Pediatr Gastroenterol Hepatol Nutr.  2014 Mar;17(1):47-51.

Neonatal Late-onset Hypocalcemia: Is There Any Relationship with Maternal Hypovitaminosis D?

• Do HJ
• Park JS
• Seo JH
• Lee ES
• Park CH
• Woo HO
• Youn HS

Abstract

PURPOSE
Neonatal late-onset hypocalcemia is defined as hypocalcemia developed after postnatal 3 days and associated with hypoparathyroidism, high phosphate diets and vitamin D deficiency. We experienced the increment of neonatal late onset hypocalcemia over 1 year. We tried to evaluate the relationship between late onset hypocalcemia and maternal hypovitaminosis D.
METHODS
The medical records in the neonates with late-onset hypocalcemia during January 2007 to July 2008 were retrospectively reviewed. Among those patients, 17 paired sera of mothers and neonates had collected. The levels of 25-OH vitamin D (25OHD) and intact parathyroid hormone (iPTH) were measured and were compared with neonate and the mother.
RESULTS
The mean gestational age was 38+1 weeks, and the mean body weight was 2,980 g. The onset time of hypocalcemia was 5.9 days of age. Most of them (88.2%) were feeding with formula and no one was only breast milk feeding. Of the 17 patients, 13 were born in spring or in winter. The median levels of calcium, phosphorus, alkaline phosphatase, iPTH and 25OHD were 7.0 mg/dL, 8.6 mg/dL, 191.0 U/L, 57.2 pg/mL and 24.0 ng/mL in neonates. The levels of 25OHD of 6 neonates were <20 ng/mL. A total of 16 mothers were considered vitamin D-deficient (<20 ng/mL), and vitamin D insufficient (20<25OHD<30 ng/mL).
CONCLUSION
Neonatal late-onset hypocalcemia in our study seems to be influenced by maternal vitamin D deficiency and insufficiency. Sun tanning and vitamin D supplements from winter to spring would be helpful to prevent maternal vitamin D deficiency, one of the causes of neonatal late-onset hypocalcemia.

Keyword

Vitamin D deficiency; Mother-newborn pair; Neonatal late-onset hypocalcemia

MeSH Terms

Alkaline Phosphatase
Body Weight
Calcium
Diet
Gestational Age
Humans
Hypocalcemia*
Hypoparathyroidism
Infant, Newborn
Medical Records
Milk, Human
Mothers
Parathyroid Hormone
Phosphorus
Retrospective Studies
Solar System
Tanning
Triacetoneamine-N-Oxyl
Vitamin D
Vitamin D Deficiency
Vitamins
Alkaline Phosphatase
Calcium
Parathyroid Hormone
Phosphorus
Triacetoneamine-N-Oxyl
Vitamin D
Vitamins

Figure

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  Fig. 1 Vitamin D status of mothers of hypocalcemic babies. Most of them showed vitamin D insufficiency and deficiency.

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