However, the benefits and safety of using higher doses remain controversial. Thus, higher vitamin D concentrations that can affect extra-skeletal action is implemented. In contrast, The European Society for Pediatric Gastroenterology Hepatology and Nutrition (ESPGHAN) recommends a higher intake (800–1000 IU/day) during the first months of life to prevent the deficiency caused by prematurity. The American Academy of Pediatrics (AAP) recommends 200–400 IU/day vitamin D (from all sources) for preterm infants. Nevertheless, high vitamin D supplementation among low-birth-weight infants with immature renal filtration can lead to vitamin D toxicity with hypercalcemia or hypercalciuria and cause serious illness. In the premature infants’ population, VDD can lead to bone disease, which is described as rickets of prematurity, osteopenia of prematurity, or metabolic bone disease (MBD). However, preterm infants are vulnerable to vitamin D deficiency (VDD) because of maternal vitamin D supply deprivation and exposure to additional risk factors, such as long-term parenteral nutrition use, intolerance to human milk fortifiers and formulas, and neonatal cholestasis. Neonatal vitamin D storage depends on 50–70% of the maternal 25-hydroxyvitamin D levels received by newborns. Therefore, an appropriate supplementation in perinatal and neonatal periods affects respiratory infections, sepsis, allergy, and mental and behavioral development. Vitamin D plays an important role in skeletal health, and its receptors are in most tissues. Supplementation with 800–1000 IU of vitamin D prevents deficiency and should be monitored to avoid overdose. Inadequate and excessive amounts of vitamin D can lead to serious health problems. Biochemical markers of vitamin D toxicity were observed in two patients at 52 weeks of PCA in the control group.
We observed increased vitamin D levels and abnormal ultrasound findings in five infants. A significantly higher infants’ percentage in the monitored group had safe vitamin D levels (20–80 ng/mL) at 52 weeks of PCA ( p = 0.017). Vitamin D supplementation was discontinued in 23% of infants subjected to standard treatment due to increased potentially toxic 25(OH)D concentrations (>90 ng/mL) at 40 weeks of PCA. 25-hydroxyvitamin D concentrations were measured at birth, 4 weeks of age, and 35, 40, and 52 ± 2 weeks of post-conceptional age (PCA). 109 preterm infants (24 0/7–32 6/7 weeks of gestation) were randomized to receive 500 IU vitamin D standard therapy ( n = 55 approximately 800–1000 IU from combined sources) or monitored therapy ( n = 54 with an option of dose modification). This study aimed to assess the effectiveness of monitored vitamin D supplementation in a population of preterm infants. Appropriate supplementation of vitamin D can affect infections, allergy, and mental and behavioral development.
0 kommentar(er)
