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Background <p>Preterm infants are at high risk for vitamin D deficiency due to limited transplacental transfer and increased postnatal requirements. Optimal vitamin D supplementation dosing in this population remains controversial.</p> Objective <p>To compare the effects of 400 IU/day versus 800 IU/day vitamin D supplementation on serum 25-hydroxyvitamin D [25(OH)D] levels, mineral metabolism, renal outcomes, and neonatal morbidities in preterm infants.</p> Methods <p>In this prospective cohort study, 66 preterm infants born at ≤ 34 weeks’ gestation and admitted to the neonatal intensive care unit (NICU) were followed. Infants were categorized into two groups according to the documented daily vitamin D supplementation regimen used in routine clinical practice (400 IU/day or 800 IU/day). Serum 25(OH)D, calcium, phosphorus, and alkaline phosphatase (ALP) levels were measured at admission and at 1 and 2 months postnatally. Renal ultrasonography and urinary calcium-to-creatinine (Ca/Cr) ratios were evaluated at 2 months. Neonatal morbidities, including bronchopulmonary dysplasia (BPD), were recorded.</p> Results <p>At admission, vitamin D deficiency or insufficiency (&lt; 20 ng/mL) was highly prevalent in both groups. By postnatal 1 month, more than 90% of infants achieved vitamin D sufficiency, and all infants were sufficient by 2 months. The increase in serum 25(OH)D from admission to 2 months was significantly greater in the 800 IU/day group (<i>p</i> = 0.040). Calcium, phosphorus, and ALP levels remained within physiological ranges in both groups. No cases of vitamin D toxicity were observed, and renal ultrasonography findings were comparable between groups. In the unadjusted analysis, the incidence of BPD was lower in infants receiving 800 IU/day compared with those receiving 400 IU/day.</p> Conclusion <p>Vitamin D supplementation with 800 IU/day appeared metabolically safe in preterm infants and resulted in greater increases in serum 25(OH)D levels compared with 400 IU/day. A lower incidence of BPD was observed in the higher-dose group, although randomized controlled trials are needed to confirm these findings.</p> Clinical Trial Registration <p>Not applicable.</p>

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Impact of different vitamin D supplementation doses on vitamin D status and bone metabolism in preterm infants

  • 期刊论文

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  • 发表日期：

    2026年4月7日

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  • Dilek Kurnaz,
  • Burcu Cebeci,
  • Hakan Cakir,
  • Berker Okay,
  • Derya Büyükkayhan

摘要

Background

Preterm infants are at high risk for vitamin D deficiency due to limited transplacental transfer and increased postnatal requirements. Optimal vitamin D supplementation dosing in this population remains controversial.

Objective

To compare the effects of 400 IU/day versus 800 IU/day vitamin D supplementation on serum 25-hydroxyvitamin D [25(OH)D] levels, mineral metabolism, renal outcomes, and neonatal morbidities in preterm infants.

Methods

In this prospective cohort study, 66 preterm infants born at ≤ 34 weeks’ gestation and admitted to the neonatal intensive care unit (NICU) were followed. Infants were categorized into two groups according to the documented daily vitamin D supplementation regimen used in routine clinical practice (400 IU/day or 800 IU/day). Serum 25(OH)D, calcium, phosphorus, and alkaline phosphatase (ALP) levels were measured at admission and at 1 and 2 months postnatally. Renal ultrasonography and urinary calcium-to-creatinine (Ca/Cr) ratios were evaluated at 2 months. Neonatal morbidities, including bronchopulmonary dysplasia (BPD), were recorded.

Results

At admission, vitamin D deficiency or insufficiency (< 20 ng/mL) was highly prevalent in both groups. By postnatal 1 month, more than 90% of infants achieved vitamin D sufficiency, and all infants were sufficient by 2 months. The increase in serum 25(OH)D from admission to 2 months was significantly greater in the 800 IU/day group (p = 0.040). Calcium, phosphorus, and ALP levels remained within physiological ranges in both groups. No cases of vitamin D toxicity were observed, and renal ultrasonography findings were comparable between groups. In the unadjusted analysis, the incidence of BPD was lower in infants receiving 800 IU/day compared with those receiving 400 IU/day.

Conclusion

Vitamin D supplementation with 800 IU/day appeared metabolically safe in preterm infants and resulted in greater increases in serum 25(OH)D levels compared with 400 IU/day. A lower incidence of BPD was observed in the higher-dose group, although randomized controlled trials are needed to confirm these findings.

Clinical Trial Registration

Not applicable.