390 Do Fractures Correlate with Vitamin D Levels in Preterm Infants?

Abstract

Background and Object: Vitamin D plays an important role in skeletal health. We previously reported a high prevalence (about 80%) of serum 25-hydroxy-vitamin D (25OHD) insufficiency in preterm VLBW infants. We aimed to evaluate the incidence of inpatient fractures noted in this population and any association with vitamin D levels.

Methods: Convalescent, stable VLBW (birth weight < =1.5kg) preterm (gestation < =32 weeks) infants, admitted to a tertiary referral NICU had serum 25-hydroxy-cholecalciferol (25-OH-D) measured using radio-immunoassay, prior to starting oral vitamin D supplements. All Xrays performed during inpatient stay were evaluated for the presence of fractures.

Results: 137 VLBW infants had 25-OH-D performed and all their Xrays reviewed. Their mean (+/-;Standard deviation) gestation was 29.6+/-;2.5 weeks, birth weight 1.3+/-;0.4kg and vitamin D levels were 40.7+/-;11.6nmol/l. 4 (2.9%) infants had fractures : 3 had long bone fractures and 1 had rib fractures. Their mean vitamin D levels were 34.6+/-; 10.9 nmol/l.

Conclusions: We have demonstrated that 80% of preterm VLBW infants have insufficient 25-OH-D levels during early postnatal life; but 25% remain insufficient at follow-up assessment. Four infants had fractures and all had decreased Vitamin D levels < 50nmol/l.

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