, Kent AL. Do Maternal Vitamin D Levels Influence Vitamin D Levels in Preterm Neonates? International Journal of Pediatrics 2019; 5: 1-7.
28. Spiro A, Buttriss JL. Vitamin D: An overview of vitamin D status and intake in Europe A. Nutr Bull 2014; 39: 322–50.
29. Aly H, Abdel Hady H. Vitamin D and the Neonate: An Update. Journal of Clinical Neonatology 2015; 4:1-7.
30. Rey C, Sánchez-Arango D, López-Herce J, Martínez-Camblor P, García-Hernándeze I, Prietof B, et al. Vitamin D deficiency at pediatric intensive care admission. J Pediatr (Rio J) 2014; 90; 135-42.
31. Hosseinzadeh Z, Kazemian M, Mashak B, Torkmandi H, Badfar GH. Vitamin D status in pregnant women and their newborn in karaj. Int J Pediatr 2018; 6: 7117-27.
32. McNally JD, Menon K, Chakraborty P, Fisher L, Williams KA, Al-Dirbashi OY, et al. The Association of Vitamin D Status with Pediatric Critical Illness. Pediatrics 2012; 130: 429-36.
33. Fallahi M, Afjeh A, Saneifard H, Namazi N, Kazemian M, Tabatabaee Sh. Comparison of Vitamin D Level in Preterm and Term Infant–Mother Pairs: A Brief Study. Iranian Journal of Neonatology 2016; 7:31-6.
34. Burris HH, Van Marter LJ, McElrath TF, Tabatabai P, Litonjua AA, Weiss ST, et al. Vitamin D status among preterm and full term infants at birth. Pediatr Res 2014; 75: 75 80.
35. Monangi N, Slaughter JL, Dawodu A, Smith C, Akinbi HT. Vitamin D status of early preterm infants and the effects of vitamin D intake during hospital stay. Arch Dis Child Fetal Neonatal Ed 2014; 99: F166-8.
36. Boskabadi H, Mamoori G, Khatami F, Faramarzi R. Serum level of vitamin D in preterm infants and its association with premature-related respiratory complications: a case -control study. Electron Physician 2018; 10: 6208-14.
2. Kim I, Kim SS, Song JI, Yoon SH, Park GY, Lee YW. Association between vitamin D level at birth and respiratory morbidities in very-low-birth-weight infants. Korean J Pediatr 2019; 62: 166-72.
3. Eremkina AK, Mokrysheva NG, Pigarova EA, Mirnaya SS. Vitamin D: effects on pregnancy, maternal, fetal and postnatal outcomes. Ter Arkh 2018; 90:115-7.
4. Baqai S, Siraj A,Imran R. Association of vitamin-D insufficiency during pregnancy with maternal & perinatal morbidity and mortality. Pak Armed Forces Med J 2020; 70: 323-7.
5. Thomas DJ, Khan HU, Paul S, Jaidev MD, Hegde P.
A study on vitamin D levels in preterm and term neonates and their mothers. International Journal of Contemporary Pediatrics 2020; 7: 387-92.
6. Sankar J, Lotha W, Ismail J, Anubhuti C, Meena RS, Sankar MJ. Vitamin D deficiency and length of pediatric intensive care unit stay: a prospective observational study. Ann Intensive Care 2016; 6: 3.
7. Behjat Sasan S, Zandvakili F, Soufizadeh N, Baybordi E. The Effects of Vitamin D Supplement on Prevention of Recurrence of Preeclampsia in Pregnant Women with a History of Preeclampsia. Obstet Gynecol Int 2017; 8249264.
8. Rostami M, Ramezani Tehrani F, Simbar M, Hosseinpanah F, Alavimajd H. Rationale and Design of Khuzestan Vitamin D Deficiency Screening Program in Pregnancy:
A Stratified Randomized Vitamin D Supplementation Controlled Trial. JMIR Res Protoc 2017; 6: e54.
9. Sepandi M, Smailzadeh S, Hosseini M, Hashemi SR, Abbaszadeh S, Alimohamadi Y, et al. Prevalence of vitamin D deficiency among Iranian pregnant women. Nutrition and Dietary Supplements 2020; 12: 97-102.
10. Mirzaei F, Amiri Moghadam T, Arasteh P. Comparison of serum 25-hydroxy vitamin D levels between mothers with small for gestational age and appropriate for gestational age newborns in Kerman. Iran J Reprod Med 2015; 13: 203-8.
11. Khuri-Bulos N, Lang RD, Blevins M, Kudyba K, Lawrence L, Davidson M, et al. Vitamin D Deficiency among Newborns in Amman, Jordan. Glob J Health Sci 2013; 6:162-71.
12. Tanbakuchi B, Taheri F, Zardast M, Ramazani A. Effect of Vitamin D Supplementation on Vitamin D Levels of Term and Preterm Neonates and their Mothers: A Clinical Trial Study. International Journal of Pediatrics 2019; 7: 10311-22.
13. Azim A, Ahmed A, Yadav S, Baronia AK, Gurjar M, Godbole MM, et al. Prevalence of vitamin D deficiency in critically ill patients and its influence on outcome: experience from a tertiary care centre in North India (an observational study). J Intensive Care 2013; 1: 14.
14. Venkatram S, Chilimuri S, Adrish M, Salako A, Patel M, Diaz-Fuentes G. Vitamin D deficiency is associated with mortality in the medical intensive care unit. Crit Care 2011; 15: R292.
15. Arnson Y, Grinzauz I, Itzhaky D, Amital H. Vitamin D deficiency is associated with poor outcomes and increased mortality in severely ill patients. QJM 2012; 105: 633-9.
16. McNally JD, Nama N, O’Hearn K, Sampson M, Amrein K, Iliriani K, et al. Vitamin D deficiency in critically ill children: a systematic review and meta-analysis. Crit Care 2017; 21: 287.
17. Madden K, Feldman HA, Smith EM, Gordon CM, Keisling SM, Sullivan RM, et al. Vitamin D Deficiency in Critically Ill Children. Pediatrics 2012; 130: 421-8.
18. Rippel C, South M, Butt ww, Shekerdermian LS. Vitamin D status in critically ill children. Intensive Care Med 2012; 38: 2055-62
19. Hebbar KB, Wittkamp M, Alvarez JA, McCracken CE, Tangpricha V. Vitamin D Deficiency in Pediatric Critical Illness. J Clin Transl Endocrinol 2014; 1:170–5.
20. Ringe JD, Kipshoven C. Vitamin D-insufficiency. An estimate of the situation in Germany. Dermatoendocrinol 2012; 4: 72-80.
21. Chiruvolu A, Engle WD, Sendelbach D, Manning MD, Jackson GL. Serum calcium values in term and late-preterm neonates receiving gentamicin. Pediatr Nephrol 2008; 23: 569-74.
22. Bhimji KM, Naburi H, Aboud S, Manji K. Vitamin D status and associated factors in neonates in a resource constrained setting. Int J pediatr 2018: 9614975.
23. Chacham S, Rajput S, Gumurkar S, Mirza A, Saxena V, Daksinamurthy S, et al. Prevalence of Vitamin D Deficiency Among Infants in Northern India: A Hospital Based Prospective Study. Cureus 2020; 12: e11353.
24. Maghbooli Z, Hossein-Nezhad A, Shafaei AR, Karimi F, Madani FS, Larijani B. Vitamin D status in mothers and their newborns in Iran. BMC Pregnancy Childbirth 2007; 7: 1.
25. Al-Wassia H, Abo-Ouf N. Prevalence of vitamin D deficiency in mother–infant pairs in a tertiary hospital in the west coast of Saudi Arabia. Journal of Clinical Neonatology 2016; 5: 243-6.
26. Munshi UK, Graziano PD, Meunier K, Ludke J, Rios A. Serum 25 Hydroxy Vitamin D Levels in Very Low Birth Weight Infants Receiving Oral Vitamin D Supplementation. J Pediatr Gastroenterol Nutr 2018; 66: 676-9.
27. Panda M, McIntosh J, Chaudhari T, Kent AL. Do Maternal Vitamin D Levels Influence Vitamin D Levels in Preterm Neonates? International Journal of Pediatrics 2019; 5: 1-7.
28. Spiro A, Buttriss JL. Vitamin D: An overview of vitamin D status and intake in Europe A. Nutr Bull 2014; 39: 322–50.
29. Aly H, Abdel Hady H. Vitamin D and the Neonate: An Update. Journal of Clinical Neonatology 2015; 4:1-7.
30. Rey C, Sánchez-Arango D, López-Herce J, Martínez-Camblor P, García-Hernándeze I, Prietof B, et al. Vitamin D deficiency at pediatric intensive care admission. J Pediatr (Rio J) 2014; 90; 135-42.
31. Hosseinzadeh Z, Kazemian M, Mashak B, Torkmandi H, Badfar GH. Vitamin D status in pregnant women and their newborn in karaj. Int J Pediatr 2018; 6: 7117-27.
32. McNally JD, Menon K, Chakraborty P, Fisher L, Williams KA, Al-Dirbashi OY, et al. The Association of Vitamin D Status with Pediatric Critical Illness. Pediatrics 2012; 130: 429-36.
33. Fallahi M, Afjeh A, Saneifard H, Namazi N, Kazemian M, Tabatabaee Sh. Comparison of Vitamin D Level in Preterm and Term Infant–Mother Pairs: A Brief Study. Iranian Journal of Neonatology 2016; 7:31-6.
34. Burris HH, Van Marter LJ, McElrath TF, Tabatabai P, Litonjua AA, Weiss ST, et al. Vitamin D status among preterm and full term infants at birth. Pediatr Res 2014; 75: 75 80.
35. Monangi N, Slaughter JL, Dawodu A, Smith C, Akinbi HT. Vitamin D status of early preterm infants and the effects of vitamin D intake during hospital stay. Arch Dis Child Fetal Neonatal Ed 2014; 99: F166-8.
36. Boskabadi H, Mamoori G, Khatami F, Faramarzi R. Serum level of vitamin D in preterm infants and its association with premature-related respiratory complications: a case -control study. Electron Physician 2018; 10: 6208-14.
| Files | ||
| Issue | Vol 15, No 2 (June 2021) | |
| Section | Original Articles | |
| DOI | https://doi.org/10.18502/jfrh.v15i2.6450 | |
| Keywords | ||
| Newborn Neonatal Intensive Care Units Vitamin D | ||
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How to Cite
1.
Mosayebi Z, Sagheb S, Mirzendedel M, Movahedian AH. Serum Vitamin D Deficiency in NICU Hospitalized Neonates and Its Association with Neonatal Outcomes. J Family Reprod Health. 2021;15(2):99-105.
