| Objective To investigate vitamin D status of the infants born in Peking Union Medical College Hospital(PUMCH) in autumn and winter and influencing factors. Methods Neonates admitted to NICU of PUMCH(39° N) form September 2014 to February 2015 were enrolled, We studied the average time of sun exposure, dietary intake, dosage of vitamin D supplementation of mothers during pregnancy by questionnaire survey. The serum 25-hydroxyvitamin D[25(OH)D]levels of the newborns were measured by isotope dilution ultra-performance liquid chromatography tandem mass spectrometry(ID-UPLC/MS/MS). A serum 25(OH)D level> 20ng/ml was defined sufficient, a serum 25(OH)D level< 20ng/ml and>15 ng/ml was defined insufficiency, a serum 25(OH)D level< 15ng/ml was defined deficiency.Bone mineral density (BMD) was measured at the infant’s left lower leg using ultrasound bone sonometer within the first week after birth. Results 141 subjects were included. Mean neonatal serum 25(OH)D levels was of 14.5±6.5ng/ml. Vitamin D deficient was indicated in 54.6% of neonates, and 22.0% of neonates were insufficient. There were no significant differences inserum 25(OH)D levels in neonates with different gestational age, gender, number of births, nor in SGA and AGA, time of exposure to sun. The serum 25(OH)D levels in neonates with maternal age≥28 were higher than those with maternal age<28(14.8±6.5 vs.8.8±5.7ng/ml, P=0.008).The serum 25(OH)D levels in neonates born in winter were lower than those born in autumn (13.4±6.0 vs.16.8±7.2ng/ml, P=0.004). The serum 25(OH)D levels in neonates with maternal vitamin D supplementation in mid to late gestation>600 IU/d were higher than those<600 IU/d (16.9±5.5 vs.12.2±5.8ng/ml, P<0.001). The serum 25(OH)D levels in neonates with maternal BMI>27 were lower in those with maternal BMI≤27 (12.9±6.6 vs.15.7±6.4 ng/ml,P=0.015). Neonatal serum 25(OH)D level differed significantly between the groups of mothers with different educational levels(F=5.854, P<0.001).The prevalences of vitamin D insufficiency and deficiency were higher among infants born in winter, infants with maternal vitamin D supplementation in mid to late gestation<600 IU/d, infants with maternal prenatal BMI>27, infants with maternal educational level bechelor’s degree or above than those born in autumn, those with maternal vitamin D supplementation in mid to late gestation ≥600 IU/d, those with maternal prenatal BMI≤27, those with maternal educational level college degree or below respectively. Neonatal serum 25(OH)D levels were negatively correlated with maternal BMI, and positively correlated with maternal educational level, maternal age, and dosage of maternal vitamin D supplementation in mid to late gestation. Multifactorial analysis showed season of birth, dosage of maternal vitamin D supplementation in mid to late gestation and antenatal BMI were the independent factors influencing neonatal 25(OH)D levels. Maternal vitamin D supplementation in mid to late gestation≥600 IU/d was associated with maternal educational level (OR=7.576,95%CI: 1.771～32.410,P=0.006), and season of delivery (OR=2.641,95%CI1:1.194～5.842, P=0.017). BMD of infants with birth weight≥1500g was higher than that with birth weight<1500g(3041±162 m/s vs.2879±206 m/s,t=2.684, P=0.008). No significant relationships in the data were observed between BMD of neonates and dosage of maternal vitamin D supplementation in the last three months of pregnancy or neonatal serum 25(OH)D levels. BMD of preterm infants was positively correlated with gestational age. Conclusion The prevalence of vitamin D deficiency was high in infants born in PUMCH in autumn and winter. Maternal vitamin D supplementation of 600IU/d is not enough to prevent neonatal vitamin D deficiency efficiently. There is no evidence for an influence of neonatal vitamin D 25(OH)D levels on bone mineral density of neonates.Objective To investigate the influencing factors of maternal and neonatal vitamin D status besides season, and the correlation between maternal and neonatal vitamin D levels. Methods Mother-single birth full term infant pairs were recruited from Peking Union Medical College Hospital(39° N) form June 1st to July 10th 2015. Serum 25(OH)D levels in maternal and cord blood were measured by ID-UPLC/MS/MS.For mothers, a serum 25(OH)D level> 30ng/ml was defined sufficient, a serum 25(OH)D level< 30ng/ml and>20 ng/ml was defined insufficiency, a serum 25(OH)D level< 20ng/ml was defined deficiency. As for infants, a serum 25(OH)D level> 20ng/ml was defined sufficient, a serum 25(OH)D level< 20ng/ml and>15 ng/ml was defined insufficiency, a serum 25(OH)D level< 15ng/ml was defined deficiency. Gestational weight gains<15kg with antenatal BMI<24 or gestational weight gains<12kg with antenatal BMI>24 was defined normal gestational weight gains. Results 102 pairs of subjects were included. Mean levels of serum 25(OH)D were (26.9±9.8) ng/ml in mothers and (13.1±5.0) ng/ml in their newborns. Vitamin D insufficiency was found in 39 mothers (38.2%) and 27 neonates (26.5%), and vitamin D deficiency was found in 25 mothers (24.5%) and 66 neonates (64.7%). The serum 25(OH)D levels in mothers with maternal vitamin D supplementation in mid to late gestation>600 IU/d, with pre-pregnant BMI<24, with normal gestational weight gains, with antenatal BMI<27 were higher than those with maternal vitamin D supplementation in mid to late gestation<600 IU/d, with pre-pregnant BMI≥24, with higher gestational weight gains, with antenatal BMI 5≥27, respectively [(31.7±9.5) vs.(24.1±8.9)ng/ml, (28.1±9.2) vs. (23.2±11.1)ng/ml, (28.4±10.2)vs. (24.5±8.7)ng/ml, (29.1±10.1) vs. (25.1±9.2ng/ml),P<0.05]. Prevalences of maternal vitamin insufficiency or deficiency were lower in those with maternal vitamin D supplementation in mid to late gestation>600 IU/d, with pre-pregnant BMI <24, with normal gestational weight gains than those with maternal vitamin D supplementation in mid to late gestation<600 IU/d, with pre-pregnant BMI≥24, with higher gestational weight gain, respectively (P<0.05).Maternal 25(OH)D levels were posivitely correlated with dosage of maternal vitamin D supplementation in the last three months of pregnancy (r=0.467, P<0.001), but negatively correlated with pre-pregnant BMI(r=-0.198, P=0.046), and antenatal BMI (r=-0.316, P=0.001). Multivariate regression analysis showed that dosage of maternal vitamin D supplementation in mid to late gestation, pre-pregnant BMI, gestational weight gains were the independent factors influencing maternal 25(OH)D levels. The group of maternal vitamin D insufficiency or deficiency had lower dosage of maternal vitamin D supplementation in last three months of pregnancy, higher pre-pregnant BMI, higher prevalence of higher gestational weight gain than the group of maternal vitamin sufficiency(P<0.05). Maternal vitamin D insufficiency or deficiency was associated with dosage of maternal vitamin D supplementation in mid to late gestation (OR=0.997,95%CI:0.995～0.999, P=0.008), and pre-pregnant BMI (OR=1.212,95%CI:1.041～1.411, P=0.013). The serum 25(OH)D levels in neonates with maternal vitamin D supplementation in mid to late gestation>600 IU/d, with normal gestational weight gains were higher than those with maternal vitamin D supplementation in mid to late gestation<600 IU/d, with higher gestational weight gains, respectively [(15.4±5.0) vs. (11.7±4.5) ng/ml, (14.1±5.1) vs. (11.6±4.5) ng/ml, P<0.05].Neonatal 25(OH)D levels were negatively correlated with gestational weight gain (r=-0.220, P=0.026), andantenatal BMI (r=-0.283, P=0.004), but positively correlated with dosage of maternal vitamin D supplementation in mid to late gestation (r=0.572, P<0.001). Multifactorial analysis showed dosage of maternal vitamin D supplementation in mid to late gestation and antenatal BMI were the independent factors influencing neonatal 25(OH)D levels. The group of neonatal vitamin D sufficiency or deficiency had lower dosage of maternal vitamin D supplementation in mid to late gestation, more gestational weight gain than the group of neonatal vitamin insufficiency (P<0.05). Neonatal vitamin D insufficiency or deficiency was associated with dosage of maternal vitamin D supplementation in mid to late gestation (OR=0.998, 95% CI:0.995～1.000, P=0.034), and gestational weight gain (OR=1.343,95%CI 1.071～1.684, P=0.011).Neonatal serum 25(OH)D level differed significantly between the groups of mothers with different serum 25(OH)D levels(F=0.914, P<0.001). A positive correlation between maternal and neonatal 25(OH)D measures was observed(r=0.914, P<0.001). When the receiver operating characteristic curve for maternal 25(OH)D level was used to predict neonatal vitamin D deficiency (≤15 ng/mL), the area under the curve was 0.962 (95%CI:0.930-0.994; P<0.001). The sensitivity and specificity of maternal serum 25(OH)D level≤27.55 ng/mL to predict neonatal vitamin D deficiency were 97.2% and 80.3%, respectively. Conclusions Dosage of maternal vitamin D supplementation in mid to late gestation, pre-pregnant BMI, gestational weight gains significantly affected maternal 25(OH)D levels. High dosage of maternal vitamin D supplementation in mid to late gestation is protective factor of maternal vitamin D insufficiency or deficiency, higher pre-pregnant BMI is risk factor of that. Dosage of maternal vitamin D supplementation in mid to late gestation, gestational weight gains significantly affected neonatal 25(OH)D levels. High dosage of maternal vitamin D supplementation in mid to late gestation is protective factor of neonatal vitamin D insufficiency or deficiency, higher gestational weight gainsis risk factor of that. Maternal vitamin D levels positively correlated with neonatal vitamin D level. Maternal 25(OH)D level can help to predict neonatal vitamin D deficiency.Objective To investigate the levels of vitamin D after four-weeks vitamin D supplementation among infants of severe vitamin D deficiency. Methods single birth full term infants with the levels of serum 25(OH)D of umbilical vein blood≤10ng/ml born form June 1st to July 10th 2015 were recruited from Peking Union Medical College Hospital(39° N). The neonates received vitamin D supplementation of 500IU/day from 15 days. Serum 25(OH)D levels of infants were measured by ID-UPLC/MS/MS after 4 weeks-supplementation. A serum 25(OH)D level> 20ng/ml was defined sufficient, a serum 25(OH)D level≤20ng/ml and>15 ng/ml was defined insufficiency, a serum 25(OH)D level≤15ng/ml was defined deficiency. Results 26 infants were included. Mean levels of serum 25(OH)D in infants after four-weeks vitamin D supplementation were apparently higher than mean levels of serum 25(OH)D of umbilical vein blood [(25.3±5.4) ng/ml vs. (6.7±2.1) ng/ml,t=21.715, P<0.001]. Vitamin D sufficiency was found in 20 infants (76.9%), insufficiency was found in 6 infants (23.1%). The levels of serum 25(OH)D of umbilical vein blood and the levels of maternal 25(OH)D of the vitamin D sufficient infants were higher than those of the vitamin D insufficient infants [(7.5±1.7) ng/ml vs. (4.2±0.6) ng/ml,t=4.541, P<0.001] [(16.5±3.9) ng/ml vs. (9.8±2.8) ng/ml, t=3.877, P=0.001]. The levels of serum 25(OH)D in infants after four-weeks vitamin D supplementation were apparently higher in infants with maternal 25(OH)D levels>15ng/ml than those with maternal 25(OH)D levels≤15ng/ml [(28.0±3.2) ng/ml vs. (23.0±5.9) ng/ml,t=2.623, P=0.015]. The levels of serum 25(OH)D in infants after four-weeks vitamin D supplementation were apparently higher in infants with the levels of serum 25(OH)D of umbilical vein blood>5ng/ml than those with the levels of serum 25(OH)D of umbilical vein blood≤5ng/ml [(27.5±3.8) ng/ml vs. (17.8±2.0) ng/ml, t=6.434, P<0.001]. The levels of serum 25(OH)D in infants after four-weeks vitamin D supplementation were correlated with serum 25(OH)D of umbilical vein blood (r=0.750, P<0.001), with maternal 25(OH)D levels (r=0.557, P=0.003), but not with feeding type or weight growth after birth. Conclusions Vitamin D supplementation of more than 500IU/d after birth was suggested for infants with the levels of serum 25(OH)D of umbilical vein blood≤5ng/ml.
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