Mar Romero-Lopez, Mamta Naik, Lindsay F Holzapfel, Ariel A Salas, Kaashif A Ahmad, Matthew A Rysavy, Waldemar A Carlo, Yuxin Zhang, Covi Tibe, Jon E Tyson
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Descriptive statistics compared responses by affiliation and level of care.</p><p><strong>Results: </strong>We analyzed responses from 253 NICUs, representing the majority of academic and level IV centers. Nearly all centers (97%) provided enteral vitamin D supplementation during the NICU stay, with 400 IU/day as the most common dosage (77%). Over half (56%) used feeding volume to initiate supplementation, with 71% of centers starting after achieving at least 120 ml/kg/day. Additionally, 94% of NICUs reported prescribing a vitamin D supplementation at discharge.</p><p><strong>Conclusions: </strong>Most NICUs in the U.S. supplement EP infants with 400 IU/day of enteral vitamin D. Clinical trials of vitamin D supplementation comparing the most common regimen to earlier and higher doses are needed to identify adequate regimens for EP infants.</p><p><strong>Impact: </strong>Despite the prevalence of vitamin D deficiency in extremely preterm (EP) infants at birth, optimal levels and supplementation strategies remain debated. Recent studies have suggested benefits of early high-dose vitamin D supplementation (800 IU/day) for reducing complications like bronchopulmonary dysplasia, infections, and disability. There is US center variation in timing and dose of vitamin D supplementation, being the most common regimen 400 IU/d started after established feedings (≥120 ml/kg/day). These findings inform and highlight the need for clinical trials of usual vs. early, higher-dose vitamin D supplementation to advance clinical outcomes and define desirable blood levels of EP infants.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":null,"pages":null},"PeriodicalIF":3.1000,"publicationDate":"2024-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Survey of vitamin D supplementation practices in extremely preterm infants.\",\"authors\":\"Mar Romero-Lopez, Mamta Naik, Lindsay F Holzapfel, Ariel A Salas, Kaashif A Ahmad, Matthew A Rysavy, Waldemar A Carlo, Yuxin Zhang, Covi Tibe, Jon E Tyson\",\"doi\":\"10.1038/s41390-024-03514-8\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Most extremely preterm (EP) infants are vitamin D deficient (serum 25-hydroxyvitamin D levels below 20 ng/mL), and optimal supplementation practices for EP infants remain unknown. 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引用次数: 0
摘要
背景:大多数极早产儿(EP)缺乏维生素 D(血清 25- 羟维生素 D 水平低于 20 ng/mL),而极早产儿的最佳补充方法仍不清楚。我们的目的是评估美国新生儿重症监护室(NICU)目前为 EP 婴儿补充维生素 D 的做法,为未来临床试验的设计提供基线信息:我们开展了一项在线调查,研究美国新生儿重症监护病房中 EP 婴儿的维生素 D 摄入量和补充方法。结果:我们分析了来自 253 个新生儿重症监护室的回复:我们分析了来自 253 个新生儿重症监护室的回复,其中大多数为学术中心和四级中心。几乎所有中心(97%)都在新生儿重症监护病房住院期间提供肠内维生素 D 补充剂,最常见的剂量为 400 IU/天(77%)。半数以上(56%)的中心使用喂养量来开始补充,71%的中心在喂养量达到至少 120 毫升/千克/天后才开始补充。此外,94% 的新生儿重症监护室报告在出院时开具了维生素 D 补充剂处方:美国大多数新生儿重症监护室为 EP 婴儿补充 400 IU/天的肠内维生素 D:尽管极早产儿出生时普遍缺乏维生素 D,但最佳水平和补充策略仍存在争议。最近的研究表明,早期补充高剂量维生素 D(800 IU/天)有利于减少支气管肺发育不良、感染和残疾等并发症。美国各中心在补充维生素 D 的时间和剂量上存在差异,最常见的方案是在确定喂养量(≥120 毫升/千克/天)后开始补充 400 IU/天。这些研究结果为临床试验提供了信息,并强调了进行常规与早期、高剂量维生素 D 补充剂对比试验的必要性,以提高临床效果并确定 EP 婴儿的理想血药浓度。
Survey of vitamin D supplementation practices in extremely preterm infants.
Background: Most extremely preterm (EP) infants are vitamin D deficient (serum 25-hydroxyvitamin D levels below 20 ng/mL), and optimal supplementation practices for EP infants remain unknown. Our objective is to assess current vitamin D supplementation practices in U.S. neonatal intensive care units (NICU) for EP infants to provide baseline information for the design of future clinical trials.
Methods: We conducted an online survey to study vitamin D intake and supplementation practices in U.S. NICUs caring for EP infants. Descriptive statistics compared responses by affiliation and level of care.
Results: We analyzed responses from 253 NICUs, representing the majority of academic and level IV centers. Nearly all centers (97%) provided enteral vitamin D supplementation during the NICU stay, with 400 IU/day as the most common dosage (77%). Over half (56%) used feeding volume to initiate supplementation, with 71% of centers starting after achieving at least 120 ml/kg/day. Additionally, 94% of NICUs reported prescribing a vitamin D supplementation at discharge.
Conclusions: Most NICUs in the U.S. supplement EP infants with 400 IU/day of enteral vitamin D. Clinical trials of vitamin D supplementation comparing the most common regimen to earlier and higher doses are needed to identify adequate regimens for EP infants.
Impact: Despite the prevalence of vitamin D deficiency in extremely preterm (EP) infants at birth, optimal levels and supplementation strategies remain debated. Recent studies have suggested benefits of early high-dose vitamin D supplementation (800 IU/day) for reducing complications like bronchopulmonary dysplasia, infections, and disability. There is US center variation in timing and dose of vitamin D supplementation, being the most common regimen 400 IU/d started after established feedings (≥120 ml/kg/day). These findings inform and highlight the need for clinical trials of usual vs. early, higher-dose vitamin D supplementation to advance clinical outcomes and define desirable blood levels of EP infants.
期刊介绍:
Pediatric Research publishes original papers, invited reviews, and commentaries on the etiologies of children''s diseases and
disorders of development, extending from molecular biology to epidemiology. Use of model organisms and in vitro techniques
relevant to developmental biology and medicine are acceptable, as are translational human studies