Maternal/neonatal vitamin D deficiency: a new risk factor for necrotizing enterocolitis in preterm infants?
Journal of Perinatology , (23 March 2017) | doi:10.1038/jp.2017.18
M Cetinkaya, T Erener-Ercan, T Kalayci-Oral, A Babayiğit, B Cebeci, S Y Semerci and G Buyukkale
Objective:
The objective of the study was to investigate the possible association between maternal/neonatal 25-hydroxy vitamin D (25-OHD) levels and development of necrotizing enterocolitis (NEC).
Study Design:
One hundred and forty-five preterm infants less than or equal to 36 weeks of gestation were enrolled. 25-OHD levels were determined in maternal/neonatal blood samples that were obtained at the time of admission to the neonatal intensive care unit.
Results:
Of the 145 enrolled patients, 26 (18%) developed NEC. Maternal/neonatal 25-OHD levels in the NEC group were significantly lower than those of the no-NEC group (P=0.001 and 0.004, respectively). In univariate logistic regression analysis, both maternal/neonatal vitamin D levels were a significant predictor of NEC (odds ratio (OR): 0.92 and 0.89; P<0.001 and P<0.005, respectively). However, multivariate logistic regression analysis revealed that only maternal vitamin D level was a significant predictor of NEC (OR: 0.86, P<0.0009).
Conclusion:
This is the first study to propose a possible association between maternal/neonatal 25-OHD levels and subsequent development of NEC in preterm infants.
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See also web
- Necrotizing enterocolitis Wikipedia
"Rates were almost three times higher for black populations than for white populations" (Note: blacks hasve lower vitamin D levels - Part 1. Current Controversies in the Understanding of Necrotizing Enterocolitis Medscape 2003
"The incidence of NEC varies. It is stated most often as 1% to 7% of all neonatal intensive care unit (NICU) admissions, or 1 to 3 per 1,000 live births" - Costs of necrotizing enterocolitis and cost-effectiveness of exclusively human milk-based products in feeding extremely premature infants Feb 2017
NEC medical + surgical cost = $270,000 - Necrotizing Enterocolitis Risk April 2012
"Necrotizing enterocolitis is a costly disease, accounting for nearly 20% of NICU costs annually."
"Necrotizing enterocolitis survivors requiring surgery often stay in the NICU more than 90 days and are among those most likely to stay more than 6 months"
"Although 90% of infants who develop NEC are born premature, full-term and near-term infants also develop the disease"
"It is estimated that nearly 12% of infants born weighing less than 1500 g will develop NEC; of those, about 30% will not survive."
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Vitamin D Life Calculation:
Vitamin D does not appear to be a cost-effective way to prevent NEC
- 1 in 1,000 live births get NEC (see web above)
- $100,000 = Conservative cost of NEC
thus NEC only adds $100 to the average cost of birth - 14% less NEC if high good level of vitamin D (study on this page)
Thus adding Vitamin D would only reduce the averagecost of birth due to NEC by $14
This calculation does not consider the decrease in extreme premie births by vitamin D
This calculation does not consider adding Vitamin D to premie after birth but before NEC starts
See also Vitamin D Life
- Infant-Child category listing has
606 items along with related searches - Stunting OR “low birth weight” OR LBW OR preemie OR preemies OR preterm 777 items as of March 2017
- Preterm births are VERY costly – Feb 2017
- Children in Intensive Care need Vitamin D loading dose of 10000 IU per kg (nearing a consensus) - Oct 2016
- 5 out of 6 children who died in pediatric critical care unit had low vitamin D – May 2014
Healthy pregnancies need lots of vitamin D has the following summary
ProblemReduces Evidence 0. Chance of not conceiving 3.4 times Observe 1. Miscarriage 2.5 times Observe 2. Pre-eclampsia 3.6 times RCT 3. Gestational Diabetes 3 times RCT 4. Good 2nd trimester sleep quality 3.5 times Observe 5. Premature birth 2 times RCT 6. C-section - unplanned 1.6 times Observe Stillbirth - OMEGA-3 4 times RCT - Omega-3 7. Depression AFTER pregnancy 1.4 times RCT 8. Small for Gestational Age 1.6 times meta-analysis 9. Infant height, weight, head size
within normal limitsRCT 10. Childhood Wheezing 1.3 times RCT 11. Additional child is Autistic 4 times Intervention 12.Young adult Multiple Sclerosis 1.9 times Observe 13. Preeclampsia in young adult 3.5 times RCT 14. Good motor skills @ age 3 1.4 times Observe 15. Childhood Mite allergy 5 times RCT 16. Childhood Respiratory Tract visits 2.5 times RCT RCT = Randomized Controlled Trial
Premies with low Vitamin D are 14 percent more like to have expensive gut problems (necrotizing enterocolitis) – March 20171719 visitors, last modified 24 Mar, 2017,