Shakiba Mehrdad, Pahloosye Ali, Mirouliaei Mehrdad, Islami Zia
Department of Pediatrics, Shahid Sadoughi University of Medical Science, Avicenna Street, Yazd, Iran.
Singapore Med J. 2014 May;55(5):266-70. doi: 10.11622/smedj.2014070.
Vitamin D deficiency is common in pregnant women, and supplementation of vitamin D is necessary for the infants of these women. This study explored the efficacy of an alternative way of vitamin D supplementation in an area with a high prevalence of vitamin D deficiency in mothers.
This was a non-randomised clinical trial conducted in 2010 in Yazd, Iran. Full-term healthy infants born to vitamin D-deficient mothers (n = 82) were divided into the high-dose regimen (HDR; single oral bolus 30,000 IU vitamin D3, n = 34) and the standard-dose regimen (SDR; 400 IU/day vitamin D3 within two weeks of life, n = 48) groups. 25-hydroxyvitamin D (25OHD) was measured using chemiluminescent immunoassays, and 25OHD level > 20 ng/mL was deemed sufficient.
Over 90% of infants in the HDR group attained vitamin D sufficiency within one month, while comparable sufficiency was reached in the SDR group only after four months. At two months, the proportion of infants attaining 25OHD > 30 ng/mL was 93.3% and 27.9% in the HDR and SDR groups, respectively (p = 0.003). None of our infants achieved 25OHD levels > 100 ng/mL.
For infants born to vitamin D-deficient mothers, oral supplementation of 30,000 IU vitamin D3 during the first month of life, followed by a routine recommended dose of 400 IU/day, should be considered. The four-month lag for attaining vitamin D sufficiency in 90% of infants in the SDR group may have clinical implications and should be further investigated.
维生素D缺乏在孕妇中很常见,这些孕妇的婴儿有必要补充维生素D。本研究在母亲维生素D缺乏患病率较高的地区探索了一种替代维生素D补充方式的效果。
这是一项于2010年在伊朗亚兹德进行的非随机临床试验。维生素D缺乏母亲所生的足月健康婴儿(n = 82)被分为高剂量方案组(HDR;单次口服30,000 IU维生素D3,n = 34)和标准剂量方案组(SDR;出生后两周内每天400 IU维生素D3,n = 48)。使用化学发光免疫分析法测量25-羟维生素D(25OHD),25OHD水平> 20 ng/mL被视为充足。
HDR组超过90%的婴儿在一个月内达到维生素D充足,而SDR组仅在四个月后才达到类似的充足水平。在两个月时,HDR组和SDR组中25OHD> 30 ng/mL的婴儿比例分别为93.3%和27.9%(p = 0.003)。我们的婴儿中没有一个达到25OHD水平> 100 ng/mL。
对于维生素D缺乏母亲所生的婴儿,应考虑在出生后第一个月口服30,000 IU维生素D3,随后按常规推荐剂量每天400 IU。SDR组90%的婴儿达到维生素D充足的四个月延迟可能具有临床意义,应进一步研究。