Comparison of the Effect of Oral Versus Parenteral Vitamin D on Serum Levels of Vitamin D in Premature Infants with Vitamin D Deficiency

Vitamin D levels lower than 20 ng/mL are defined as vitamin D deficiency and levels between 20 and 30 ng/mL are defined as insufficient vitaminD.Dueto the high prevalence of vitaminDdeficiency in premature infants and the need for obtaining optimal treatment methods, we compared the serum levels of vitamin D before and fifteen days after administration of the drug orally and by injection.

In this randomized clinical trial, 90 premature infants with gestational age < 37 weeks were admitted to NICU of Shahid Akbarabadi Hospital, with concomitant vitamin D deficiency and insufficiency entered the study and randomly received oral (with oral drops of 1,000 units daily for 15 days) or injectable (a single dose of 15,000 units intramuscularly) vitamin D supplement and followed on the 16th day after drug administration by measuring 25 (OH) D, calcium, phosphorus, and serum alkaline phosphatase (ALP).

In this study, the gestational age of the patients was 29.39 ± 2.42 weeks, and their average birth weight was 1,208.45 ± 238.98 grams. There was no significant difference between the two groups that received the drug, and they were similar. The level of vitamin D in premature infants suffering from vitamin D deficiency was equal to 13.20 ± 6.37 ng/dL. There was no significant difference between the serum levels of ALP, phosphorus, and calcium in the patients of the injection and oral groups before and after the intervention (P-value > 0.05). Although there was no significant difference between the serum vitamin D levels in the two groups before the intervention, its level in the oral group was significantly higher than in the injection group after the intervention (P-value = 0.006). However, none of the treatment methods independently changed the effectiveness of the treatment (P-value = 0.073).

The results of our study showed that, in premature infants with vitamin D deficiency or insufficiency, administration of vitamin D orally or by injection significantly increases the serum concentration of 25 (OH) D3 to sufficient levels safely, and both treatment routes can be used in practice.