Korean J Perinatol.  2015 Dec;26(4):329-335. 10.14734/kjp.2015.26.4.329.

Vitamin D in Full-term Neonates in Daegu and Gyeongbuk Province of Korea and the Association with Maternal and Neonatal Diseases

• Moon JE
• Lee JM
• Ro DE
• Kim HM

• KMID: 2164188
• DOI: http://doi.org/10.14734/kjp.2015.26.4.329

Abstract

PURPOSE
This study aimed to evaluate serum 25-hydroxyvitamin D [25(OH)D3] levels of full-term neonates in Daegu and Gyeongbuk province of Korea to determine the association between maternal and neonatal diseases, known to be affected by low 25(OH)D3 levels.
METHODS
Serum 25(OH)D3 levels were evaluated in full-term neonates (n=122) who were born at Kyungpook National University Hospital. Normal full-term neonates (control group, n=38) were classified by sex, season of birth, and delivery mode (normal or caesarean section). Serum 25(OH)D3 levels in neonates (n=84) with maternal diseases (gestational diabetes mellitus, hypothyroidism, pregnancy induced hypertension, premature rupture of membrane and systemic lupus erythematosus) and neonatal diseases (small for gestational age, transient tachypnea of newborn and pneumonia) were compared with those in control group.
RESULTS
The mean serum 25(OH)D3 level in the control group was 9.2+/-5.0 ng/mL. There were no statistically significant differences of serum 25(OH)D3 level between the control group and the disease group. In the control group, 63.2% of serum 25(OH)D3 levels referred to vitamin D deficiency, and 34.2% referred to vitamin D insufficiency. In the maternal disease group and the neonatal disease group, 56.1% and 63.0% of serum 25(OH)D3 levels referred to vitamin D deficiency, and 35.0% and 33.3% referred to vitamin D insufficiency.
CONCLUSION
High percentages of neonates were found to be deficient or insufficient in vitamin D. Although low 25(OH)D3 levels have previously been associated with maternal and infant diseases, the association was not observed in this study.

Keyword

Vitamin D; Full-term infant; Vitamin D deficiency

MeSH Terms

Daegu*
Diabetes Mellitus
Female
Gestational Age
Gyeongsangbuk-do*
Humans
Hypertension, Pregnancy-Induced
Hypothyroidism
Infant
Infant, Newborn*
Korea*
Membranes
Parturition
Pregnancy
Rupture
Seasons
Transient Tachypnea of the Newborn
Vitamin D Deficiency
Vitamin D*
Vitamins*
Vitamin D
Vitamins

Reference

References

1. Adams JS, Hewison M. Unexpected actions of vitamin D: new perspectives on the regulation of innate and adaptive immunity. Nat Clin Pract Endocrinol Metab. 2008; 4:80–90.

2. Pludowski P, Holick MF, Pilz S, Wagner CL, Hollis BW, Grant WB, et al. Vitamin D effects on musculoskeletal health, immunity, autoimmunity, cardiovascular disease, cancer, fertility, pregnancy, dementia and mortality-a review of recent evidence. Autoimmun Rev. 2013; 12:976–89.

3. Lee JH. Vitamin D: a view of perinatal medicine. Korean J Perinatol. 2011; 22:88–94.

4. Moon RJ, Harvey NC, Cooper C. Endocrinology in pregnancy: Influence of maternal vitamin D status on obstetric outcomes and the fetal skeleton. Eur J Endocrinol. 2015; 173:69–83.

5. Merewood A, Mehta SD, Chen TC, Bauchner H, Holick MF. Association between vitamin D deficiency and primary cesarean section. J Clin Endocrinol Metab. 2009; 94:940–5.

6. Dinlen N, Zenciroglu A, Beken S, Dursun A, Dilli D, Okumus N. Association of vitamin D deficiency with acute lower respiratory tract infections in newborns. J Matern Fetal Neonatal Med. 2016; 29:928–32.

7. Onwuneme C, Martin F, McCarthy R, Carroll A, Segurado R, Murphy J, et al. The association of vitamin D status with acute respiratory morbidity in preterm infants. J Pediatr. 2015; 166:1175–80.

8. Camargo CA Jr, Ingham T, Wickens K, Thadhani R, Silvers KM, Epton MJ, et al. Cord-blood 25-hydroxyvitamin D levels and risk of respiratory infection, wheezing, and asthma. Pediatrics. 2011; 127:e180–7.

9. Ben-Shoshan M. Vitamin D deficiency/insufficiency and challenges in developing global vitamin D fortification and supplementation policy in adults. Int J Vitam Nutr Res. 2012; 82:237–59.

10. Nah EH, Kim S, Cho HI. Vitamin D levels and prevalence of vitamin D deficiency associated with sex, age, region, and season in Koreans. Lab Med Online. 2015; 5:84–91.

11. Kim SH, Oh MK, Namgung R, Park MJ. Prevalence of 25-hydroxyvitamin D deficiency in Korean adolescents: association with age, season and parental vitamin D status. Public Health Nutr. 2014; 17:122–30.

12. Saraf R, Morton SM, Camargo CA Jr, Grant CC. Global summary of maternal and newborn vitamin D status – a systematic review. Matern Child Nutr. In press. 2015.

13. Na B, No S, Kim MJ, Han HS, Jeong EH, Han Y, et al. Nutritional status of vitamin D in Korean mothers and their newborn infants. Korean J Perinatol. 2007; 18:399–406.

14. Shin YH, Yu J, Kim KW, Ahn K, Hong SA, Lee E, et al. Association between cord blood 25-hydroxyvitamin D concentrations and respiratory tract infections in the first 6 months of age in a Korean population: a birth cohort study (COCOA). Korean J Pediatr. 2013; 56:439–45.

15. Cho WI, Yu HW, Chung HR, Shin CH, Yang SW, Choi CW, et al. Clinical and laboratory characteistics of neonatal hypocalcemia. Ann Pediatr Endocrinol Metab. 2015; 20:86–91.

16. Do HJ, Park JS, Seo JH, Lee ES, Park CH, Woo HO, et al. Neonatal late-onset hypocalcemia: Is there any relationship with maternal hypovitaminosis D? Pediatr Gastroenterol Hepatol Nutr. 2014; 17:47–51.

17. Prevention and management of osteoporosis. World Health Organ Tech Rep Ser. 2003; 921:1–164.

18. Grant CC, Stewart AW, Scragg R, Milne T, Rowden J, Ekeroma A, et al. Vitamin D during pregnancy and infancy and infant serum 25-hydroxyvitamin D concentration. Pediatrics. 2014; 133:e143–53.

19. Aghajafari F, Nagulesapillai T, Ronksley PE, Tough SC, O'Beirne M, Rabi DM. Association between maternal serum 25-hydroxyvitamin D level and pregnancy and neonatal outcomes: systematic review and metaanalysis of observational studies. BMJ. 2013; 346:f1169.

20. Park S, Yoon HK, Ryu HM, Han YJ, Lee SW, Park BK, et al. Maternal vitamin D deficiency in early pregnancy is not associated with gestational diabetes mellitus development or pregnancy outcomes in Korean pregnant women in a prospective study. J Nutr Sci Vitaminol. 2014; 60:269–75.

21. Choi R, Kim S, Yoo H, Cho YY, Kim SW, Chung JH, et al. High prevalence of vitamin D deficiency in pregnant Korean women: the first trimester and the winter season as risk factors for vitamin D deficiency. Nutrients. 2015; 7:3427–48.

22. Chen YH, Fu L, Hao JH, Yu Z, Zhu P, Wang H, et al. Maternal vitamin D deficiency during pregnancy elevates the risks of small for gestational age and low birth weight infants in Chinese population. J Clin Endocrinol Metab. 2015; 100:1912–9.

23. Burris HH, Rifas-Shiman SL, Camargo CA Jr, Litonjua AA, Huh SY, Rich-Edwards JW, et al. Plasma 25-hydroxyvita-min D during pregnancy and small-for-gestational age in black and white infants. Ann Epidemiol. 2012; 22:581–6.

24. Konca C, Kahramaner Z, Bulbul M, Erdemir A, Tekin M, Ercan S, et al. Association between serum 25-hydroxy-vitamin D levels and TTN. Horm Res Paediatr. 2014; 81:397–401.

25. Lykkedegn S, Sorensen GL, Beck-Nielsen SS, Christesen HT. The impact of vitamin D on fetal and neonatal lung maturation. A systematic review. Am J Physiol Lung Cell Mol Physiol. 2015 1; 308:L587–602.

26. Pérez-López FR, Pasupuleti V, Mezones-Holguin E, Benites-Zapata VA, Thota P, Deshpande A, et al. Effect of vitamin D supplementation during pregnancy on maternal and neonatal outcomes: a systematic review and metaanalysis of randomized controlled trials. Fertil Steril. 2015; 103:1278–88.