Objective To analyze the influence of serum 25-(OH) D level on the clinical outcomes of very low birth weight infants, in order to provide new orientation for the prevention and treatment of related disease in preterm infants. Methods From September 2019 and September 2020, a total of 105 very low birth weight infants hospitalized in Neonatal Intensive Care Unit (NICU) of Affiliated Hospital of Jining Medical College were selected as study subjects. According to the level of serum 25-(OH)D within 24 hours after birth, infants were divided into severe vitamin D deficiency group (group A), vitamin D deficiency group (group B) and control group. General characteristics, length of hospital stay, complications and clinical outcomes of infants in the three groups were compared. Results A total of 105 infants with very low birth weight were included.The mean serum 25-(OH)D was (14.33±3.60)ng/ml at birth.The incidence of vitamin D deficiency was 79.1%.The serum 25-(OH)D level of infants born in summer and autumn was significantly higher than that in winter and spring (t=2.71,P=0.01).The birth weight of the infants for group A and group B was lower than those of the control group(F=0.86,P<0.01;Z score: F=5.43,P=0.01).1- minute Apgar score of the infants for group A and group B were lower than those of the control group(F=9.05,P<0.01).The older the mother was, the higher the incidence of vitamin D deficiency was, and the difference between the three groups was statistically significant (F=8.40,P<0.01).The length of hospital stay, duration of oxygen use, duration of ventilation in infants with vitamin D deficiency were significantly higher than those in the control group, with statistically significant differences among the three groups (F=19.65,7.45,15.97,4.87,P<0.05).The incidence of RDS、BPD and ROP in infants with vitamin D deficiency was higher than control group, the difference between the three groups was statistically significant (χ2=17.37,P<0.05).Logistic regression analysis showed that vitamin D deficiency at birth was a risk factor for RDS(OR=6.604,95%CI:1.828 - 23.862,P=0.004)、BPD(OR=8.199,95%CI:1.428 - 47.067,P=0.018). Conclusions Serum 25-(OH) D deficiency is prevalent in very low birth weight infants. For very low birth weight infants, low serum 25-(OH)D level may increase the duration of oxygen therapy and respiratory support, increase the incidence of BPD, RDS and ROP, and prolong the length of hospital stay.
Key words
very low birth weight infants /
vitamin D deficiency /
clinical outcomes
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References
[1] 薛静,杨亚俊,程小宁,等. 产妇及其新生儿血25羟维生素D水平变化及临床意义研究[J]. 中国妇幼健康研究,2017,28(1):23-25.
[2] 马海然.维生素D对早产儿免疫系统的影响及其临床意义[J].中国实用医药, 2018, 13(7):9-11.
[3] 杨玲蓉,李桦,杨涛义,等. 维生素d缺乏与新生儿早发型败血症的相关性研究[J]. 中国当代儿科杂志, 2016, 18(9):791-795.
[4] 邓庆先,林梅芳,袁新华,等. 不同剂量维生素D对极低出生体重儿血清钙、磷、碱性磷酸酶和25-羟维生素D水平的影响[J]. 中华围产医学杂志, 2017,20(3):223-227.
[5] 管利荣, 吴翼君, 余静,等. 住院新生儿维生素D水平调查及影响因素分析[J].重庆医学, 2017,46(013):1823-1824.
[6] Adegoke SA,Braga JAP,Adekile AD,et al.Impact of hydroxyurea on Anthropometry and serum 25-hydroxyvitamin D among children with sickle cell disease[J]. Journal of Pediatric Hematology/Oncology, 2018,40(4):e243-e247.
[7] Cetinkaya M, Cekmez F, Buyukkale G, et al. Lower vitamin D levels are associated with increased risk of early-onset neonatal sepsis in term infants[J]. J Perinatol, 2015, 35(1):39-45.
[8] Taha G, Abd-Allah M, Mostafa H, et al. Neonatal and maternal 25-OH vitamin D serum levels in neonates with early-onset sepsis[J]. Children (Basel, Switzerland), 2017,4(37):1-9.
[9] Cetinkaya M, Erener-Ercan T, Kalayci-Oral T, et al. Maternal/neonatal vitamin D deficiency: a new risk factor for necrotizing enterocolitis in preterm infants?[J]. J Perinatol, 2017,37:673-678.
[10] Ataseven F, Aygün C, Okuyucu A, et al. Is vitamin D deficiency a risk factor for respiratory distress syndrome?[J].Int J Vitam Nutr Res, 2013, 83(4):232-237.
[11] Çetinkaya M, Çekmez F, Erener-Ercan T, et al. Maternal/neonatal vitamin D deficiency: a risk factor for bronchopulmonary dysplasia in preterms?[J]. J Perinatol, 2015,35:813-817.
[12] Joung KE, Burris HH, van Marter LJ, et al. Vitamin D and bronchopulmonary dysplasia in preterm infants[J]. J Perinatol, 2016,36:878-882.
[13] Holick MF, Binkley NC, Bischoff-Ferrari HA, et al. Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline[J]. J Clin Endocrinol Metab,2011,96:1911-1930.
[14] Shin YH, Yu J, Kim KW, et al. Association between cord blood 25-hydroxyvitamin D concentrations and respiratory tract infections in the first 6 months of age in a Korean population: a birth cohort study (COCOA)[J]. Korean J Pediatr, 2013, 56(10):439-445.
[15] Sook-Hyun P, Gi-Min L, Jung-Eun M, et al. Severe vitamin D deficiency in preterm infants: maternal and neonatal clinical features[J]. Korean J Pediatr, 2015, 58(11):427-433.
[16] Morgan C,Dodds L, Langille DB, et al. Cord blood vitamin D status and neonatal outcomes in a birth cohort in Quebec, Canada[J].Arch Gynecol Obstet, 2016, 293(4):731-738.
[17] 国家卫生和计划生育委员会办公厅.早产儿保健工作规范[J].中华围产医学杂志,2017,20(6):401-406.
[18] Augusto AL. Vitamin D deficiency as a risk factor for childhood allergic disease and asthma[J]. Curr Opin Allergy Clin Immunol, 2012, 12(2):179-185.
[19] Kumar R. Prenatal factors and the development of asthma[J]. Curr Opin Pediatr, 2008, 20(6):682-687.
[20] Bertagnolli M,Nuyt AM,Thébaud B,et al.Endothelial progenitor cells as prognostic markers of preterm birth-associated complications[J].Stem Cells Transl Med,2017,6(1):7-13.
[21] Konstantinopoulou S,Tapia IE. Vitamin D and the lung[J]. Paediatr Respir Rev, 2017,24:39-43.
[22] Kho AT, Bhattacharya S, Tantisira KG, et al. Transcriptomic analysis of human lung development[J]. Am J Respir Crit Care Med, 2010, 181(1):54-63.
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