Trial of Daily Vitamin D Supplementation in Preterm Infants

1. Chandra Kumar Natarajan, DM^a, 
2. M. Jeeva Sankar, DM^a,
3. Ramesh Agarwal, DM^a, 
4. O. Tejo Pratap, DM^a, 
5. Vandana Jain, MD^b,
6. Nandita Gupta, PhD^c, 
7. Arun Kumar Gupta, MD^d, 
8. Ashok K. Deorari, MD^a, 
9. Vinod K. Paul, MD^a, and 
10. Vishnubhatla Sreenivas, PhD^e
11. Pediatrics. 2014 Mar;133(3):e628-34. doi: 10.1542/peds.2012-3395. Epub 2014 Feb 10.
    
    
    OBJECTIVE: To compare the effect of 800 vs 400 IU of daily oral vitamin D₃on the prevalence of vitamin D deficiency (VDD) at 40 weeks’ postmenstrual age (PMA) in preterm infants of 28 to 34 weeks’ gestation.
    METHODS: In this randomized double-blind trial, we allocated eligible infants to receive either 800 or 400 IU of vitamin D₃ per day (n = 48 in both groups). 
    RESULTS: Prevalence of VDD in the 800-IU group was significantly lower than in the 400-IU group at 40 weeks (38.1% vs 66.7%; relative risk: 0.57; 95% confidence interval: 0.37–0.88) and at 3 months’ CA (12.5% vs 35%; relative risk: 0.36; 95% confidence interval: 0.14–0.90). One infant (2.4%) in the 800-IU group had vitamin D excess (100–150 ng/mL). Bone mineral content (mean ± SD: 79.6 ± 16.8 vs 84.7 ± 20.7 g; P = .27) and bone mineral density (0.152 ± 0.019 vs 0.158 ± 0.021 g/cm²; P = .26) were not different between the 2 groups.
    CONCLUSIONS: Daily supplementation with 800 IU of vitamin D reduces the prevalence of VDD at 40 weeks’ PMA and at 3 months’ CA in preterm infants without showing any improvement in bone mineralization. However, there is a possibility that this dose may occasionally result in vitamin D excess