Effect of Vitamin D3 (Cholecalciferol) Administration as an Adjuvant Therapy in Preterm Neonates with Respiratory Distress Syndrome

Abstract
Background: RDS is one of the major problems among newborns and a major reason for increased morbidity and mortality among infants. Preterm babies are the main risk factor for development of RDS. Vitamin D is a steroid hormone that has been known for its important role in regulating body levels of calcium and phosphorus and in mineralization of bone. Since vitamin D deficiency may have a role in several diseases involving the respiratory system as respiratory distress syndrome, we hypothesized that vitamin D3 administration may have a role in improvement of respiratory distress syn-drome in preterm neonates.
Aim of Study: It was to evaluate the effect of Vitamin D as an adjuvant therapy in treatment of respiratory distress syndrome.
Patients and Methods: This study was conducted on 60 preterm neonates, their ages ranged between 28 weeks to 36 weeks gestation according to New Ballard Score. They were chosen from those at the Neonatal Intensive Care Unit (NICU), Pediatric department, Tanta University Hospital. They were allocated into three groups (20 each), Group 1 given the traditional therapy of RDS, Group 2 given vitamin D in the low ideal dose (400IU/Day) in addition to the traditional therapy of RDS, Group 3 given vitamin D in the high ideal dose (800 IU/Day) in addition to the traditional therapy of RDS. All preterm neonates were subjected to complete history taking, thorough clinical examination, routine laboratory investigations in addition to serum 25-hydroxyvitamin D by ELISA techniques, chest X-ray at the first 24 hours after delivery. Follow-up of the three groups was done at day 1, 3 and 7 of admission. At Day 21 of Life: Blood samples were taken from the serum of infants again for measuring the serum 25-hydroxyvitamin D level. Data was analyzed by using SPSS.
Results: There was statistical significant increase as regard vitamin D level after treatment in group 3 as compared to group 2 as the difference increase value in group 3 (Mean ± SD=75.719±18.231) was higher than in group 2 (Mean ± SD =43.453±14.728). There was significant improvement in the ABG findings, chest X-ray findings, Down's Score value in group 2,3 but especially in the group 3 of the intake of 800 IU/Day at day seven of admission. There was high statistical significant decrease as regarding the hospital stay duration in group 3 as compared to group 1. There was statistical significant decrease in the morbidity between the three studied groups as group 3 was lower than group 2 and group 2 was lower than group 1. There was no significant difference between all the studied groups as regard the number of died cases.
Conclusion: 25 hydroxy-vitamin D level was found defi-cient in most cases of RDS in preterm neonates and adminis-tration of Vitamin D as an adjuvant therapy in cases of RDS was associated with decreased severity, complications and days of hospital stay in the group that received 800 IU/Day more than the group that received 400 IU/Day.