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

Ann L Anderson Berry, Melissa Thoene, Julie Wagner, Elizabeth Lyden, Glenville Jones, Martin Kaufmann, Matthew Van Ormer, Corrine K Hanson

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Background: Recommendations for vitamin D supplementation for preterm infants span a wide range of doses. Response to vitamin D supplementation and impact on outcomes in preterm infants is not well understood. Objective: Evaluate serum 25(OH)D3 concentration changes after 4 weeks in response to two different doses of vitamin D3 supplementation in a population of premature infants and quantify the impact on NICU outcomes. Design: 32 infants born at 24–32 weeks gestation were prospectively randomized to receive 400 or 800 IU/day vitamin D3 supplementation. Serum 25(OH)D3 levels were measured every 4 weeks. The Wilcoxon signed rank test was used to compare serum levels of 25(OH)D3 at 4 weeks and each subsequent time point. A p-value of <0.05 was considered statistically significant. Results: Serum 25(OH)D3 levels at birth were 41.9 and 42.9 nmol/l for infants in the 400 IU group and 800 IU group, respectively (p = 0.86). Cord 25(OH)D3 concentrations significantly correlated with gestational age (r = 0.40, p = 0.04). After 4 weeks of D3 supplementation, median 25(OH)D3 levels increased in both groups (84.6vs. 105.3 nmol/l for 400 vs. 800 IU/day respectively, with significantly more improvement in the higher dose (p = 0.048). Infants in the 400 IU group were significantly more likely to have dual energy x-ray absorptiometry (DEXA) bone density measurements <10 percentile (56% vs 16%, p = 0.04). Conclusions: Improvement in 25(OH)D3 levels at 4 weeks, bone density, and trends towards improvement in linear growth support consideration of a daily dose of 800 IU of vitamin D for infants <32 weeks cared for in the NICU.

Original languageEnglish (US)
Article numbere0185950
JournalPloS one
Volume12
Issue number10
DOIs
StatePublished - Oct 1 2017

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cholecalciferol
Cholecalciferol
Premature Infants
Vitamin D
vitamin D
bone density
Bone
dosage
Serum
Bone Density
Population
gestational age
Nonparametric Statistics
Gestational Age
X rays
X-radiation
X-Rays
Parturition
pregnancy
Pregnancy

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)

Cite this

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. / Anderson Berry, Ann L; Thoene, Melissa; Wagner, Julie; Lyden, Elizabeth; Jones, Glenville; Kaufmann, Martin; Van Ormer, Matthew; Hanson, Corrine K.

In: PloS one, Vol. 12, No. 10, e0185950, 01.10.2017.

Research output: Contribution to journalArticle

Anderson Berry, Ann L ; Thoene, Melissa ; Wagner, Julie ; Lyden, Elizabeth ; Jones, Glenville ; Kaufmann, Martin ; Van Ormer, Matthew ; Hanson, Corrine K. / 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. In: PloS one. 2017 ; Vol. 12, No. 10.
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abstract = "Background: Recommendations for vitamin D supplementation for preterm infants span a wide range of doses. Response to vitamin D supplementation and impact on outcomes in preterm infants is not well understood. Objective: Evaluate serum 25(OH)D3 concentration changes after 4 weeks in response to two different doses of vitamin D3 supplementation in a population of premature infants and quantify the impact on NICU outcomes. Design: 32 infants born at 24–32 weeks gestation were prospectively randomized to receive 400 or 800 IU/day vitamin D3 supplementation. Serum 25(OH)D3 levels were measured every 4 weeks. The Wilcoxon signed rank test was used to compare serum levels of 25(OH)D3 at 4 weeks and each subsequent time point. A p-value of <0.05 was considered statistically significant. Results: Serum 25(OH)D3 levels at birth were 41.9 and 42.9 nmol/l for infants in the 400 IU group and 800 IU group, respectively (p = 0.86). Cord 25(OH)D3 concentrations significantly correlated with gestational age (r = 0.40, p = 0.04). After 4 weeks of D3 supplementation, median 25(OH)D3 levels increased in both groups (84.6vs. 105.3 nmol/l for 400 vs. 800 IU/day respectively, with significantly more improvement in the higher dose (p = 0.048). Infants in the 400 IU group were significantly more likely to have dual energy x-ray absorptiometry (DEXA) bone density measurements <10 percentile (56{\%} vs 16{\%}, p = 0.04). Conclusions: Improvement in 25(OH)D3 levels at 4 weeks, bone density, and trends towards improvement in linear growth support consideration of a daily dose of 800 IU of vitamin D for infants <32 weeks cared for in the NICU.",
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