Vitamin D Supplementation and T Cell Regulation in Preterm Infants

Abstract

The objective of this study was to evaluate the effect of 2 different doses of vitamin D on the expression of T regulatory cells (Treg) in premature infants. A double-blind randomized controlled trial was conducted on preterm infants born with gestational age between 280/7 and 336/7 weeks. Subjects were randomly assigned to receive 400 or 800 IU/day of vitamin D3 when they achieved 100 mL/kg of enteral feeds. Percentage increase in Treg cell counts were measured by flow cytometry at enrollment, and after 1 and 4 weeks of oral vitamin D supplementation at the allotted doses in both groups. Short-term morbidity and mortality outcomes were also assessed. A total of 40 infants were enrolled, 20 in each group. The change in Treg count (%) was significantly less in the low-dose vitamin D3 supplementation group after 1 week (1.9 ± 5.5 vs 60 ± 5.6, P = 0.0005) and after 4 weeks (1.8 ± 5.7 vs 73.7 ± 5.6, P = 0.0028). The 2 groups did not differ in anthropometric measurements, duration of oxygen and respiratory support, and mortality. Length of hospital stay was longer in the low-dose group (24.9 ± 5.14 vs 22 ± 3.49, P = 0.04). Oral vitamin D supplementation has a dose and time dependent effect on percentage of Treg in infants born prematurely. The 800 IU dose of vitamin D3 did not have apparent short-term side effects. Larger studies are needed to explore the effect of vitamin D3 dosing on length of hospital stay.

Effects of Vitamin D in Neonates and Young Infants: An Updated Systematic Review

“…Infants administered with high doses of vitamin D were discharged nearly two days earlier compared to those who received lower doses. 5 Previous study also indicate a correlation between vitamin D levels and neurodevelopment in children, suggesting that higher maternal vitamin D intake during pregnancy may benefit child neurodevelopment, particularly in the language domain. Additionally, the study suggests that the vitamin D binding protein (VDBP) genotype may influence child neurodevelopment independently of vitamin D status.…”

“…was significantly lower in the low-dose group after 1 week (1.9 ± 5.5 vs 60 ± 5.6, P = 0.0005) and after 4 weeks (1.8 ± 5.7 vs 73.7 ± 5.6, P = 0.0028). There were no significant differences in other outcomes, except for a longer hospital stay in the lowdose group (24.9 ± 5.14 vs 22 ± 3.49, P = 0.04) Aly, et al 5 (2019) conducted oral vitamin D supplementation on premature born infants. T regulatory cell count is influenced by vitamin D supplementation in preterm babies.…”

Vitamin D supplementation improved physical growth and neurologic development of Preterm Infants receiving Nesting Care in the neonatal Intensive Care Unit

“…For example, a systematic review and meta-analysis of clinical intervention trials by Zittermann A et al revealed that 400 IU/day Vitamin D supplementation was sufficient for achieving 25(OH)D concentrations in infants, thus being able to prevent nutritional rickets [ 27 ]. Moreover, preterm infants receive 400, 800 or 1000 IU/day of vitamin D 3 did not differ in anthropometric measurements and mortality according to the result of a randomized controlled trial [ 28 ] and an updated meta-analysis [ 29 ]. We firstly showed that a smaller percentage of VDD at 36 weeks’ PMA in nesting + vitamin D group in infants daily allocated to 400 IU vitamin D according to our policy.…”

Preterm Infants on Early Solid Foods and Vitamin D Status in the First Year of Life—A Secondary Outcome Analysis of a Randomized Controlled Trial

“…Vitamin D and mineral status are not only important for bone health but might also have an impact on respiratory morbidity as it has biological importance in lung development and surfactant synthesis [ 8 ]. Vitamin D plays a critical role in cellular function and shows other extra-skeletal anti-inflammatory and immune effects as well [ 9 , 10 , 11 ].…”