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Evolution of Vitamin D concentrations in hospitalized preterm infants

Grant number: 15/15399-1
Support type:Regular Research Grants
Duration: December 01, 2015 - November 30, 2017
Field of knowledge:Health Sciences - Medicine
Principal Investigator:Fabíola Isabel Suano de Souza
Grantee:Fabíola Isabel Suano de Souza
Home Institution: Faculdade de Medicina do ABC (FMABC). Organização Social de Saúde. Fundação do ABC. Santo André , SP, Brazil
Assoc. researchers:Bianca Alves Vieira Bianco ; Fernando Luiz Affonso Fonseca ; Milene Saori Kassai Nakama ; Roseli Oselka Saccardo Sarni


Introduction: Recent studies suggest that more than 50% of pregnant women have vitamin D deficiency (25-OH-vitamin D <20 ug / dL). The vitamin D deficiency repercussions for the woman and newborn are not yet fully known. Some studies has shown vitamin D deficiency, during pregnancy, is associated with increased risk gestational diabetes mellitus, hypertensive disorders, prematurity and intrauterine growth restriction. In Brazil there is not recommendation for vitamin D supplementation during pregnancy. Preterm infants (PT) have 2.5 more likely to have vitamin D deficiency compared to those born at term. Blood vitamin D decrease during the hospital stay. A study conducted in India with PT showed that the plasma concentrations of 25-OH-vitamin D suffered a significant decline during hospitalization (deficiency at birth - 12.6% and after 6 weeks - 52.2%), even with enteral supplementation 400 IU / day. Vitamin D deficiency seems to be associated with greater risk for lung diseases, sepsis and bone diseases in PT. Because of lack of studies assessing concentrations and possible consequences of vitamin D deficiency in hospitalized PT we decided to realize this study. Objective: To describe the concentrations and frequency of vitamin D deficiency (25-OH-vitaminaD) in preterm infants less than 32 weeks and / or 1750 g at birth and when they reach the term (37 weeks). Specific: relate to vitamin D concentrations in mother, with gestational age, complications during hospitalization, length of stay, growth (weight, length and head circumference) and parathyroid hormone concentrations, calcium, phosphorus and alkaline phosphatase. Method: Through a prospective study will be included consecutively for a period of 18 months, PT (<32 weeks and / or 1750 g) who are born at the University Hospital Municipal de São Bernardo do Campo (HMU-SBC). The HMU-SBC is the only public hospital in the city, held about 350 deliveries a month and of these 15% are premature and 5% have less than 32 weeks and / or 1750 g. Whereas 20% of losses we expect to include 2 to 3 PT per month (total n = 30 to 40). PT with serious malformations, congenital heart defects, genetic syndromes, children of mothers with HIV, who are died and those presenting neonatal anoxia will be exclude. Of the patients included will be recorded prenatal data, maternal health, birth data and evolution during the hospital stay through with standardized questionnaire. Blood samples will be collect in two moments: at birth (the mother and the umbilical cord) and when PT to reach 37 weeks (± 1 week). For laboratory measurements will be obtained 5.0 ml of blood to determine the concentrations of: vitamin D (25-OH-vitamin D) by electrochemiluminescence (Kit, Roche®), it will be adopted as the cutoff for deficiency values <20 ug / dL; parathyroid hormone by electrochemiluminescence (Kit, Roche®) values above 60 nmol / L are considered increased; total calcium, ionized calcium, phosphorus, and alkaline phosphatase (colorimetric method). (AU)

Scientific publications
(References retrieved automatically from Web of Science and SciELO through information on FAPESP grants and their corresponding numbers as mentioned in the publications by the authors)
KASSAI, MILENE SAORI; CAFEO, FERNANDA RAMIREZ; AFFONSO-KAUFMAN, FERNANDO ALVES; SUANO-SOUZA, FABIOLA ISABEL; SACCARDO SARNI, ROSELI OSELKA. Vitamin D plasma concentrations in pregnant women and their preterm newborns. BMC PREGNANCY AND CHILDBIRTH, v. 18, OCT 22 2018. Web of Science Citations: 5.

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