Association of vitamin D status at birth with pulmonary disease morbidity in very preterm infants

Abstract

Objective We aimed to assess whether serum 25‐hydroxyvitamin D (25(OH)D) levels at birth are associated with pulmonary disease morbidities in very preterm infants. Methods This prospective cohort analysis included 93 infants born before 32 weeks of gestation in the Second Xiangya Hospital of Central South University between March 2016 and February 2017. Participants were classified into three groups according to their 25(OH)D levels at birth. The groups were compared in terms of demographic variables and pulmonary disease morbidities. Results The mean serum 25(OH)D level at birth was 35.7 ± 19.1 nmol/L, and 38 (40.9%), 31 (33.3%), and 24 (25.8%) infants had 25(OH)D levels of less than 25 nmol/L, 25–50 nmol/L, and more than or equal to 50 nmol/L, respectively. There was a statistically significant difference in neonatal respiratory distress syndrome (RDS) rates among the three groups (43.6% vs. 35.9% vs. 20.5%, p = .029). The rates of bronchopulmonary dysplasia, apnea, respiratory failure, persistent pulmonary hypertension, and pulmonary hemorrhage did not differ significantly among the groups. Logistic analysis, adjusted for gestational age and birth weight, showed that a low serum 25(OH)D level (<50 nmol/L) was a risk factor for RDS (odds ratio, 0.195; p = .017). Conclusion There was a high prevalence of low 25(OH)D levels (<50 nmol/L) and an association between vitamin D status and RDS in very preterm infants. However, more research on this association is required.

Association between vitamin D level and respiratory distress syndrome: A systematic review and meta-analysis

“…The characteristics of the 15 studies [ 5 , 11 , 15 – 17 , 22 – 31 ] included in this meta-analysis are shown in Table 1 . When evaluating the association between vitamin D deficiency and RDS, 2,051 infants were included.…”

Effects of early vitamin D supplementation on the prevention of bronchopulmonary dysplasia in preterm infants

“…19 The relationship between vitamin D content and lung function and structure developing, maturity, and lung diseases in preterm infants has become a research hotspot in recent years. 20,21 However, there is still a lack of clinical trial data. In the present study, we showed that early vitamin D supplementation is significantly associated with the occurrence of BPD but not classification in preterm newborns.…”

“…The study has shown that insufficient D levels during pregnancy could affect the development and weight of the placenta, increasing the risk of premature birth, thereby increasing the occurrence of BPD 19 . The relationship between vitamin D content and lung function and structure developing, maturity, and lung diseases in preterm infants has become a research hotspot in recent years 20,21 . However, there is still a lack of clinical trial data.…”

Utility of umbilical cord blood 25-hydroxyvitamin D levels for predicting bronchopulmonary dysplasia in preterm infants with very low and extremely low birth weight

“…As a result, vitamin D deficiency contributes to several respiratory complications and lung function impairments in premature infants, including airway hyperresponsiveness, increased resistance, and reduced compliance ( 15 , 40 ). However, the association between vitamin D status and the development of BPD remains controversial in clinical research due to the multifactorial etiology of BPD ( 8 , 9 , 12 , 41 ). Moreover, vitamin D deficiency is not the sole risk factor for BPD, and the risk factors and infants included in analysis vary across studies.…”