Multi-dose vitamin d supplementation in stable very preterm infants: Prospective randomized trial response to three different vitamin D supplementation doses.
Background:Risk factors for maternal vitamin D deficiency and preterm birth overlap, but the distribution of 25-hydroxyvitamin D (25(OH)D) levels among preterm infants is not known. We aimed to determine the associations between 25(OH)D levels and gestational age.Methods:We measured umbilical cord plasma levels of 25(OH)D from 471 infants born at Brigham and Women’s Hospital in Boston. We used generalized estimating equations to determine whether preterm (<37 wks’ gestation) or very preterm (<32 wks’ gestation) infants had greater odds of having 25(OH)D levels below 20 ng/ml than more mature infants. We adjusted for potential confounding by season of birth, maternal age, race, marital status, and singleton or multiple gestation.Results:Mean cord plasma 25(OH)D level was 34.0 ng/ml (range: 4.1–95.3 and SD: 14.1). Infants born before 32 wks’ gestation had increased odds of having 25(OH)D levels below 20 ng/ml in unadjusted (odds ratio (OR): 2.2; 95% confidence interval (CI): 1.1–4.3) and adjusted models (OR: 2.4; 95% CI: 1.2–5.3) as compared with more mature infants.Conclusion:Infants born in <32 wks’ gestation are at higher risk than more mature infants for low 25(OH)D levels. Further investigation of the relationships between low 25(OH)D levels and preterm birth and its sequelae is thus warranted.