Correlation of Vitamin D and Calcium Concentration in Infant of Mother with High Risk of Vitamin D Deficiency
Main Article Content
Vitamin D deficiency is a significant concern during pregnancy, and its prevention is critical for neonatal health. However, there is a lack of comprehensive studies on screening vitamin D and calcium concentrations in neonates born to high-risk mothers. This study aimed to assess serum 25OHD and calcium concentrations in neonates from mothers previously identified as high risk for vitamin D deficiency, and to explore how these measurements might influence the management of such neonates. A cohort study, initiated in 2018 and continuing through 2023, was conducted using 241 venous blood samples from neonates aged 7 days. The concentrations of serum 25OHD and calcium were analyzed, and the relationship between the variables was evaluated using bivariate analysis and logistic regression. The results revealed a high prevalence of vitamin D insufficiency (85%, 30–50 nmol/L) and deficiency (37%, < 30 nmol/L) in neonates from this high-risk group. Additionally, a statistically significant and strong correlation (r: 0.965, P < 0.05) was observed between 25OHD and serum calcium concentrations. Interestingly, most venous samples collected within the first 24 hours postpartum exhibited hypercalcemia. These findings suggest that while vitamin D insufficiency and deficiency are common in neonates of high-risk mothers, the risk of neonatal hypocalcemia due to vitamin D deficiency is relatively low. Given the financial and physical burdens of neonatal blood screening, routine supplementation of vitamin D from birth, without the need for screening, may be a more efficient approach to managing this issue.
Keywords:
vitamin D, calcium, neonates, prevalence, concentration or levels, high risk
Bennett, Annemarie E., and John M. Kearney. 2018. ‘Predictors of Vitamin D Supplementation amongst Infants in Ireland throughout the First Year of Life’. Journal of Public Health 26(5):577–83. doi: 10.1007/s10389-017-0891-3.
Dalgård, Christine, Maria Skaalum Petersen, Ulrike Steuerwald, Pál Weihe, and Philippe Grandjean. 2016. ‘Umbilical Cord Serum 25?Hydroxyvitamin D Concentrations and Relation to Birthweight, Head Circumference and Infant Length at Age 14 Days’. Paediatric and Perinatal Epidemiology 30(3):238–45. doi: 10.1111/ppe.12288.
Gharibeh, Nathalie J. 2021. The Determinants of Bone Health in Infancy Including Vitamin D Status at Birth and Postnatal Vitamin D Supplementation. McGill University (Canada).
Högler, Wolfgang. 2015. ‘Complications of Vitamin D Deficiency from the Foetus to the Infant: One Cause, One Prevention, but Who’s Responsibility?’ Best Practice & Research Clinical Endocrinology & Metabolism 29(3):385–98. doi: 10.1016/j.beem.2015.03.003.
Judistiani, Raden Tina Dewi, Lani Gumilang, Sefita Aryuti Nirmala, Setyorini Irianti, Deni Wirhana, Irman Permana, Liza Sofjan, Hesty Duhita, Lies Ani Tambunan, Jeffry Iman Gurnadi, Umar Seno, Reni Ghrahani, Agnes Rengga Indrati, Yunia Sribudiani, Tetty Yuniati, and Budi Setiabudiawan. 2018. ‘Association of Colecalciferol, Ferritin, and Anemia among Pregnant Women: Result from Cohort Study on Vitamin D Status and Its Impact during Pregnancy and Childhood in Indonesia’. Anemia 2018:1–6. doi: 10.1155/2018/2047981.
Kozgar, Sheikh Arif M., Paul Chay, and Craig F. Munns. 2020. ‘Screening of Vitamin D and Calcium Concentrations in Neonates of Mothers at High Risk of Vitamin D Deficiency’. BMC Pediatrics 20(1):332. doi: 10.1186/s12887-020-02204-8.
Lykkedegn, Sine, Signe Sparre Beck-Nielsen, Grith Lykke Sorensen, Louise Bjoerkholt Andersen, Palle Bach Nielsen Fruekilde, Jan Nielsen, Henriette Boye Kyhl, Jan Stener Joergensen, Steffen Husby, and Henrik Thybo Christesen. 2017. ‘Vitamin D Supplementation, Cord 25-Hydroxyvitamin D and Birth Weight: Findings from the Odense Child Cohort’. Clinical Nutrition 36(6):1621–27. doi: 10.1016/j.clnu.2016.10.008.
Di Marco, Nelfio, Jonathan Kaufman, and Christine P. Rodda. 2019. ‘Shedding Light on Vitamin D Status and Its Complexities during Pregnancy, Infancy and Childhood: An Australian Perspective’. International Journal of Environmental Research and Public Health 16(4):538. doi: 10.3390/ijerph16040538.
Marshall, Ian, Rajeev Mehta, Charletta Ayers, Smita Dhumal, and Anna Petrova. 2016. ‘Prevalence and Risk Factors for Vitamin D Insufficiency and Deficiency at Birth and Associated Outcome’. BMC Pediatrics 16(1):208. doi: 10.1186/s12887-016-0741-4.
Medeiros, Marina, Andréa C. Matos, Silvia E. Pereira, Carlos Saboya, and Andréa Ramalho. 2016. ‘Vitamin D and Its Relation with Ionic Calcium, Parathyroid Hormone, Maternal and Neonatal Characteristics in Pregnancy after Roux-En-Y Gastric Bypass’. Archives of Gynecology and Obstetrics 293(3):539–47. doi: 10.1007/s00404-015-3861-4.
Munns, Craig F., Nick Shaw, Mairead Kiely, Bonny L. Specker, Tom D. Thacher, Keiichi Ozono, Toshimi Michigami, Dov Tiosano, M. Zulf Mughal, Outi Mäkitie, Lorna Ramos-Abad, Leanne Ward, Linda A. DiMeglio, Navoda Atapattu, Hamilton Cassinelli, Christian Braegger, John M. Pettifor, Anju Seth, Hafsatu Wasagu Idris, Vijayalakshmi Bhatia, Junfen Fu, Gail Goldberg, Lars Sävendahl, Rajesh Khadgawat, Pawel Pludowski, Jane Maddock, Elina Hyppönen, Abiola Oduwole, Emma Frew, Magda Aguiar, Ted Tulchinsky, Gary Butler, and Wolfgang Högler. 2016. ‘Global Consensus Recommendations on Prevention and Management of Nutritional Rickets’. The Journal of Clinical Endocrinology & Metabolism 101(2):394–415. doi: 10.1210/jc.2015-2175.
Pettifor, John M., and Kebashni Thandrayen. 2024. ‘The Role of Vitamin D in Paediatric Bone Health’. The Lancet Diabetes & Endocrinology 12(1):4–5. doi: 10.1016/S2213-8587(23)00353-4.
Randev, Shivani, Pankaj Kumar, and Vishal Guglani. 2018. ‘Vitamin D Supplementation in Childhood – A Review of Guidelines’. The Indian Journal of Pediatrics 85(3):194–201. doi: 10.1007/s12098-017-2476-0.
Richard, Aline, Sabine Rohrmann, and Katharina Quack Lötscher. 2017. ‘Prevalence of Vitamin D Deficiency and Its Associations with Skin Color in Pregnant Women in the First Trimester in a Sample from Switzerland’. Nutrients 9(3):260. doi: 10.3390/nu9030260.
Rucker, Derek D., Blakeley B. McShane, and Kristopher J. Preacher. 2015. ‘A Researcher’s Guide to Regression, Discretization, and Median Splits of Continuous Variables’. Journal of Consumer Psychology 25(4):666–78. doi: 10.1016/j.jcps.2015.04.004.
Saggese, Giuseppe, Francesco Vierucci, Annemieke M. Boot, Justyna Czech-Kowalska, Giovanna Weber, Carlos A. Camargo, Eric Mallet, Margherita Fanos, Nick J. Shaw, and Michael F. Holick. 2015. ‘Vitamin D in Childhood and Adolescence: An Expert Position Statement’. European Journal of Pediatrics 174(5):565–76. doi: 10.1007/s00431-015-2524-6.
Tammo, Ömer, and Süleyman Y?ld?z. 2022. ‘Vitamin D Deficiency and Its Clinical Results in Preeclamptic Mothers and Their Babies’. Cureus 14(3).
Tous, Monica, Marcela Villalobos, Lucia Iglesias, Silvia Fernandez-Barres, and Victoria Arija. 2020. ‘Vitamin D Status during Pregnancy and Offspring Outcomes: A Systematic Review and Meta-Analysis of Observational Studies’. European Journal of Clinical Nutrition 74(1):36–53.
Vinkhuyzen, Anna A. E., Darryl W. Eyles, Thomas H. Burne, Laura M. E. Blanken, Claudia J. Kruithof, Frank Verhulst, Vincent W. Jaddoe, Henning Tiemeier, and John J. McGrath. 2016. ‘Prevalence and Predictors of Vitamin D Deficiency Based on Maternal Mid-Gestation and Neonatal Cord Bloods: The Generation R Study’. The Journal of Steroid Biochemistry and Molecular Biology 164:161–67. doi: 10.1016/j.jsbmb.2015.09.018.
Y?lmaz, Bü?ra, Canan Aygün, and Erhan Çetino?lu. 2018. ‘Vitamin D Levels in Newborns and Association with Neonatal Hypocalcemia’. The Journal of Maternal-Fetal & Neonatal Medicine 31(14):1889–93. doi: 10.1080/14767058.2017.1331430.
Young, Bridget E., Thomas J. McNanley, Elizabeth M. Cooper, Allison W. McIntyre, Frank Witter, Z. Leah Harris, and Kimberly O. O’Brien. 2012. ‘Maternal Vitamin D Status and Calcium Intake Interact to Affect Fetal Skeletal Growth in Utero in Pregnant Adolescents’. The American Journal of Clinical Nutrition 95(5):1103–12. doi: 10.3945/ajcn.111.023861.
Dalgård, Christine, Maria Skaalum Petersen, Ulrike Steuerwald, Pál Weihe, and Philippe Grandjean. 2016. ‘Umbilical Cord Serum 25?Hydroxyvitamin D Concentrations and Relation to Birthweight, Head Circumference and Infant Length at Age 14 Days’. Paediatric and Perinatal Epidemiology 30(3):238–45. doi: 10.1111/ppe.12288.
Gharibeh, Nathalie J. 2021. The Determinants of Bone Health in Infancy Including Vitamin D Status at Birth and Postnatal Vitamin D Supplementation. McGill University (Canada).
Högler, Wolfgang. 2015. ‘Complications of Vitamin D Deficiency from the Foetus to the Infant: One Cause, One Prevention, but Who’s Responsibility?’ Best Practice & Research Clinical Endocrinology & Metabolism 29(3):385–98. doi: 10.1016/j.beem.2015.03.003.
Judistiani, Raden Tina Dewi, Lani Gumilang, Sefita Aryuti Nirmala, Setyorini Irianti, Deni Wirhana, Irman Permana, Liza Sofjan, Hesty Duhita, Lies Ani Tambunan, Jeffry Iman Gurnadi, Umar Seno, Reni Ghrahani, Agnes Rengga Indrati, Yunia Sribudiani, Tetty Yuniati, and Budi Setiabudiawan. 2018. ‘Association of Colecalciferol, Ferritin, and Anemia among Pregnant Women: Result from Cohort Study on Vitamin D Status and Its Impact during Pregnancy and Childhood in Indonesia’. Anemia 2018:1–6. doi: 10.1155/2018/2047981.
Kozgar, Sheikh Arif M., Paul Chay, and Craig F. Munns. 2020. ‘Screening of Vitamin D and Calcium Concentrations in Neonates of Mothers at High Risk of Vitamin D Deficiency’. BMC Pediatrics 20(1):332. doi: 10.1186/s12887-020-02204-8.
Lykkedegn, Sine, Signe Sparre Beck-Nielsen, Grith Lykke Sorensen, Louise Bjoerkholt Andersen, Palle Bach Nielsen Fruekilde, Jan Nielsen, Henriette Boye Kyhl, Jan Stener Joergensen, Steffen Husby, and Henrik Thybo Christesen. 2017. ‘Vitamin D Supplementation, Cord 25-Hydroxyvitamin D and Birth Weight: Findings from the Odense Child Cohort’. Clinical Nutrition 36(6):1621–27. doi: 10.1016/j.clnu.2016.10.008.
Di Marco, Nelfio, Jonathan Kaufman, and Christine P. Rodda. 2019. ‘Shedding Light on Vitamin D Status and Its Complexities during Pregnancy, Infancy and Childhood: An Australian Perspective’. International Journal of Environmental Research and Public Health 16(4):538. doi: 10.3390/ijerph16040538.
Marshall, Ian, Rajeev Mehta, Charletta Ayers, Smita Dhumal, and Anna Petrova. 2016. ‘Prevalence and Risk Factors for Vitamin D Insufficiency and Deficiency at Birth and Associated Outcome’. BMC Pediatrics 16(1):208. doi: 10.1186/s12887-016-0741-4.
Medeiros, Marina, Andréa C. Matos, Silvia E. Pereira, Carlos Saboya, and Andréa Ramalho. 2016. ‘Vitamin D and Its Relation with Ionic Calcium, Parathyroid Hormone, Maternal and Neonatal Characteristics in Pregnancy after Roux-En-Y Gastric Bypass’. Archives of Gynecology and Obstetrics 293(3):539–47. doi: 10.1007/s00404-015-3861-4.
Munns, Craig F., Nick Shaw, Mairead Kiely, Bonny L. Specker, Tom D. Thacher, Keiichi Ozono, Toshimi Michigami, Dov Tiosano, M. Zulf Mughal, Outi Mäkitie, Lorna Ramos-Abad, Leanne Ward, Linda A. DiMeglio, Navoda Atapattu, Hamilton Cassinelli, Christian Braegger, John M. Pettifor, Anju Seth, Hafsatu Wasagu Idris, Vijayalakshmi Bhatia, Junfen Fu, Gail Goldberg, Lars Sävendahl, Rajesh Khadgawat, Pawel Pludowski, Jane Maddock, Elina Hyppönen, Abiola Oduwole, Emma Frew, Magda Aguiar, Ted Tulchinsky, Gary Butler, and Wolfgang Högler. 2016. ‘Global Consensus Recommendations on Prevention and Management of Nutritional Rickets’. The Journal of Clinical Endocrinology & Metabolism 101(2):394–415. doi: 10.1210/jc.2015-2175.
Pettifor, John M., and Kebashni Thandrayen. 2024. ‘The Role of Vitamin D in Paediatric Bone Health’. The Lancet Diabetes & Endocrinology 12(1):4–5. doi: 10.1016/S2213-8587(23)00353-4.
Randev, Shivani, Pankaj Kumar, and Vishal Guglani. 2018. ‘Vitamin D Supplementation in Childhood – A Review of Guidelines’. The Indian Journal of Pediatrics 85(3):194–201. doi: 10.1007/s12098-017-2476-0.
Richard, Aline, Sabine Rohrmann, and Katharina Quack Lötscher. 2017. ‘Prevalence of Vitamin D Deficiency and Its Associations with Skin Color in Pregnant Women in the First Trimester in a Sample from Switzerland’. Nutrients 9(3):260. doi: 10.3390/nu9030260.
Rucker, Derek D., Blakeley B. McShane, and Kristopher J. Preacher. 2015. ‘A Researcher’s Guide to Regression, Discretization, and Median Splits of Continuous Variables’. Journal of Consumer Psychology 25(4):666–78. doi: 10.1016/j.jcps.2015.04.004.
Saggese, Giuseppe, Francesco Vierucci, Annemieke M. Boot, Justyna Czech-Kowalska, Giovanna Weber, Carlos A. Camargo, Eric Mallet, Margherita Fanos, Nick J. Shaw, and Michael F. Holick. 2015. ‘Vitamin D in Childhood and Adolescence: An Expert Position Statement’. European Journal of Pediatrics 174(5):565–76. doi: 10.1007/s00431-015-2524-6.
Tammo, Ömer, and Süleyman Y?ld?z. 2022. ‘Vitamin D Deficiency and Its Clinical Results in Preeclamptic Mothers and Their Babies’. Cureus 14(3).
Tous, Monica, Marcela Villalobos, Lucia Iglesias, Silvia Fernandez-Barres, and Victoria Arija. 2020. ‘Vitamin D Status during Pregnancy and Offspring Outcomes: A Systematic Review and Meta-Analysis of Observational Studies’. European Journal of Clinical Nutrition 74(1):36–53.
Vinkhuyzen, Anna A. E., Darryl W. Eyles, Thomas H. Burne, Laura M. E. Blanken, Claudia J. Kruithof, Frank Verhulst, Vincent W. Jaddoe, Henning Tiemeier, and John J. McGrath. 2016. ‘Prevalence and Predictors of Vitamin D Deficiency Based on Maternal Mid-Gestation and Neonatal Cord Bloods: The Generation R Study’. The Journal of Steroid Biochemistry and Molecular Biology 164:161–67. doi: 10.1016/j.jsbmb.2015.09.018.
Y?lmaz, Bü?ra, Canan Aygün, and Erhan Çetino?lu. 2018. ‘Vitamin D Levels in Newborns and Association with Neonatal Hypocalcemia’. The Journal of Maternal-Fetal & Neonatal Medicine 31(14):1889–93. doi: 10.1080/14767058.2017.1331430.
Young, Bridget E., Thomas J. McNanley, Elizabeth M. Cooper, Allison W. McIntyre, Frank Witter, Z. Leah Harris, and Kimberly O. O’Brien. 2012. ‘Maternal Vitamin D Status and Calcium Intake Interact to Affect Fetal Skeletal Growth in Utero in Pregnant Adolescents’. The American Journal of Clinical Nutrition 95(5):1103–12. doi: 10.3945/ajcn.111.023861.
