Department of Pediatrics, Shanxi Medical University, Taiyuan, 030001, China.
Shanxi Medical University, No. 56, Xinjian South Road, Yingze District, Taiyuan City, Shanxi Province, China.
Sci Rep. 2024 Oct 14;14(1):23972. doi: 10.1038/s41598-024-75191-w.
This study explored the factors influencing serum 25(OH)D levels and the effects of Vitamin D deficiency (VDD) and VD supplementation on 25(OH)D levels and neuropsychobehavioral development in premature infants, to provide a theoretical basis for improving their prognosis. Physical examination, neuropsychobehavioral development and serum 25(OH)D levels were assessed regularly in 158 preterm infants supplemented with VD formulation. 25(OH)D levels were analyzed at 3, 6, 9, 12, and 18 months after birth. The Gesell neuropsychological development test was conducted at 6, 9, 12, and 18 months after birth to obtain the developmental quotient (DQ). Based on the serum 25(OH)D levels at 42 days of age, the infants were divided into VDD and non-VDD groups. Preterm infants in the VDD group were supplemented with more VD until their 25(OH)D levels were normal, and were divided into sustained VDD (SVDD) and corrected VDD (CVDD) groups according to serum 25(OH)D levels at 3 months of age. Appropriate statistical methods were chosen to compare differences in 25(OH)D and DQ between or among different groups, screen for the factors influencing 25(OH)D levels in preterm infants at 42 days of age, and analyze the relationship between 25(OH)D and DQ. The 25(OH)D levels of preterm infants at 42 days of age were positively correlated with VD supplementation during pregnancy, and before 42 days after birth (P < 0.05). The 25(OH)D levels in preterm infants at 42 days and 3 months of age were positively correlated with the DQ levels at 6, 9, 12, and 18 months of age (P < 0.05). The DQ level in the VDD group, especially SVDD group, was lower than that in CVDD and non-VDD groups at the same time point (P < 0.05). This research thus demonstrates that VD supplementations during pregnancy and after birth is a major factor affecting 25(OH)D levels in premature infants. Early VDD and SVDD can affect their neuropsychobehavioral development, and effective VD supplementation can gradually correct VDD and mitigate this influence.
本研究旨在探讨影响血清 25（OH）D 水平的因素，以及维生素 D 缺乏（VDD）和 VD 补充对早产儿 25（OH）D 水平和神经行为发育的影响，为改善早产儿预后提供理论依据。对 158 例补充 VD 制剂的早产儿进行体格检查、神经行为发育和血清 25（OH）D 水平定期评估。于生后 3、6、9、12、18 个月检测血清 25（OH）D 水平。生后 6、9、12、18 个月采用盖塞尔神经心理发育量表进行测试，获得发育商（DQ）。根据生后 42 天的血清 25（OH）D 水平将早产儿分为 VDD 组和非 VDD 组。VDD 组早产儿补充 VD 至血清 25（OH）D 水平正常，根据生后 3 个月血清 25（OH）D 水平分为持续 VDD（SVDD）和纠正 VDD（CVDD）组。选择适当的统计学方法比较不同组间或组内 25（OH）D 和 DQ 的差异，筛选影响早产儿生后 42 天血清 25（OH）D 水平的因素，并分析 25（OH）D 与 DQ 的关系。早产儿生后 42 天血清 25（OH）D 水平与孕期及生后 42 天前 VD 补充呈正相关（P＜0.05）。早产儿生后 42 天和 3 个月的 25（OH）D 水平与生后 6、9、12、18 个月的 DQ 水平呈正相关（P＜0.05）。VDD 组，尤其是 SVDD 组，在同一时间点的 DQ 水平均低于 CVDD 组和非 VDD 组（P＜0.05）。本研究表明，孕期及生后 VD 补充是影响早产儿 25（OH）D 水平的主要因素。早期 VDD 和 SVDD 可影响其神经行为发育，有效的 VD 补充可逐渐纠正 VDD，减轻这种影响。
