Papalia Honoré, Samonini Anais, Buffat Christophe, Gras E, des Robert Clotilde, Landrier Jean-Francois, Pauly Vanessa, Boubred Farid
Neonatal Unit, Hospital University La Conception, APHM, Marseille, France.
Laboratory of Biochemistry and Molecular Biology, Hospital University la Conception, APHM, Marseille, France.
Front Pediatr. 2022 Jan 21;9:790839. doi: 10.3389/fped.2021.790839. eCollection 2021.
Vitamin D (VitD) is involved in lung development but its influence on respiratory distress syndrome of extremely preterm (EPT) infants have been little investigated. In this study, we examined the influence of low vitamin D status at birth on early respiratory outcomes of this vulnerable infant population.
Cord blood 25(OH)D levels ≤ 75 nmol/L were considered as Low vitamin D levels. Stepwise logistic regression and classification regression-tree analyses were used and the primary outcome was the combined outcome of death or mechanical ventilation need by the end of the first week (death or MV DoL7) as a marker od RDS severity.
The mean (SD) GA and birth weight were 26 (1.4) weeks and 801 (212) gr, respectively; 81/109 (74%) infants had low 25(OH)D levels. Infants with low VitD levels had 25% higher initial FiO levels ( < 0.05) and were more likely to be mechanically ventilated on DoL7 (36 vs. 7%, < 0.05). Adjusted for gestational age, they had 10-fold higher odds of death or MV DoL7 ( < 0.01). By regression tree analysis, the rate of death or MV DoL7 increased from 18 to 71% in infants with GA < 26 weeks and with cord blood 25(OH)D levels higher and lower than 74 nmol/L, respectively ( < 0.05).
Low vitamin D levels at birth are associated with early adverse respiratory outcomes in infants with GA less 29 weeks. Further largest studies are needed to confirm this association.
维生素D（VitD）参与肺部发育，但其对极早产儿（EPT）呼吸窘迫综合征的影响鲜有研究。在本研究中，我们探讨了出生时低维生素D状态对这一脆弱婴儿群体早期呼吸结局的影响。
脐血25(OH)D水平≤75 nmol/L被视为低维生素D水平。采用逐步逻辑回归和分类回归树分析，主要结局是第一周结束时死亡或需要机械通气的联合结局（第7天死亡或机械通气，DoL7）作为RDS严重程度的指标。
平均（标准差）孕周和出生体重分别为26（1.4）周和801（212）克；81/109（74%）的婴儿25(OH)D水平较低。维生素D水平低的婴儿初始FiO水平高25%（<0.05），且在第7天更有可能接受机械通气（36%对7%，<0.05）。经孕周调整后，他们死亡或第7天机械通气的几率高10倍（<0.01）。通过回归树分析，孕周<26周且脐血25(OH)D水平高于和低于74 nmol/L的婴儿中，第7天死亡或机械通气的发生率分别从18%增至71%（<0.05）。
出生时维生素D水平低与孕周<29周婴儿的早期不良呼吸结局相关。需要进一步开展更大规模的研究来证实这种关联。
