Low Vitamin D Levels at Birth and Early Respiratory Outcome in Infants With Gestational Age Less Than 29 Weeks

Honoré Papalia; Anais Samonini; Christophe Buffat; E Gras; Clotilde des Robert; Jean-Francois Landrier; Vanessa Pauly; Farid Boubred

doi:10.3389/fped.2021.790839

Low Vitamin D Levels at Birth and Early Respiratory Outcome in Infants With Gestational Age Less Than 29 Weeks

Front Pediatr. 2022 Jan 21:9:790839. doi: 10.3389/fped.2021.790839. eCollection 2021.

Authors

Honoré Papalia¹, Anais Samonini¹, Christophe Buffat², E Gras¹, Clotilde des Robert¹, Jean-Francois Landrier³, Vanessa Pauly⁴, Farid Boubred^{1

3}

Affiliations

¹ Neonatal Unit, Hospital University La Conception, APHM, Marseille, France.
² Laboratory of Biochemistry and Molecular Biology, Hospital University la Conception, APHM, Marseille, France.
³ Aix-Marseille University, INSERM, INRAE, C2VN, Marseille, France.
⁴ EA 3279, CEReSS-Health Service Research and Quality of Life Center, Public Health and Medical Information Department, APHM, Marseille, France.

Abstract

Background: Vitamin 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.

Methods: Cord 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.

Results: The 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).

Conclusion: Low 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.

Keywords: LISA (less invasive surfactant administration); RDS—respiratory distress syndrome; SGA (samll for gestational age); bronchopulmonary dysplasia; extremely preterm infants; nasal CPAP (continuous positive airway pressure); surfactant; vitamin D.