Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

Genomics and personalized strategies in nutrition

Comparison of cord blood and 6‐month‐old vitamin D levels of healthy term infants supplemented with 400 IU/day dose of vitamin D

Abstract

Objectives

To determine the prevalence and risk factors of vitamin D deficiency in pregnant women and their infants at birth (cord blood) and at six months of age in Turkey, as well as to assess the compliance rates of families with vitamin D supplementation.

Methods

Serum 25-hydroxyvitamin D [25(OH)D] level was measured of the mothers before delivery and of the infants both at birth (cord blood) and at six months of age. Infants who received and did not take regular vitamin D supplements were compared in terms of 25(OH) levels. Independent risk factors were determined by multiple logistic regression analysis.

Results

The study included a total of 140 pregnant women and their infants. Vitamin D deficiency was found in 95.7% of the mothers. The prevalence of vitamin D deficiency was 87.1% in infants at birth but decreased to 5.8% at sixth month. 65.7% of infants received vitamin D supplements regularly. Despite regular vitamin D use, it was determined that 2.2% of the infants in the supplementation compliant group had vitamin D deficiency. Maternal age, maternal education level, and the number of siblings were determined to be determining factors on infants’ 25(OH)D levels at six months (p < 0.05).

Conclusions

In Turkey, vitamin D deficiency still exists in both pregnant women and infants. Healthcare professionals and the public need to be more educated about the importance of regular supplementation. Serum 25(OH)D levels of infants should be tested periodically and personalized vitamin D supplementation planning is required based on test results.

This is a preview of subscription content, access via your institution

Access options

Buy article

Get time limited or full article access on ReadCube.

$32.00

All prices are NET prices.

Fig. 1: Study design.
Fig. 2: 25(OH)D level of the participants.

Data availability

The data sets generated and/or analyzed during the current study are not publicly available due to the data confidentiality requirements of the ethics committee but are available from the corresponding author on reasonable request and approval from the ethics committee.

References

  1. Kulie T, Groff A, Redmer J, Hounshell J, Schrager S. Vitamin D: an evidence-based review. JABFM. 2009;22:698–706.

    Article  PubMed  Google Scholar 

  2. Deluca HF. Overview of general physiologic features and functions of vitamin D. Am J Clin Nutr. 2004;80:1686–9.

    Article  Google Scholar 

  3. Bikle D. Nonclassic actions of vitamin D. J Clin Endocrinol Metab. 2009;9:26–34.

    Article  Google Scholar 

  4. Hyppönen E, Läärä E, Reunanen A, Järvelin MR, Virtanen SM. Intake of vitamin D and risk of type 1 diabetes: a birth-cohort study. Lancet 2001;358:1500–3.

    Article  PubMed  Google Scholar 

  5. Lappe JM, Travers-Gustafson D, Davies KM, Recker RR, Heaney RP. Vitamin D and calcium supplementation reduces cancer risk: results of a randomized trial. Am J Clin Nutr. 2007;85:1586–91.

    Article  CAS  PubMed  Google Scholar 

  6. Walker VP, Modlin RL. The vitamin D connection to pediatric infections and immune function. Pediatr Res. 2009;65:106–13.

    Article  Google Scholar 

  7. Alpdemir M, Alpdemir MF. Meta-Analysis Vitamin D deficiency status in Turkey: A meta-analysis. Int J Med Biochem. 2019;2:118–31.

    Google Scholar 

  8. Halicioglu O, Aksit S, Koç F, Akman SA, Albudak E, Yaprak, et al. Vitamin D deficiency in pregnant women and their neonates in spring time in western Turkey. Paediatr Perinat Epidemiol. 2012;26:53–60.

    Article  PubMed  Google Scholar 

  9. Aghajafari F, Field CJ, Weinberg AR, Letourneau N. APrON study team. both mother and infant require a vitamin D supplement to ensure that infants’ vitamin D status meets current guidelines. Nutriens. 2018;10:429.

    Article  Google Scholar 

  10. Aghajafari F, Nagulesapillai T, Ronksley PE, Tough SC, O’Beirne M, Rabi DM. Association between maternal serum 25-hydroxyvitamin D level and pregnancy and neonatal outcomes: systematic review and meta-analysis of observational studies. BMJ. 2013;346:f1169.

    Article  PubMed  Google Scholar 

  11. Mohr SB, Garland CF, Gorham ED, Garland FC. The association between ultraviolet B irradiance, vitamin D status and incidence rates of type 1 diabetes in 51 regions worldwide. Diabetologia. 2008;51:1391–8.

    Article  CAS  PubMed  Google Scholar 

  12. Hatun S, Bereket A, Ozkan B, Coskun T, Köse R, Calıkoglu AS. Free vitamin D supplementation for every infant in Turkey. Arch Dis Child. 2007;92:373–4.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Hatun S, Ozkan B, Bereket A. Vitamin D deficiency and prevention: Turkish experience. Acta Paediatr. 2011;100:1195–9.

    Article  PubMed  Google Scholar 

  14. Gülez P, Korkmaz HA, Özkök D, Can D, Özkan B. Factors influencing serum vitamin D concentration in Turkish children residing in İzmir: A single-center experience. J Clin Res Pediatr Endocrinol. 2015;7:294–300.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Hurmuzlu Kozler S, Saylı TR. Factors influencing initiation and discontinuation of vitamin D supplementation among children 1-24-months-old. Curr Med Res Opin. 2021;10:1–7.

    Google Scholar 

  16. Halicioglu O, Sutcuoglu S, Koc F, Yildiz O, Akman SA, Aksit S. Vitamin D status of exclusively breastfed 4-month-old infants supplemented during different seasons. Pediatrics 2012;130:921–7.

    Article  Google Scholar 

  17. Onal H, Adal E, Alpaslan S, Ersen A, Aydin A. Is daily 400 IU of vitamin D supplementation appropriate for every country: a cross-sectional study. Eur J Nutr. 2010;49:395–400.

    Article  CAS  PubMed  Google Scholar 

  18. Mutlu GY, Kusdal Y, Ozsu E, Cizmecioglu FM, Hatun S. Prevention of Vitamin D deficiency in infancy: daily 400 IU vitamin D is sufficient. Int J Pediatr Endocrinol. 2011;2011:4.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Koc F, Halicioglu O, Sutcuoglu S, Asik Akman S, Aksit S. Vitamin D supplementation during the first two years of life in Izmir, Turkey. Minerva Pediatr. 2014;66:141–6.

    CAS  PubMed  Google Scholar 

  20. Holick MF, Binkley NC, Bischoff-Ferrari HA, Gordon CM, Hanley DA, Heaney RP, et al. Evaluation, treatment, and prevention of vitamin D deficiency: An Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2011;96:1911–30.

    Article  CAS  PubMed  Google Scholar 

  21. Wolters M, Intemann T, Russo P, Moreno LA, Molnar D, Veidebaum T, et al. 25-hydroxyvitamin D reference percentiles and the role of their determinants among European children and adolescents. Eur J Clin Nutr. 2022;76:564–73.

    Article  CAS  PubMed  Google Scholar 

  22. Palacios C, Gonzalez L. Is D-vit deficiency a major global public health problem? J Steroid Biochem Mol Biol. 2014;144 PA:138–45.

    Article  Google Scholar 

  23. Hollis BW, Wagner CL. New insights into the vitamin D requirements during pregnancy. Bone Res. 2017;5:17030.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  24. Wang J, Zhang JY, Wei R, Hu S, Lin T, Lash GE. et al. Serum 25 hydroxyvitamin D status in 6‐month‐old infants in Guangzhou, China: A paired Longitudinal follow study. Matern Child. 2020;16:1294

    Google Scholar 

  25. Oktaria V, Graham SM, Triasih R, Soenarto Y, Bines JE, Ponsonby AL, et al. The prevalence and determinants of vitamin D deficiency in Indonesian infants at birth and six months of age. PLoS One. 2020;15:e0239603.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  26. Perrine CG, Sharma AJ, Jefferds ME, Serdula MK, Scanlon KS. Adherence to vitamin D recommendations among US infants. Pediatrics 2010;125:627–32.

    Article  PubMed  Google Scholar 

  27. Dratva J, Merten S, Ackermann-Liebrich U. Vitamin D supplementation in Swiss infants. Swiss Med Wkly. 2006;136:473–81.

    CAS  PubMed  Google Scholar 

  28. Alramdhan AM, El-Zubair AG. Poor vitamin D supplementation in infants. Cross-sectional study of maternal practices and awareness of vitamin D supplementation in infants in Al-Ahsa, Eastern Saudi Arabia. Saudi Med J. 2014;35:67–71.

    PubMed  Google Scholar 

  29. Uday S, Kongjonaj A, Aguiar M, Tulchinsky T, Högler W. Variations in infant and childhood vitamin D supplementation programmes across Europe and factors influencing adherence. Endocr Connect. 2017;6:667–75.

    Article  PubMed  PubMed Central  Google Scholar 

  30. Simon AE, Ahrens KA. Adherence to Vitamin D Intake Guidelines in the United States. Pediatrics. 2020;145:e20193574.

    Article  PubMed  Google Scholar 

  31. Elitok GK, Bulbul L, Bulbul A, Cigerli S, Uslu S. Vitamin D levels of 12–24-month-old healthy children in Turkey who received vitamin D supplementation until the age of one-year. Arch Argent Pediatr. 2020;118:95–101.

    Google Scholar 

  32. Korchia G, Amitai Y, Moshe G, Korchia L, Tenenbaum A, Rosenblum J, et al. Vitamin D deficiency in children in Jerusalem: the need for updating the recommendation for supplementation. Isr Med Assoc J. 2013;15:333–8.

    PubMed  Google Scholar 

  33. Hunter D, De Lange M, Snieder H, MacGregor AJ, Swaminathan R, Thakker RV, et al. Genetic contribution to bone metabolism, calcium excretion, and vitamin D and parathyroid hormone regulation. J Bone Min Res. 2001;16:371–8.

    Article  CAS  Google Scholar 

  34. Rodd C, Jean-Philippe S, Vanstone C, Weiler H. Comparison of 2 vitamin D supplementation modalities in newborns: adherence and preference. Appl Physiol Nutr Metab. 2011;36:414–8.

    Article  CAS  PubMed  Google Scholar 

  35. Unsur EK. Vitamin D levels of the healthy infants using oral spray or drop form of vitamin D supplement in the first year of life. North Clin Istanb. 2021;8:31–36.

    PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Contributions

BH contributed to the conceptualization and design of the study; BH and RE recruited the patients and collected the data; BH and HKY contributed to the acquisition and analysis of data; BH contributed to the interpretation of data; BH drafted the manuscript. All authors have read and agreed to the published version of the manuscript.

Corresponding author

Correspondence to Berna Hekimoğlu.

Ethics declarations

Competing interests

The authors declare no competing interests.

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Hekimoğlu, B., Erin, R. & Yılmaz, H.K. Comparison of cord blood and 6‐month‐old vitamin D levels of healthy term infants supplemented with 400 IU/day dose of vitamin D. Eur J Clin Nutr (2022). https://doi.org/10.1038/s41430-022-01220-4

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1038/s41430-022-01220-4

Search

Quick links