Randomised controlled trial of vitamin D supplementation on bone density and biochemical indices in preterm infants
a Department of
Paediatrics, Tampere University Hospital,
Tampere, Finland, b Department of Clinical Chemistry, c UKK Institute,
Tampere, Finland, d Institute of Medical
Technology, University of Tampere, e Tampere School of Public Health,
University of Tampere,
Tampere
Correspondence to: Dr Maria Backström Karlebyvägen 1457 66530, Kvevlax Finland. Email: maria.backstrom{at}pp.qnet.fi
Accepted 27 October
1998
AIMS
To test the
hypothesis that a vitamin D dose of 200 IU/kg, maximum 400 IU/day,
given to preterm infants will maintain normal vitamin D status and will
result in as high a bone mineral density as that attained with the
recommended dose of 960 IU/day.
METHODSThirty nine
infants of fewer than 33 weeks of gestational age were randomly
allocated to receive vitamin D 200 IU/kg of body weight/day up to a
maximum of 400 IU/day or 960 IU/day until 3 months old. Vitamin D
metabolites, bone mineral content and density were determined by dual
energy x-ray absorptiometry, and plasma ionised calcium, plasma alkaline phosphatase, and intact parahormone measurements were used to evaluate outcomes.
RESULTSThe 25 hydroxy
vitamin D concentrations tended to be higher in infants receiving 960 IU/day, but the differences did not reach significance at any age.
There was no difference between the infants receiving low or high
vitamin D dose in bone mineral content nor in bone mineral density at 3 and 6 months corrected age, even after taking potential risk factors
into account.
CONCLUSIONSA vitamin
D dose of 200 IU/kg of body weight/day up to a maximum of 400 IU/day
maintains normal vitamin D status and as good a bone mineral accretion
as the previously recommended higher dose of 960 IU/day. Vitamin D is a
potent hormone which affects organs other than bone and should not be
given in excess to preterm infants.
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Key points
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Keywords: vitamin D; preterm infant; bone mineral density
© 1999 by Archives of Disease in Childhood
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