[2183.8] Daily Vitamin D Supplementation with 800 IU vs. 400 IU in Preterm Infants: A Randomized Trial
Chandra Kumar N, M. Jeeva Sankar, Ramesh Agarwal, O. Tejo Pratap, Vandana Jain, Nandita Gupta, Arun K. Gupta, Ashok K. Deorari, Vinod K. Paul, V. Sreenivas. Division of Neonatology, Pediatrics, All India Institute of Medical Sciences, New Delhi, India; Endocrinology& Metabolism, All India Institute of Medical Sciences, New Delhi, India; Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, India; Biostatistics, All India Institute of Medical Sciences, New Delhi, India.
BACKGROUND: Consensus is lacking in regard to the dose of vitamin D supplementation required for preterm infants given the paucity of evidence. AAP, ESPGHAN and WHO have recommended different dosages of vitamin D ranging from 400 IU to 1000 IU per day.
OBJECTIVE: Primary To compare the prevalence of vitamin D insufficiency (VDI; serum 25 hydroxy vitamin D <20 ng/mL) at 40 weeks postmenstrual age (PMA) in preterm infants of 28 to 34 weeks' gestation randomized to receive 800 IU or 400 IU of oral vitamin D3 per day. Secondary To compare the (1) prevalence of VDI at 3m corrected age (CA), (2) incidence of vitamin D toxicity, as assessed by urine calcium creatinine ratio (UCa/Cr) for hypercalciuria and renal ultrasound for nephrocalcinosis during therapy and (3) bone mineral content (BMC) and bone mineral density (BMD) by dual energy x-ray absorptiometry (DEXA) at 3m CA.
DESIGN/METHODS: In this randomized double blind trial, we allocated infants to 800 IU/ day or 400 IU/day of oral vitamin D3 (n=48 in both groups) from the time of full enteral feeds until 3m CA. UCa/Cr in a spot sample and renal ultrasound were performed both at 40 weeks PMA and 3m CA while DEXA was done at 3m CA.
RESULTS: The prevalence of VDI in '800 IU group' was significantly lower than '400 IU group' at 40 weeks and at 3m CA.
|Prevalence of vitamin D insufficiency|
Vitamin D insufficiency
|RR (95% CI)||NNT (95% CI)||p|
|40±2 weeks n (%)||16 (38)||30 (67)||0.57 (0.37 to 0.88)||4 (2 to 12)||0.008|
|3 months corrected age n (%)||5 (12)||14 (35)||0.36 (0.14 to 0.90)||4 (3 to 20)||0.03|