Clinical Focus ›› 2022, Vol. 37 ›› Issue (8): 717-722.doi: 10.3969/j.issn.1004-583X.2022.08.008

• Original article • Previous Articles     Next Articles

Dynamic monitoring of blood 25 (OH) D level and its effect on pulmonary disease in very premature infants

Xi Hongmin1, Yang Lijuan2, Yin Xiangyun1, Yang Ping1, Ma Lili1, Li Xianghong1()   

  1. 1. Department of Neonatology, The Affiliated Hospital of QingDao University, Qingdao 26600, China
    2. Department of Neonatology, BinZhou Medical University Hospital, Binzhou 256600, China
  • Received:2022-04-14 Online:2022-08-20 Published:2022-09-26
  • Contact: Li Xianghong E-mail:lixianghong0329@126.com

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Abstract:

Objective To monitor the vitamin D level dynamically and to explore its effect on lung diseases of very preterm infants. Methods A total of 126 very premature infants <32 weeks were enrolled, who were admitted to the NICU of Affiliated Hospital of Qingdao University from June 2019 to December 2020 with informed consent of their parents. Serum 25-(OH)D levels were measured at postnatal 24h and postnatal month 1 and 2. All preterm infants were given vitamin AD (vitamin D 500 IU, vitamin A 1500 IU) daily and vitamin D3 400 IU after feeding tolerance. General clinical data were collected from the three groups which comprised Vitamin D deficiency group(n=71, 25-[OH] D <12 ng/ml), insufficient group(n=46, 25-[OH]D≥12~<20 ng/ml), and sufficient group(n=9, 25-OH]D≥20~≤100 ng/ml).The incidence of respiratory distress syndrome(RDS), duration of mechanical ventilation, hospital stay, early pulmonary hypertension(PH), patent ductus arteriosus(PDA), and bronchopulmonary dysplasia(BPD) were included as comparator, and statistical analysis was conducted. Results A total of 126 premature infants were included, ranging from 26 to 31+6 weeks with an average gestational age of (29.75±1.52) weeks, including 65 males (51.59%) and 61 females (48.41%). There were no significant differences in gestational age, birth weight, head circumference and body length among the three groups(P>0.05). The average level of vitamin D at birth was (10.57±4.79) ng/ml, and the rate of vitamin D deficiency reached 92.86%. Vitamin D900IU was taken orally daily. The mean level of vitamin D was (18.14±2.88) ng/ml and (21.13±7.48) ng/ml at month 1 and month 2 with deficiency rate 73.8% and 53.17%, no vitamin D overdose. The incidence of RDS or BPD was significantly higher in the vitamin D deficiency group at birth (P<0.05). However, there was no significant correlation between different vitamin D levels and the severity of BPD (P=0.984). There was no significant differences in postnatal Apgar score, duration of caffeine use, rate of mechanical ventilation, duration of non-invasive ventilation, duration of total oxygen use, patent ductus arteriosus (PDA), total length of hospital stay, and early pulmonary hypertension (P>0.05). Conclusion Vitamin D deficiency is common in very premature infants. After vitamin D900IU supplementation, the rate of vitamin D deficiency still accounted for 53.17% at aged 2 months. Therefore, it is recommended to provide individual vitamin D supplementation for premature infants.Vitamin D deficiency at birth in very premature infants increases the risk of RDS and BPD.

Key words: infant, premature, vitamin D, lung disease

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