Abstract
BackgroundVitamin 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.MethodsCord 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.ResultsThe 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 FiO2 levels (p < 0.05) and were more likely to be mechanically ventilated on DoL7 (36 vs. 7%, p < 0.05). Adjusted for gestational age, they had 10-fold higher odds of death or MV DoL7 (p < 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 (p < 0.05).ConclusionLow 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.
Highlights
Respiratory distress syndrome (RDS) can be considered as a developmental disease which predominantly concerned extremely preterm (EPT) infants
Vitamin D is well known for its major role in fetal bone metabolism, but recent evidence shows a biological role in normal lung development and in surfactant synthesis [1,2,3,4]
The objective of the study was to examine the association between vitamin D status at birth and early respiratory outcomes of infants with Gestational age (GA)
Summary
Respiratory distress syndrome (RDS) can be considered as a developmental disease which predominantly concerned extremely preterm (EPT) infants. These infants often have severe form of RDS with early high oxygen needs, multiple surfactant administration and prolonged mechanical ventilation. The few randomized clinical studies looking into the effects of vitamin D supply on respiratory outcomes have shown variable effects with either no effects or decreased RDS severity [10,11,12]. Vitamin D (VitD) is involved in lung development but its influence on respiratory distress syndrome of extremely preterm (EPT) infants have been little investigated. We examined the influence of low vitamin D status at birth on early respiratory outcomes of this vulnerable infant population
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