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American Academy of Pediatrics
Article

Trial of Daily Vitamin D Supplementation in Preterm Infants

Chandra Kumar Natarajan, M. Jeeva Sankar, Ramesh Agarwal, O. Tejo Pratap, Vandana Jain, Nandita Gupta, Arun Kumar Gupta, Ashok K. Deorari, Vinod K. Paul and Vishnubhatla Sreenivas
Pediatrics March 2014, 133 (3) e628-e634; DOI: https://doi.org/10.1542/peds.2012-3395
Chandra Kumar Natarajan
Divisions of aNeonatology and
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M. Jeeva Sankar
Divisions of aNeonatology and
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Ramesh Agarwal
Divisions of aNeonatology and
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O. Tejo Pratap
Divisions of aNeonatology and
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Vandana Jain
bPediatric Endocrinology, Department of Pediatrics and
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Nandita Gupta
cDepartments of Endocrinology and Metabolism,
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Arun Kumar Gupta
dRadiodiagnosis, and
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Ashok K. Deorari
Divisions of aNeonatology and
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Vinod K. Paul
Divisions of aNeonatology and
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Vishnubhatla Sreenivas
eBiostatistics, All India Institute of Medical Sciences, New Delhi, India
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Abstract

OBJECTIVE: To compare the effect of 800 vs 400 IU of daily oral vitamin D3 on the prevalence of vitamin D deficiency (VDD) at 40 weeks’ postmenstrual age (PMA) in preterm infants of 28 to 34 weeks’ gestation.

METHODS: In this randomized double-blind trial, we allocated eligible infants to receive either 800 or 400 IU of vitamin D3 per day (n = 48 in both groups). Primary outcome was VDD (serum 25-hydroxyvitamin D levels <20 ng/mL) at 40 weeks’ PMA. Secondary outcomes were VDD, bone mineral content, and bone mineral density at 3 months’ corrected age (CA).

RESULTS: Prevalence of VDD in the 800-IU group was significantly lower than in the 400-IU group at 40 weeks (38.1% vs 66.7%; relative risk: 0.57; 95% confidence interval: 0.37–0.88) and at 3 months’ CA (12.5% vs 35%; relative risk: 0.36; 95% confidence interval: 0.14–0.90). One infant (2.4%) in the 800-IU group had vitamin D excess (100–150 ng/mL). Bone mineral content (mean ± SD: 79.6 ± 16.8 vs 84.7 ± 20.7 g; P = .27) and bone mineral density (0.152 ± 0.019 vs 0.158 ± 0.021 g/cm2; P = .26) were not different between the 2 groups.

CONCLUSIONS: Daily supplementation with 800 IU of vitamin D reduces the prevalence of VDD at 40 weeks’ PMA and at 3 months’ CA in preterm infants without showing any improvement in bone mineralization. However, there is a possibility that this dose may occasionally result in vitamin D excess.

  • DXA
  • preterm
  • supplementation
  • vitamin D
  • Accepted December 13, 2013.
  • Copyright © 2014 by the American Academy of Pediatrics

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Pediatrics
Vol. 133, Issue 3
1 Mar 2014
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Trial of Daily Vitamin D Supplementation in Preterm Infants
Chandra Kumar Natarajan, M. Jeeva Sankar, Ramesh Agarwal, O. Tejo Pratap, Vandana Jain, Nandita Gupta, Arun Kumar Gupta, Ashok K. Deorari, Vinod K. Paul, Vishnubhatla Sreenivas
Pediatrics Mar 2014, 133 (3) e628-e634; DOI: 10.1542/peds.2012-3395

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Trial of Daily Vitamin D Supplementation in Preterm Infants
Chandra Kumar Natarajan, M. Jeeva Sankar, Ramesh Agarwal, O. Tejo Pratap, Vandana Jain, Nandita Gupta, Arun Kumar Gupta, Ashok K. Deorari, Vinod K. Paul, Vishnubhatla Sreenivas
Pediatrics Mar 2014, 133 (3) e628-e634; DOI: 10.1542/peds.2012-3395
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