Cho Hannah, Lee Yoon, Oh Saelin, Heo Ju Sun
Department of Pediatrics, Korea University College of Medicine, Seoul, Republic of Korea; Department of Pediatrics, Korea University Anam Hospital, Seoul, Republic of Korea.
Department of Radiology, Korea University Anam Hospital, Seoul, Republic of Korea.
Pediatr Neonatol. 2025 Jan;66(1):31-36. doi: 10.1016/j.pedneo.2024.04.004. Epub 2024 May 15.
Vitamin D is essential for bone health and immune system. Vitamin D deficiency (VDD) poses a high-risk to very preterm (VP) infants. This study aimed to evaluate the risk factors associated with VDD in VP infants and its potential clinical outcomes.
A retrospective cohort study was conducted on VP infants admitted to the neonatal intensive care unit of a specialized tertiary hospital in Seoul, Republic of Korea, between January 2018 and June 2022. Serum 25-hydroxyvitamin D (25(OH)D) levels and other biochemical parameters were measured between 4 and 6 weeks of age. VDD was defined as a serum 25(OH)D level <20 ng/mL. Prenatal and postnatal risk factors and clinical outcomes were compared between the VDD and non-VDD groups.
Of the 82 VP infants analyzed, 27 (32.9%) were diagnosed with VDD. The VDD group exhibited a significantly longer duration of parenteral nutrition (PN) compared to the non-VDD group (adjusted odds ratio [OR] = 1.12; 95% confidence interval [CI]: 1.008-1.245). Breast milk intake was lower in the VDD group than in the non-VDD group (adjusted OR = 0.976, 95% CI, 0.955-0.999). Notably, calcium levels were significantly lower in the VDD group, while parathyroid hormone levels were significantly higher, compared with the non-VDD group. Additionally, the rickets severity score was higher in the VDD group than in the non-VDD, although the difference was not statistically significant.
Prolonged PN duration and low breast milk intake significantly increased the risk of VDD in VP infants.
维生素D对骨骼健康和免疫系统至关重要。维生素D缺乏（VDD）对极早产儿（VP）构成高风险。本研究旨在评估VP婴儿中与VDD相关的危险因素及其潜在临床结局。
对2018年1月至2022年6月期间入住韩国首尔一家专业三级医院新生儿重症监护病房的VP婴儿进行回顾性队列研究。在4至6周龄时测量血清25-羟基维生素D（25(OH)D）水平和其他生化参数。VDD定义为血清25(OH)D水平<20 ng/mL。比较VDD组和非VDD组的产前和产后危险因素及临床结局。
在分析的82例VP婴儿中，27例（32.9%）被诊断为VDD。与非VDD组相比，VDD组的肠外营养（PN）持续时间显著更长（调整优势比[OR]=1.12；95%置信区间[CI]：1.008-1.245）。VDD组的母乳摄入量低于非VDD组（调整OR=0.976，95%CI，0.955-0.999）。值得注意的是，与非VDD组相比，VDD组的钙水平显著更低，而甲状旁腺激素水平显著更高。此外，VDD组的佝偻病严重程度评分高于非VDD组，尽管差异无统计学意义。
PN持续时间延长和母乳摄入量低显著增加了VP婴儿发生VDD的风险。
