Association between Vitamin D Insufficiency and Respiratory Problems in Premature Neonates

Abstract

Background: Few studies have been performed to investigate the association between vitamin D and respiratory problems in premature neonates. Methods: In this cohort study, a low serum level of vitamin D was considered as exposure and respiratory problems and associated interventions were considered as outcome. All patients were followed during their hospital stay. All preterm neonates admitted to the neonatal intensive care unit of a general hospital in Iran during one-year period from January 2018 were enrolled in this study. Serum vitamin D level was measured in the first 24 hours of life by liquid chromatography-spectrometry. Then, respiratory complications were compared between neonates with and without vitamin D insufficiency. Results: Among the 113 preterm newborns, 65 (58%) had a low and 48 (42%) had a normal level of vitamin D who were classified into two groups I and II, respectively. Respiratory distress syndrome (RDS) and requirement for surfactant administration was found in 40 cases (61.5%) in group I and in 20 cases (41.7%) in group II (P=0.036). Also, 46 newborns (70.8%) in the first group and 22 (45.8%) in the second group needed non-invasive ventilation (NIV) (P=0.007). Multiple logistic regression showed a significant association between vitamin D status and RDS (OR, 95% CI=2.840 (1.083–7.447), P=0.034), need for surfactant (OR, 95% CI=2.840 (1.083–7.447), P=0.034) and need for NIV (OR, 95% CI=3.929 (1.526–10.113), P=0.005). Conclusion: The incidence of RDS, need for surfactants, and need for NIV in newborns with vitamin D insufficiency were higher than the neonates with normal levels.