scholarly journals Dose-Response Effects of Early Vitamin D Supplementation on Neurodevelopmental and Respiratory Outcomes of Extremely Preterm Infants at 2 Years of Age: A Randomized Trial

Neonatology ◽  
2018 ◽  
Vol 113 (3) ◽  
pp. 256-262 ◽  
Author(s):  
Ariel A. Salas ◽  
Taylor Woodfin ◽  
Vivien Phillips ◽  
Myriam Peralta-Carcelen ◽  
Waldemar A. Carlo ◽  
...  
Keyword(s):  
Vitamin D ◽  
Randomized Trial ◽  
Preterm Infants ◽  
Dose Response ◽  
Vitamin D Supplementation ◽  
Extremely Preterm ◽  
Extremely Preterm Infants ◽  
Respiratory Outcomes

scholarly journals A Comparison of 3 Vitamin D Dosing Regimens in Extremely Preterm Infants: A Randomized Controlled Trial

2016 ◽  
Vol 174 ◽  
pp. 132-138.e1 ◽  
Author(s):  
Prem Fort ◽  
Ariel A. Salas ◽  
Teodora Nicola ◽  
Carolyne M. Craig ◽  
Waldemar A. Carlo ◽  
...  
Keyword(s):  
Vitamin D ◽  
Randomized Controlled Trial ◽  
Preterm Infants ◽  
Controlled Trial ◽  
Randomized Controlled ◽  
Extremely Preterm ◽  
Extremely Preterm Infants ◽  
Dosing Regimens

scholarly journals Bronchopulmonary Dysplasia: Can We Agree on a Definition?

2018 ◽  
Vol 35 (06) ◽  
pp. 537-540 ◽  
Author(s):  
Deepak Jain ◽  
Eduardo Bancalari
Keyword(s):  
Respiratory Failure ◽  
Preterm Infants ◽  
Bronchopulmonary Dysplasia ◽  
Nasal Cannula ◽  
Clinical Practices ◽  
Unique Challenge ◽  
Extremely Preterm ◽  
Extremely Preterm Infants ◽  
Respiratory Outcomes

AbstractThe advances in obstetric and neonatal care over the last half century have resulted in changes in pathophysiology and clinical presentation of bronchopulmonary dysplasia (BPD). In contrast to the original description of BPD by Northway et al as a severe lung injury in relatively mature preterm infants, the most common form of BPD currently is characterized by chronic respiratory insufficiency in extremely preterm infants. This evolution in the presentation of BPD, along with changes in respiratory support strategies such as increased use of nasal cannula oxygen, has presented a unique challenge to find a definition that describes the severity of lung damage and predict the long-term respiratory outcomes with some accuracy.The limitations of current definitions of BPD include inconsistent correlation with long-term respiratory outcomes, inability to classify infants dying from severe respiratory failure prior to 36 weeks' postmenstrual age, and potential inappropriate categorization of infants on nasal cannula oxygen or with extrapulmonary causes of respiratory failure. In the long term, the aim for a new definition of BPD is to develop a classification based on the pathophysiology and objective lung function evaluation providing a more accurate assessment for individual patients. Until then, a consensus definition that encompasses current clinical practices, provides reasonable prediction of later respiratory outcomes, and is relatively simple to use should be achieved.

scholarly journals Pilot Randomized Trial of Hydrocortisone in Ventilator-Dependent Extremely Preterm Infants: Effects on Regional Brain Volumes

2013 ◽  
Vol 162 (4) ◽  
pp. 685-690.e1 ◽  
Author(s):  
Nehal A. Parikh ◽  
Kathleen A. Kennedy ◽  
Robert E. Lasky ◽  
Georgia E. McDavid ◽  
Jon E. Tyson
Keyword(s):  
Randomized Trial ◽  
Preterm Infants ◽  
Brain Volumes ◽  
Regional Brain ◽  
Extremely Preterm ◽  
Extremely Preterm Infants

scholarly journals Exclusive Human Milk VS Preterm Formula: Randomized Trial in Extremely Preterm Infants

2011 ◽  
Vol 70 ◽  
pp. 4-4 ◽  
Author(s):  
E A Cristofalo ◽  
R J Schanler ◽  
C L Blanco ◽  
S Sullivan ◽  
R Trawoeger ◽  
...  
Keyword(s):  
Human Milk ◽  
Randomized Trial ◽  
Preterm Infants ◽  
Preterm Formula ◽  
Extremely Preterm ◽  
Extremely Preterm Infants

scholarly journals Effects of vitamin D deficiency on neurobehavioural outcomes in children: a systematic review

2020 ◽  
Vol 5 ◽  
pp. 28 ◽  
Author(s):  
Agnes M. Mutua ◽  
Reagan M. Mogire ◽  
Alison M. Elliott ◽  
Thomas N. Williams ◽  
Emily L. Webb ◽  
...  
Keyword(s):  
Systematic Review ◽  
Vitamin D ◽  
Beneficial Effect ◽  
Brain Development ◽  
Vitamin D Deficiency ◽  
Experimental Studies ◽  
Vitamin D Supplementation ◽  
Cochrane Library ◽  
Extremely Preterm ◽  
Extremely Preterm Infants

Introduction: Vitamin D plays an important role in brain development in experimental studies; however, the effect of vitamin D deficiency on child development remains inadequately characterized. We aimed to estimate the effects of vitamin D deficiency on neurobehavioural outcomes in children up to 18 years of age. Methods: We searched PubMed, EMBASE, PsycINFO, Scopus, Cochrane Library, Web of Science and Open Grey for published studies up to 10th January 2020. We included all studies that assessed the effects of maternal or child vitamin D status or vitamin D supplementation on neurobehavioural outcomes in children. Study findings were synthesized qualitatively as the high level of heterogeneity in study populations and methodologies precluded a quantitative meta-analysis. Results: Our search identified 5,633 studies, of which 32 studies with 31,445 participants from 18 countries were included in the systematic review. Of the studies identified, two were randomized controlled trials (RCTs) of vitamin D supplementation in children, while 30 were observational. One RCT (n=55) reported a beneficial effect of supplementation with lower doses compared to higher doses of vitamin D on motor development while the other RCT (n=70) found no beneficial effect of vitamin D supplementation on cognition in extremely preterm infants. Twelve mother-child studies (n=17,136) and five studies in children (n=1,091) reported an association between low maternal or child 25-hydroxyvitamin D levels and impaired neurobehavioural outcomes in children, while 15 mother-child studies (n=20,778) and eight studies in children (n=7,496) reported no association. Conclusions: Although animal studies point to an effect of vitamin D deficiency on brain development, there are few studies on the effects of vitamin D deficiency on neurobehavioural outcomes in children and their findings are inconsistent. There is a need for well-conducted, adequately powered studies to further determine these effects in children. Registration: PROSPERO ID CRD42018087619; registered on 15 February 2018.

scholarly journals A Randomized Trial of Maternal Docosahexaenoic Acid Supplementation to Reduce Inflammation in Extremely Preterm Infants

2019 ◽  
Vol 69 (3) ◽  
pp. 388-392 ◽  
Author(s):  
Christina J. Valentine ◽  
Kelly A. Dingess ◽  
Jeanne Kleiman ◽  
Ardythe L. Morrow ◽  
Lynette K. Rogers
Keyword(s):  
Docosahexaenoic Acid ◽  
Randomized Trial ◽  
Preterm Infants ◽  
Acid Supplementation ◽  
Extremely Preterm ◽  
Extremely Preterm Infants

scholarly journals Body composition of extremely preterm infants fed protein-enriched, fortified milk: a randomized trial

2021 ◽  
Author(s):  
Ariel A. Salas ◽  
Maggie Jerome ◽  
Amber Finck ◽  
Jacqueline Razzaghy ◽  
Paula Chandler-Laney ◽  
...  
Keyword(s):  
Body Composition ◽  
Randomized Trial ◽  
Preterm Infants ◽  
Fortified Milk ◽  
Extremely Preterm ◽  
Extremely Preterm Infants

scholarly journals Safety of Early Vitamin D Supplementation in Premature Infants at Risk of Bronchopulmonary Dysplasia (BPD) and Growth Failure (P11-070-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Mary Holder ◽  
Ariel Salas
Keyword(s):  
Vitamin D ◽  
Growth Failure ◽  
Vitamin D Supplementation ◽  
Mean Difference ◽  
Target Range ◽  
Orogastric Tube ◽  
Extremely Preterm ◽  
Extremely Preterm Infants ◽  
The Mean ◽  
Study Participants

Abstract Objectives To determine safety and efficacy profiles of enteral vitamin D in extremely preterm infants (< 28 weeks of gestation) exposed to early vitamin D supplementation. Methods We analyzed demographic, clinical, and supplementation data of 74 study participants randomly assigned to receive three different regimens of early vitamin D supplementation: placebo (G1), 200 IU/day (G2) or 800 IU/day (G3) (CT.gov: NCT01600430). Study participants included in this analysis received ≥ 70 doses (0.5 ml of vitamin D or placebo every 6 hours through an orogastric tube) in the first 28 days after birth. We defined safety outcomes based on 25 (OH) vitamin D concentrations at birth (D0), postnatal day 14 (D14), and postnatal day 28 (D28). Efficacy outcomes were defined using the new BPD classification and length z-scores. Results The median gestational age of study participants was 26 weeks and the mean birth weight was 815g [+ /- 199]. Thirty-one participants received placebo (42%), 20 received 200 IU/day (27%), and 23 received 800 IU/day (31%). Half were male and 56% were black. Most infants received the first dose of vitamin D on or before D5 (90%). The median value of vitamin D doses given was 90 [IQR: 84-94]. The mean difference between 25 (OH) D concentrations (in ng/ml) at D14 and 25 (OH) D concentrations at D0 was + 5 in G1, + 18 in G2, + 33 in G3 (P < 0.05). The increase in 25 (OH) D concentrations from D0 to D14 was higher among black participants (26 vs 14; P < 0.05). The mean difference between 25 (OH) D concentrations at D28 and 25 (OH) D concentrations at D14 was + 2 in G1, + 6 in G2, and + 25 in G3. Vitamin D concentrations in G3 at D14 (57, IQR: 41–67) were not significantly different than vitamin D concentrations in G2 at D28 (38, IQR: 21–50; P = 0.08). At 36 weeks postmenstrual age, moderate or severe BPD was more common in infants that received placebo (31% vs 16%; P = 0.16). A decline in length-for-age Z score of > 1.2 SD was also more common in infants that received placebo (85% vs. 75%; P = 0.33). Conclusions In this secondary analysis, a vitamin D dose of 800 IU/day increased vitamin D concentrations to target range by D14 and a vitamin D dose of 200 IU/day increased vitamin D concentrations to target range by D28. A combination of these two supplementation regimens seems ideal to avoid toxicity. Funding Sources KPRI.

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