Effects of Vitamin D deficiency and supplementation on 25(OH)D3 levels and neuropsychobehavioral development in premature infants.
Efectos de la deficiencia de vitamina D y la suplementación sobre los niveles de 25(OH)D3 y el desarrollo neuropsicológicoconductual en bebés prematuros.
Abstract
This study systematically examined how vitamin D metabolic imbalance impacts 25(OH)D3 levels and neuropsychological development in premature infants and proposed a personalized supplementation approach. Premature infants were classified as adequate, insufficient, or deficient based on umbilical cord blood 25(OH)D3 levels and then randomly assigned to either a standard-dose group (800 IU/d) or an individualized supplementation group (400-1000 IU/d) with vitamin D. In the vitamin D-deficient group, infants receiving personalized supplementation had significantly higher 25(OH)D3 levels at three and nine months, adjusted for gestational age, than those receiving the fixed dose, indicating that 1000 IU/d is more effective than 800 IU/d for correcting deficiency (p<0.05). At nine and 18 months adjusted gestational age, infants in the vitamin D-insufficient and deficient groups scored significantly lower on the Gesell Developmental Scales across categories such as gross motor, fine motor, language, adaptive, and social skills compared to the adequate group (p<0.05). Within the deficient group, those receiving personalized supplementation scored higher in all five areas at both nine and 18 months adjusted gestational age compared to those on the fixed dose (p<0.05). The study highlights notable differences in umbilical cord blood 25(OH)D3 levels among premature infants, emphasizing that a customized vitamin D supplement protocol is more effective for correcting deficiencies.
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References
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De Beritto TV, Chu A. The Evolving Need for Neonatal Care: From the Pre- mature Infant to the Rare Disease. Pediatr Ann. 2023;52(8):e282. https://doi.org/10.3928/19382359-20230613-03.
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Mansur JL, Oliveri B, Giacoia E, Fusaro D, Costanzo PR. Vitamin D: Before, during and after Pregnancy: Effect on Neonates and Children. Nutrients. 2022;14(9):1900. https://doi.org/10.3390/nu14091900.
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Abrams SA. Vitamin D and bone minerals in neonates. Early Hum Dev. 2021;162:105461. https://doi.org/10.1016/j.earlhumdev.2021.105461.
Chinnappan A, Sharma A, Agarwal R, Thukral A, Deorari A, Sankar MJ. Fortification of Breast Milk with Preterm Formula Powder vs Human Milk Fortifier in Preterm Neonates: A Randomized Noninferiority Trial. JAMA Pediatr. 2021;175(8):790-796. https://doi.org/10.1001/jamapediatrics.2021.0678.
Chacham S, Pasi R, Chegondi M, Ahmad N, Mohanty SB. Metabolic Bone Disease in Premature Neonates: An Unmet Challenge. J Clin Res Pediatr Endocrinol. 2020;12(4):332-339. https://doi.org/10.4274/jcrpe.galenos.2019.2019.0091.
Stoica AB, Mărginean C. The Impact of Vitamin D Deficiency on Infants’ Health. Nutrients. 2023;15(20):4379. https://doi.org/10.3390/nu15204379.
Jafari N, Taslimi Taleghani N, Kazemi SA, Abouoasef S, Motamed N, Jalilvand A. Association between Vitamin D Insufficiency and Respiratory Problems in Premature Neonates. Arch Iran Med. 2022;25(1):32-36. https://doi.org/10.34172/aim.2022.06.
Taiorazova G, Alimbaeva A, Tanatarov S. The role of vitamin D and trace elements in premature newborns with congenital pneumonia. Bratisl Lek Listy. 2023;124(8):572-577. https://doi.org/10.4149/BLL_2023_089.
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van den Heuvel EG, Lips P, Schoonmade LJ, Lanham-New SA, van Schoor NM. Comparison of the Effect of Daily Vitamin D2 and Vitamin D3 Supplementation on Serum 25-Hydroxyvitamin D Concentration (Total 25(OH)D, 25(OH)D2, and 25(OH) D3) and Importance of Body Mass Index: A Systematic Review and Meta-Analysis. Adv Nutr. 2024;15(1):100133. https://doi.org/10.1016/j.advnut.2023.09.016.
Płudowski P, Kos-Kudła B, Walczak M, Fal A, Zozulińska-Ziółkiewicz D, Sieroszewski P, et al. Guidelines for Preventing and Treating Vitamin D Deficiency: A 2023 Up-date in Poland. Nutrients. 2023;15(3):695. https://doi.org/10.3390/nu15030695.
Liu CC, Huang JP. Potential benefits of vitamin D supplementation on pregnancy. J Formos Med Assoc. 2023;122(7):557-563. https://doi.org/10.1016/j.jfma.2023.02.004.
Kumar M, Shaikh S, Sinha B, Upadhyay RP, Choudhary TS, Chandola TR, et al. Enteral Vitamin D Supplementation in Preterm or Low Birth Weight Infants: A Systematic Review and Meta-analysis. Pediatrics. 2022;150(Suppl 1):e2022057092K. https://doi.org/10.1542/peds.2022-057092K.
Fisher M, Marro L, Arbuckle TE, Potter BK, Little J, Weiler H, et al. Association between toxic metals, vitamin D and preterm birth in the Maternal-Infant research on environmental chemicals study. Paediatr Perinat Epidemiol. 2023;37(5):447- 457. https://doi.org/10.1111/ppe.12962.
Guo H, Xie J, Yu X, Tian Y, Guan M, Wei J. Effects of vitamin D supplementation on serum 25(OH)D(3) levels and neurobehavioral development in premature infants after birth. Sci Rep. 2024;14(1):23972. https://doi.org/10.1038/s41598-024-75191-w.
Chen GD, Pang TT, Li PS, Zhou ZX, Lin DX, Fan DZ, et al. Early pregnancy vitamin D and the risk of adverse maternal and infant outcomes: a retrospective cohort study. BMC Pregnancy Childbirth. 2020;20(1):465. https://doi.org/10.1186/s12884-020-03158-6.
Motlagh AJ, Davoodvandi A, Saeieh SE. Association between vitamin D level in mother’s serum and the level of vitamin D in the serum of pre-term infants. BMC Pediatr. 2023;23(1):97. https://doi.org/10.1186/s12887-023-03854-0.
Bollen SE, Bass JJ, Fujita S, Wilkinson D, Hewison M, Atherton PJ. The Vitamin D/Vitamin D receptor (VDR) axis in muscle atrophy and sarcopenia. Cell Signal. 2022;96:110355. https://doi.org/10.1016/j.cellsig.2022.110355.
Aggeletopoulou I, Thomopoulos K, Mouzaki A, Triantos C. Vitamin D-VDR Novel Anti-Inflammatory Molecules-New Insights into Their Effects on Liver Diseases. Int J Mol Sci. 2022;23(15):8465. https://doi.org/10.3390/ijms23158465.
Voutsadakis IA. Vitamin D receptor (VDR) and metabolizing enzymes CYP27B1 and CYP24A1 in breast cancer. Mol Biol Rep. 2020;47(12):9821-9830. https://doi.org/10.1007/s11033-020-05780-1.
Usategui-Martín R, De Luis-Román DA, Fernández-Gómez JM, Ruiz-Mambrilla M, Pérez-Castrillón JL. Vitamin D Receptor (VDR) Gene Polymorphisms Modify the Response to Vitamin D Supplementation: A Systematic Review and Meta-Analysis. Nutrients. 2022;14(2):360. https://doi.org/10.3390/nu14020360.
Bacchetta J, Edouard T, Laverny G, Bernardor J, Bertholet-Thomas A, Castanet M, et al. Vitamin D and calcium in-takes in general pediatric populations: A French expert consensus paper. Arch Pediatr. 2022;29(4):312-325. https://doi.org/10.1016/j.arcped.2022.02.008.
Artman A, Huang A, Bowker R, Cerwinske L, Cooper S, Johnson T, et al. Evaluation of vitamin D protocol in the neonatal intensive care unit at Rush University Medical Center. JPEN J Parenter Enteral Nutr. 2022;46(3):618-625. https://doi.org/10.1002/jpen.2138.
Golan-Tripto I, Bistritzer J, Loewenthal N, Staretz-Chacham O, Dizitzer Y, Goldbart A. The effect of vitamin D administration on vitamin D status and respiratory morbidity in late premature infants. Pediatr Pulmonol. 2020;55(11):3080-3087. https://doi.org/10.1002/ppul.25006.
Irwinda R, Hiksas R, Lokeswara AW, Wibowo N. Vitamin D supplementation higher than 2000 IU/day compared to lower dose on maternal-fetal outcome: Systematic review and meta-analysis. Womens Health (Lond). 2022;18:17455057221111066. https://doi.org/10.1177/17455057221111066.
Rizzoli R. Vitamin D supplementation: upper limit for safety revisited? Aging Clin Exp Res 2021;33(1):19-24. https://doi.org/10.1007/s40520-020-01678-x.
Kołodziejczyk-Nowotarska A, Bokiniec R, Seliga-Siwecka J. Monitored Supplementation of Vitamin D in Preterm Infants: A Randomized Controlled Trial. Nutrients. 2021;13(10):3442. https://doi.org/10.3390/nu13103442.
Matejek T, Zapletalova B, Stepan M, Malakova J, Palicka V. Dynamics of the vitamin D C3-epimer levels in preterm infants. Clin Chem Lab Med. 2023;61(6):1084-94. https://doi.org/10.1515/cclm-2022-1128.
Romero-Lopez M, Tyson JE, Naik M, Pedroza C, Holzapfel LF, Avritscher E, et al. Randomized controlled trial of enteral vitamin D supplementation (ViDES) in infants <28 weeks gestational age or <1000 g birth weight: study protocol. Trials. 024;25(1):423. https://doi.org/10.1186/s13063-024-08274-8.
Jung JH, Kim EA, Lee SY, Moon JE, Lee EJ, Park SH. Vitamin D Status and Factors Associated with Vitamin D Deficiency during the First Year of Life in Preterm Infants. Nutrients. 021;13(6):2019. https://doi.org/10.3390/nu13062019.
Aristizabal N, Holder MP, Durham L, Ashraf AP, Taylor S, Salas AA. Safety and Efficacy of Early Vitamin D Supplementation in Critically Ill Extremely Preterm Infants: An Ancillary Study of a Randomized Trial. J Acad Nutr Diet. 2023;123(1):87- 94. https://doi.org/10.1016/j.jand.2022. 06.012.
Lo ACQ, Lo CCW. The effect of vitamin D supplementation on glycemic control/glucose metabolism and maternal-neonatal outcomes in women with established gestational diabetes mellitus: An updated meta-analysis. Clin Nutr. 2022;41(10):2420-2423. https://doi.org/10.1016/j.clnu.2022.08.014.
Cho MC, Cho IA, Seo HK, Kang MJ, Jo JY, Shin JK, et al. Serum vitamin D-binding protein (VDBP) concentration and rs7041 genotype may be associated with pre-term labor. J Matern Fetal Neonatal Med 2022;35(25):9422-9429. https://doi.org/10.1080/14767058.2022.2040475.
Tang WQ, Ma N, Meng LY, Luo YW, Wang YJ, Zhang D. Vitamin D supplementation improved physical growth and neurologic development of Preterm Infants receiving Nesting Care in the neonatal Intensive Care Unit. BMC Pediatr 2023;23(1):248. https://doi.org/10.1186/s12887-023-04075-1.
Jamali Z, Ghorbani F, Shafie’ei M, Tolooefar F, Maleki E. Risk factors associated with vitamin D deficiency in preterm neonates: a single-center step-wise regression analysis. BMC Pediatr 2023;23(1):324. https://doi.org/10.1186/s12887-023-04088-w.
Lian RH, Qi PA, Yuan T, Yan PJ, Qiu WW, Wei Y, et al. Systematic review and meta-analysis of vitamin D deficiency in different pregnancy on preterm birth: Deficiency in middle pregnancy might be at risk. Medicine (Baltimore). 2021;100(24):e26303. https://doi.org/10.1097/MD.0000000000026303.
Sarıdemir H, Surmeli Onay O, Aydemir O, Tekin AN. Questioning the adequacy of standardized vitamin D supplementation protocol in very low birth weight infants: a prospective cohort study. J Pediatr Endocrinol Metab 2021;34(12):1515-1523. https://doi.org/10.1515/jpem-2021-0390.
Treiber M, Mujezinović F, Pečovnik Balon B, Gorenjak M, Maver U, Dovnik A. Association between umbilical cord vitamin D levels and adverse neonatal outcomes. J Int Med Res 2020;48(10):300060520955001. https://doi.org/10.1177/0300060520955001.
Ashrafizadeh M. Cell Death Mechanisms in Human Cancers: Molecular Pathways, Therapy Resistance and Therapeutic Perspective. J Can Biomol Therap 2024;1(1):17- 40. https://doi.org/10.62382/jcbt.v1i1.13.
Jiang X, Lu J, Zhang Y, Teng H, Pei J, Zhang C, et al. Association between maternal vitamin D status with pregnancy outcomes and offspring growth in a population of Wuxi, China. Asia Pac J Clin Nutr 2021;30(3):464-476. https://doi.org/10.6133/apjcn.202109_30(3).0013.
Ren J. Advances in combination therapy for gastric cancer: integrating targeted agents and immunotherapy. Adv Clin Pharmacol Ther 2024;1(1):1-15. https://doi.org/10.63623/9k14tf70.
Amiri M, Rostami M, Sheidaei A, Fallahzadeh A, Ramezani Tehrani F. Mode of delivery and maternal vitamin D deficiency: an optimized intelligent Bayesian network algorithm analysis of a stratified randomized controlled field trial. Sci Rep 2023;13(1):8682. https://doi.org/10.1038/s41598-023-35838-6.
Kaempf JW, Gautham K. Do small baby units improve extremely premature infant outcomes? J Perinatol. 2022;42(2):281- 285. https://doi.org/10.1038/s41372-021-01076-9.
De Beritto TV, Chu A. The Evolving Need for Neonatal Care: From the Pre- mature Infant to the Rare Disease. Pediatr Ann. 2023;52(8):e282. https://doi.org/10.3928/19382359-20230613-03.
Flake AW. A supportive physiologic environment for the extreme premature infant: Improving life outside the womb. J Pediatr Surg. 2022;57(2):167-171. https://doi.rg/10.1016/j.jpedsurg.2021.10.025.
Mansur JL, Oliveri B, Giacoia E, Fusaro D, Costanzo PR. Vitamin D: Before, during and after Pregnancy: Effect on Neonates and Children. Nutrients. 2022;14(9):1900. https://doi.org/10.3390/nu14091900.
Zhang H, Wang S, Tuo L, Zhai Q, Cui J, Chen D, Xu D. Relationship between Maternal Vitamin D Levels and Adverse Outcomes. Nutrients. 2022;14(20):4230. https://doi.org/10.3390/nu14204230.
Abrams SA. Vitamin D and bone minerals in neonates. Early Hum Dev. 2021;162:105461. https://doi.org/10.1016/j.earlhumdev.2021.105461.
Chinnappan A, Sharma A, Agarwal R, Thukral A, Deorari A, Sankar MJ. Fortification of Breast Milk with Preterm Formula Powder vs Human Milk Fortifier in Preterm Neonates: A Randomized Noninferiority Trial. JAMA Pediatr. 2021;175(8):790-796. https://doi.org/10.1001/jamapediatrics.2021.0678.
Chacham S, Pasi R, Chegondi M, Ahmad N, Mohanty SB. Metabolic Bone Disease in Premature Neonates: An Unmet Challenge. J Clin Res Pediatr Endocrinol. 2020;12(4):332-339. https://doi.org/10.4274/jcrpe.galenos.2019.2019.0091.
Stoica AB, Mărginean C. The Impact of Vitamin D Deficiency on Infants’ Health. Nutrients. 2023;15(20):4379. https://doi.org/10.3390/nu15204379.
Jafari N, Taslimi Taleghani N, Kazemi SA, Abouoasef S, Motamed N, Jalilvand A. Association between Vitamin D Insufficiency and Respiratory Problems in Premature Neonates. Arch Iran Med. 2022;25(1):32-36. https://doi.org/10.34172/aim.2022.06.
Taiorazova G, Alimbaeva A, Tanatarov S. The role of vitamin D and trace elements in premature newborns with congenital pneumonia. Bratisl Lek Listy. 2023;124(8):572-577. https://doi.org/10.4149/BLL_2023_089.
Vivanti AJ, Monier I, Salakos E, Elie C, Tsatsaris V, Senat MV, et al. Vitamin D and pregnancy outcomes: Overall results of the FEPED study. J Gynecol Obstet Hum Reprod. 2020;49(8):101883. https://doi.org/10.1016/j.jogoh.2020.101883.
Cheng H, Chi P, Zhuang Y, Alifu X, Zhou H, Qiu Y, et al. Association of 25-Hydroxyvitamin D with Preterm Birth and Premature Rupture of Membranes: A Mendelian Randomization Study. Nutrients. 2023;15(16):3593. https://doi.org/10.3390/nu15163593.
Barbosa O, Sim-Sim M, Silvestre MP, Pedro C, Cruz D. Effects of vitamin D levels during pregnancy on prematurity: a systematic review protocol. BMJ Open. 2024;14(2):e076702. https://doi.org/10.1136/bmjopen-2023-076702.
van den Heuvel EG, Lips P, Schoonmade LJ, Lanham-New SA, van Schoor NM. Comparison of the Effect of Daily Vitamin D2 and Vitamin D3 Supplementation on Serum 25-Hydroxyvitamin D Concentration (Total 25(OH)D, 25(OH)D2, and 25(OH) D3) and Importance of Body Mass Index: A Systematic Review and Meta-Analysis. Adv Nutr. 2024;15(1):100133. https://doi.org/10.1016/j.advnut.2023.09.016.
Płudowski P, Kos-Kudła B, Walczak M, Fal A, Zozulińska-Ziółkiewicz D, Sieroszewski P, et al. Guidelines for Preventing and Treating Vitamin D Deficiency: A 2023 Up-date in Poland. Nutrients. 2023;15(3):695. https://doi.org/10.3390/nu15030695.
Liu CC, Huang JP. Potential benefits of vitamin D supplementation on pregnancy. J Formos Med Assoc. 2023;122(7):557-563. https://doi.org/10.1016/j.jfma.2023.02.004.
Kumar M, Shaikh S, Sinha B, Upadhyay RP, Choudhary TS, Chandola TR, et al. Enteral Vitamin D Supplementation in Preterm or Low Birth Weight Infants: A Systematic Review and Meta-analysis. Pediatrics. 2022;150(Suppl 1):e2022057092K. https://doi.org/10.1542/peds.2022-057092K.
Fisher M, Marro L, Arbuckle TE, Potter BK, Little J, Weiler H, et al. Association between toxic metals, vitamin D and preterm birth in the Maternal-Infant research on environmental chemicals study. Paediatr Perinat Epidemiol. 2023;37(5):447- 457. https://doi.org/10.1111/ppe.12962.
Guo H, Xie J, Yu X, Tian Y, Guan M, Wei J. Effects of vitamin D supplementation on serum 25(OH)D(3) levels and neurobehavioral development in premature infants after birth. Sci Rep. 2024;14(1):23972. https://doi.org/10.1038/s41598-024-75191-w.
Chen GD, Pang TT, Li PS, Zhou ZX, Lin DX, Fan DZ, et al. Early pregnancy vitamin D and the risk of adverse maternal and infant outcomes: a retrospective cohort study. BMC Pregnancy Childbirth. 2020;20(1):465. https://doi.org/10.1186/s12884-020-03158-6.
Motlagh AJ, Davoodvandi A, Saeieh SE. Association between vitamin D level in mother’s serum and the level of vitamin D in the serum of pre-term infants. BMC Pediatr. 2023;23(1):97. https://doi.org/10.1186/s12887-023-03854-0.
Bollen SE, Bass JJ, Fujita S, Wilkinson D, Hewison M, Atherton PJ. The Vitamin D/Vitamin D receptor (VDR) axis in muscle atrophy and sarcopenia. Cell Signal. 2022;96:110355. https://doi.org/10.1016/j.cellsig.2022.110355.
Aggeletopoulou I, Thomopoulos K, Mouzaki A, Triantos C. Vitamin D-VDR Novel Anti-Inflammatory Molecules-New Insights into Their Effects on Liver Diseases. Int J Mol Sci. 2022;23(15):8465. https://doi.org/10.3390/ijms23158465.
Voutsadakis IA. Vitamin D receptor (VDR) and metabolizing enzymes CYP27B1 and CYP24A1 in breast cancer. Mol Biol Rep. 2020;47(12):9821-9830. https://doi.org/10.1007/s11033-020-05780-1.
Usategui-Martín R, De Luis-Román DA, Fernández-Gómez JM, Ruiz-Mambrilla M, Pérez-Castrillón JL. Vitamin D Receptor (VDR) Gene Polymorphisms Modify the Response to Vitamin D Supplementation: A Systematic Review and Meta-Analysis. Nutrients. 2022;14(2):360. https://doi.org/10.3390/nu14020360.
Bacchetta J, Edouard T, Laverny G, Bernardor J, Bertholet-Thomas A, Castanet M, et al. Vitamin D and calcium in-takes in general pediatric populations: A French expert consensus paper. Arch Pediatr. 2022;29(4):312-325. https://doi.org/10.1016/j.arcped.2022.02.008.
Artman A, Huang A, Bowker R, Cerwinske L, Cooper S, Johnson T, et al. Evaluation of vitamin D protocol in the neonatal intensive care unit at Rush University Medical Center. JPEN J Parenter Enteral Nutr. 2022;46(3):618-625. https://doi.org/10.1002/jpen.2138.
Golan-Tripto I, Bistritzer J, Loewenthal N, Staretz-Chacham O, Dizitzer Y, Goldbart A. The effect of vitamin D administration on vitamin D status and respiratory morbidity in late premature infants. Pediatr Pulmonol. 2020;55(11):3080-3087. https://doi.org/10.1002/ppul.25006.
Irwinda R, Hiksas R, Lokeswara AW, Wibowo N. Vitamin D supplementation higher than 2000 IU/day compared to lower dose on maternal-fetal outcome: Systematic review and meta-analysis. Womens Health (Lond). 2022;18:17455057221111066. https://doi.org/10.1177/17455057221111066.
Rizzoli R. Vitamin D supplementation: upper limit for safety revisited? Aging Clin Exp Res 2021;33(1):19-24. https://doi.org/10.1007/s40520-020-01678-x.
Kołodziejczyk-Nowotarska A, Bokiniec R, Seliga-Siwecka J. Monitored Supplementation of Vitamin D in Preterm Infants: A Randomized Controlled Trial. Nutrients. 2021;13(10):3442. https://doi.org/10.3390/nu13103442.
Matejek T, Zapletalova B, Stepan M, Malakova J, Palicka V. Dynamics of the vitamin D C3-epimer levels in preterm infants. Clin Chem Lab Med. 2023;61(6):1084-94. https://doi.org/10.1515/cclm-2022-1128.
Romero-Lopez M, Tyson JE, Naik M, Pedroza C, Holzapfel LF, Avritscher E, et al. Randomized controlled trial of enteral vitamin D supplementation (ViDES) in infants <28 weeks gestational age or <1000 g birth weight: study protocol. Trials. 024;25(1):423. https://doi.org/10.1186/s13063-024-08274-8.
Jung JH, Kim EA, Lee SY, Moon JE, Lee EJ, Park SH. Vitamin D Status and Factors Associated with Vitamin D Deficiency during the First Year of Life in Preterm Infants. Nutrients. 021;13(6):2019. https://doi.org/10.3390/nu13062019.
Aristizabal N, Holder MP, Durham L, Ashraf AP, Taylor S, Salas AA. Safety and Efficacy of Early Vitamin D Supplementation in Critically Ill Extremely Preterm Infants: An Ancillary Study of a Randomized Trial. J Acad Nutr Diet. 2023;123(1):87- 94. https://doi.org/10.1016/j.jand.2022. 06.012.
Lo ACQ, Lo CCW. The effect of vitamin D supplementation on glycemic control/glucose metabolism and maternal-neonatal outcomes in women with established gestational diabetes mellitus: An updated meta-analysis. Clin Nutr. 2022;41(10):2420-2423. https://doi.org/10.1016/j.clnu.2022.08.014.
Cho MC, Cho IA, Seo HK, Kang MJ, Jo JY, Shin JK, et al. Serum vitamin D-binding protein (VDBP) concentration and rs7041 genotype may be associated with pre-term labor. J Matern Fetal Neonatal Med 2022;35(25):9422-9429. https://doi.org/10.1080/14767058.2022.2040475.
Tang WQ, Ma N, Meng LY, Luo YW, Wang YJ, Zhang D. Vitamin D supplementation improved physical growth and neurologic development of Preterm Infants receiving Nesting Care in the neonatal Intensive Care Unit. BMC Pediatr 2023;23(1):248. https://doi.org/10.1186/s12887-023-04075-1.
Jamali Z, Ghorbani F, Shafie’ei M, Tolooefar F, Maleki E. Risk factors associated with vitamin D deficiency in preterm neonates: a single-center step-wise regression analysis. BMC Pediatr 2023;23(1):324. https://doi.org/10.1186/s12887-023-04088-w.
Lian RH, Qi PA, Yuan T, Yan PJ, Qiu WW, Wei Y, et al. Systematic review and meta-analysis of vitamin D deficiency in different pregnancy on preterm birth: Deficiency in middle pregnancy might be at risk. Medicine (Baltimore). 2021;100(24):e26303. https://doi.org/10.1097/MD.0000000000026303.
Sarıdemir H, Surmeli Onay O, Aydemir O, Tekin AN. Questioning the adequacy of standardized vitamin D supplementation protocol in very low birth weight infants: a prospective cohort study. J Pediatr Endocrinol Metab 2021;34(12):1515-1523. https://doi.org/10.1515/jpem-2021-0390.
Treiber M, Mujezinović F, Pečovnik Balon B, Gorenjak M, Maver U, Dovnik A. Association between umbilical cord vitamin D levels and adverse neonatal outcomes. J Int Med Res 2020;48(10):300060520955001. https://doi.org/10.1177/0300060520955001.
Ashrafizadeh M. Cell Death Mechanisms in Human Cancers: Molecular Pathways, Therapy Resistance and Therapeutic Perspective. J Can Biomol Therap 2024;1(1):17- 40. https://doi.org/10.62382/jcbt.v1i1.13.
Jiang X, Lu J, Zhang Y, Teng H, Pei J, Zhang C, et al. Association between maternal vitamin D status with pregnancy outcomes and offspring growth in a population of Wuxi, China. Asia Pac J Clin Nutr 2021;30(3):464-476. https://doi.org/10.6133/apjcn.202109_30(3).0013.
Ren J. Advances in combination therapy for gastric cancer: integrating targeted agents and immunotherapy. Adv Clin Pharmacol Ther 2024;1(1):1-15. https://doi.org/10.63623/9k14tf70.
Amiri M, Rostami M, Sheidaei A, Fallahzadeh A, Ramezani Tehrani F. Mode of delivery and maternal vitamin D deficiency: an optimized intelligent Bayesian network algorithm analysis of a stratified randomized controlled field trial. Sci Rep 2023;13(1):8682. https://doi.org/10.1038/s41598-023-35838-6.
Published
2026-03-04
How to Cite
Guo, X., Sun, Y., Chen, Y., Xu , F., & Li, Y. (2026). Effects of Vitamin D deficiency and supplementation on 25(OH)D3 levels and neuropsychobehavioral development in premature infants.: Efectos de la deficiencia de vitamina D y la suplementación sobre los niveles de 25(OH)D3 y el desarrollo neuropsicológicoconductual en bebés prematuros. Investigación Clínica, 67(1), 5-18. https://doi.org/10.54817/IC.v67n1a01
Section
Original Works
