Oral vitamin D supplementation is associated with full enteral feeding in very low birth weight infants
Background and aims As vitamin D is mostly transferred to the fetus during the third trimester, preterm infants are born with lower vitamin D stores. However, most clinical guidelines do not suggest clearly when to initiate vitamin D in very low birth weight (VLBW) infants. This retrospective study...
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Taylor & Francis Group
2025-12-01
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| Series: | The Journal of Maternal-Fetal & Neonatal Medicine |
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| Online Access: | https://www.tandfonline.com/doi/10.1080/14767058.2025.2515426 |
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| author | Yie Huang Ping Zhou Ruiping Wu Xiaomei Fan Ping Zheng Xintian Shen |
| author_facet | Yie Huang Ping Zhou Ruiping Wu Xiaomei Fan Ping Zheng Xintian Shen |
| author_sort | Yie Huang |
| collection | DOAJ |
| description | Background and aims As vitamin D is mostly transferred to the fetus during the third trimester, preterm infants are born with lower vitamin D stores. However, most clinical guidelines do not suggest clearly when to initiate vitamin D in very low birth weight (VLBW) infants. This retrospective study aimed to assess whether the initiation of oral vitamin D supplementation was associated with full enteral feeding (FEF) in VLBW infants.Methods A total of 383 VLBW infants (gestational age, 24–32 weeks; birth weight, 570–1500 g) admitted to our neonatal intensive care unit between October 2018 and December 2022 were included in this study. To assess the independent association between oral vitamin D and FEF, univariate or multivariate Cox analyses were performed, adjusting for 16 major confounders (birth weight, initiation of enteral feeding, sepsis, the enteral feed volume when oral vitamin D started, etc.). Time-varying coefficients method is used to accommodate the non-constant hazard ratio implied by the proportional hazards assumption violation.Results Multivariate Cox regression for the time to reach full enteral feeding (T-FEF) and time to add human milk fortifier (T-HMF) were analyzed respectively. Delayed oral vitamin D supplementation (after postnatal day 13) was independently and negatively associated with the cumulative probability of achieving FEF (B − 5.088, RR 0.006 (0.001–0.057), p < .00001). Delayed oral vitamin D supplementation was independently and negatively associated with the cumulative probability of adding human milk fortifier (HMF) (B − 3.115, RR 0.044 (0.006–0.334), p = .002). The hazard effect of the delayed supplementation diminished over time, with the RR = EXP(−5.088 + 1.447 × Ln(T-FEF)) or RR = EXP(−3.115 + 0.729 × Ln(T-HMF)), respectively.Conclusions Our research suggests that earlier initiation of oral vitamin D is associated with improved FEF in VLBW infants. |
| format | Article |
| id | doaj-art-dcee16d2afab463ca41e8e0873a8739e |
| institution | OA Journals |
| issn | 1476-7058 1476-4954 |
| language | English |
| publishDate | 2025-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | The Journal of Maternal-Fetal & Neonatal Medicine |
| spelling | doaj-art-dcee16d2afab463ca41e8e0873a8739e2025-08-20T02:31:27ZengTaylor & Francis GroupThe Journal of Maternal-Fetal & Neonatal Medicine1476-70581476-49542025-12-0138110.1080/14767058.2025.2515426Oral vitamin D supplementation is associated with full enteral feeding in very low birth weight infantsYie Huang0Ping Zhou1Ruiping Wu2Xiaomei Fan3Ping Zheng4Xintian Shen5Department of Prevention and Healthcare, Shenzhen Baoan Women’s and Children’s Hospital, Shenzhen, ChinaNeonatal Intensive Care Unit, Shenzhen Baoan Women’s and Children’s Hospital, Shenzhen, ChinaDepartment of Pharmacy, Beijing University of Chinese Medicine Shenzhen Hospital (Longgang), Shenzhen, ChinaDepartment of Pharmacy, Shenzhen Baoan Women’s and Children’s Hospital, Shenzhen, ChinaDepartment of Pharmacy, Nanfang Hospital, Southern Medical University, Guangzhou, ChinaDepartment of Pharmacy, Shenzhen Baoan Women’s and Children’s Hospital, Shenzhen, ChinaBackground and aims As vitamin D is mostly transferred to the fetus during the third trimester, preterm infants are born with lower vitamin D stores. However, most clinical guidelines do not suggest clearly when to initiate vitamin D in very low birth weight (VLBW) infants. This retrospective study aimed to assess whether the initiation of oral vitamin D supplementation was associated with full enteral feeding (FEF) in VLBW infants.Methods A total of 383 VLBW infants (gestational age, 24–32 weeks; birth weight, 570–1500 g) admitted to our neonatal intensive care unit between October 2018 and December 2022 were included in this study. To assess the independent association between oral vitamin D and FEF, univariate or multivariate Cox analyses were performed, adjusting for 16 major confounders (birth weight, initiation of enteral feeding, sepsis, the enteral feed volume when oral vitamin D started, etc.). Time-varying coefficients method is used to accommodate the non-constant hazard ratio implied by the proportional hazards assumption violation.Results Multivariate Cox regression for the time to reach full enteral feeding (T-FEF) and time to add human milk fortifier (T-HMF) were analyzed respectively. Delayed oral vitamin D supplementation (after postnatal day 13) was independently and negatively associated with the cumulative probability of achieving FEF (B − 5.088, RR 0.006 (0.001–0.057), p < .00001). Delayed oral vitamin D supplementation was independently and negatively associated with the cumulative probability of adding human milk fortifier (HMF) (B − 3.115, RR 0.044 (0.006–0.334), p = .002). The hazard effect of the delayed supplementation diminished over time, with the RR = EXP(−5.088 + 1.447 × Ln(T-FEF)) or RR = EXP(−3.115 + 0.729 × Ln(T-HMF)), respectively.Conclusions Our research suggests that earlier initiation of oral vitamin D is associated with improved FEF in VLBW infants.https://www.tandfonline.com/doi/10.1080/14767058.2025.2515426Initiation of oral vitamin D supplementationfull enteral feedingvery low birth weight infantsmultivariate Cox regressionhuman milk fortifier |
| spellingShingle | Yie Huang Ping Zhou Ruiping Wu Xiaomei Fan Ping Zheng Xintian Shen Oral vitamin D supplementation is associated with full enteral feeding in very low birth weight infants The Journal of Maternal-Fetal & Neonatal Medicine Initiation of oral vitamin D supplementation full enteral feeding very low birth weight infants multivariate Cox regression human milk fortifier |
| title | Oral vitamin D supplementation is associated with full enteral feeding in very low birth weight infants |
| title_full | Oral vitamin D supplementation is associated with full enteral feeding in very low birth weight infants |
| title_fullStr | Oral vitamin D supplementation is associated with full enteral feeding in very low birth weight infants |
| title_full_unstemmed | Oral vitamin D supplementation is associated with full enteral feeding in very low birth weight infants |
| title_short | Oral vitamin D supplementation is associated with full enteral feeding in very low birth weight infants |
| title_sort | oral vitamin d supplementation is associated with full enteral feeding in very low birth weight infants |
| topic | Initiation of oral vitamin D supplementation full enteral feeding very low birth weight infants multivariate Cox regression human milk fortifier |
| url | https://www.tandfonline.com/doi/10.1080/14767058.2025.2515426 |
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