Gebelik Yaşı ≤32 Hafta Olan Preterm Bebeklerde 25-Hidroksivitamin D Düzeyleri ve Respiratuvar Distres Sendromu Arasındaki İlişki

Amaç: Bu çalışmanın amacı, gebelik yaşı ≤ 32 hafta olan prematüre bebeklerde D vitamini durumunu ve D vitamini düzeylerinin respiratuvar distres sendromu (RDS) gelişimine etkisini değerlendirmektir. RDS ile D vitamini eksikliğinin şiddeti arasındaki ilişki bu çalışmanın ikincil sonucunu oluşturmaktadır. Yöntem: RDS'li gebelik yaşı ≤32 hafta olan yenidoğanlar çalışma grubunu oluştururken, yenidoğan yoğun bakım ünitesinde yatan ve RDS bulgusu olmayan ≤32 hafta olan yenidoğanlar kontrol grubunu oluşturmakta idi. Bulgular: Çalışma süresi boyunca gebelik yaşı ≤ 32 hafta olan 122 erken doğmuş bebek dahil edildi. Bunlardan 56'sında (%46) RDS (çalışma grubu) varken, 66 yenidoğanda (%54) (kontrol grubu) RDS saptanmadı. Gruplar arasında anne yaşı, çoğul gebelik, antenatal steroid kullanımı, cinsiyet, doğum şekli, anne yaşı, antenatal steroid kullanımı, eşlik eden anne hastalıkları ve doğum mevsimi açısından anlamlı fark yoktu. Çalışma grubu ve kontrol grubunun medyan 25-OHD seviyeleri benzerdi (12.3 ng/ml'ye karşı 15.6 ng/ml; p=0.38). Gruplar arasında D vitamini düzeyi düşük olan (25-OHD düzeyi <15 ng/ml) erken doğmuş bebeklerin oranları açısından farklılık saptanmadı (38/56, %68'e karşı 35/66, %53; p=0,09). Sonuç: Hem zamanında doğan hem de prematüre bebekler için belirlenmiş bir optimal 25-OHD seviyesi yoktur. Buna karşın, D vitamini eksikliğinin hem maternal hem de neonatal olası olumsuz etkileri göz önünde bulundurularak, D vitamini eksikliğinin yaygın olduğu ülkelerde yeterli D vitamini desteği sağlanmalıdır.

Anahtar Kelimeler:

25-hidroksivitamin D, preterm bebek, respiratuvar distres sendromu

25-Hydroxyvitamin D Levels in Preterm Infants ≤32 Weeks Gestational Age and Respiratory Distress Syndrome

Objective: The aim of this study was to evaluate neonatal vitamin D status and effect of vitamin D levels on the development of respiratory distress syndrome (RDS) in preterm infants with a gestational age of ≤ 32 weeks. The association between RDS and severity of vitamin D deficiency was secondary outcome of this study. Method: Newborns having a gestational age of ≤32 weeks with RDS consisted the study group, while newborns hospitalized in the neonatal intensive care unit having ≤32 weeks of gestational age with no signs of RDS were the control group. Results: During the study period, 122 preterm infants having a gestational age of ≤ 32 weeks were included. From these, 56 (46%) had RDS (study group), while 66 (54%) newborns (control group) did not have RDS. There was no significant difference between the groups in terms of maternal age, multiple pregnancy, use of antenatal steroid, sex, mode of delivery, maternal age, antenatal steroid use, accompanying maternal diseases and birth season. Median 25-OHD levels of study group and control group were similar (12.3 ng/ml vs 15.6 ng/ml; p=0.38). The rates of preterm infants having low vitamin D levels (25-OHD level<15 ng/ml) did not differ between the groups (38/56, 68% vs 35/66, 53%; p=0.09). Conclusions: There is no established optimal 25-OHD level for both term and premature infants. Besides, taking into account possible unfavorable both maternal and neonatal effects of vitamin D deficiency, adequate vitamin D supplementation should be provided in countries where vitamin D deficiency is common.

Keywords:

25-hydroxyvitamin D, preterm infant, respiratory distress syndrome,

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