Çok Düşük Doğum Ağırlıklı Prematüre Bebeklerde Maternal D Vitamini Eksikliğinin Prematüre Osteopenisi Üzerine Etkileri
Author :
Abstract
Amaç: Çok düşük doğum ağırlıklı prematüre bebeklerde, maternal vitamin D eksikliğinin prematüre
osteopenisi üzerindeki etkilerini değerlendirmek.
Gereç ve Yöntem: Bu çalışma, 32. gebelik haftasından önce doğan ve doğum ağırlığı < 1.500 g olan 60
prematüre bebek üzerinde gerçekleştirildi. Annelerinde 25-OH D vitamini düzeyi <40 nmol/L olan bebekler
“grup 1” (n=30), ≥40 nmol/L olan bebekler ise “grup 2” (n= 30) olarak gruplandırıldı. Serum kalsiyum, fosfor
ve alkalen fosfataz (ALP) seviyeleri doğum sonrası ilk gün ve hastanede yatış süresince haftalık olarak ölçüldü.
Bebekler 40. gebelik haftalarını tamamladıklarında tübüler fosfor geri emilimi, femur radyografileri, serum
üre, kreatinin, kalsiyum, fosfor ve ALP düzeyleri değerlendirildi. En az bir hafta arayla alınan iki ALP değerinin
> 800 IU/L olması osteopeni tanısı için anlamlı olarak kabul edildi.
Bulgular: Grup 1’deki 5 hastada (%16,7), grup 2’deki 2 hastada (%6.7) prematüre osteopenisi saptandı. Her
iki grup arasında prematüre osteopenisi gelişimi açısından fark saptanmadığı ancak 40. gebelik haftasındaki
serum fosfor düzeylerinin grup 1’deki bebeklerde daha düşük olduğu (p= 0,04) görüldü.
Sonuç: Prematüre osteopenisinin gelişiminde makro-mineral eksikliği önemli rol oynamaktadır. Maternal D
vitamini eksikliği, prematüre bebeklerin kemik metabolizması ve serum fosfor seviyeleri üzerinde olumsuz bir
etkiye sahip olabilir.
Keywords
Abstract
Aim: This study aimed to evaluate the effects of maternal vitamin D deficiency on osteopenia of prematurity in
very low birth weight premature infants.
Methods: This study was conducted on 60 premature infants born before 32 weeks of gestation with a birth
weight < 1,500 g. Infants whose mothers had a 25-hydroxycholecalciferol (25-OHD) level < 40 nmol/L were
assigned to group 1 (n = 30), while those with a 25-OHD level ≥ 40 nmol/L were assigned to group 2 (n = 30).
Serum calcium, phosphate, and alkaline phosphatase (ALP) levels were measured on the first postnatal day,
and weekly during hospitalization. Tubular phosphate reabsorption (TRP), femoral radiographs, and serum
urea, creatinine, calcium, phosphate, and ALP were evaluated after 40 weeks of gestation. Two values of ALP >
800 IU/L, at least 1 week apart, was considered diagnostic of osteopenia.
Results: Osteopenia of prematurity was detected in five patients (16.7%) in group 1, and two patients (6.7%) in
group 2. No statistically significant differences were found between the two groups, except for lower phosphate
levels in group 1 (p = 0.04).
Conclusions: Macro-mineral deficiencies could play a key role in the development of osteopenia of
prematurity. Maternal vitamin D deficiencies can have a negative impact on bone metabolism and phosphate
levels in infants.
Keywords
- Statistical analyses were performed using NCSS 2007 and
- PASS 2008 statistical software (NCSS LLC., Kaysville, UT,
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