Incidence of rickets of prematurity at Kenyatta National Hospital, Nairobi (original) (raw)
South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde, 1984
A prospective study to determine the prevalence rates of rickets, as determined by clinical, biochemical and radiological examinations performed at the age of 12 months in preterm infants of low birth weight and full-term control infants of mothers in lower socio-economic classes, was carried out. Clinical rickets was suspected in 5 cases. Biochemical and/or radiological evidence of rickets was not evident in any of the infants studied, although 4 infants showed radiological evidence of osteopenia. Serum alkaline phosphatase and 25-hydroxycholecalciferol levels showed significant seasonal variations. Serum zinc and copper levels were within normal ranges for age. The true prevalence rate of rickets during infancy among the prematurely born or full-term infants in Cape Town is not known. The findings of our study show that as long as the mother utilizes the available community health services her infant should not develop nutritional rickets by the age of 12 months.
Research Square (Research Square), 2023
Background Use of vitamin D in premature infants is one of the important preventive factors for Osteopenia of prematurity but there are con icting results on the appropriate doses, so this study aimed to compare the dose of 400 and 600 units vitamin D in the prevention of osteopenia of prematurity in infants with gestational age ≤ 32 weeks. Methods This clinical trial study was conducted on 108 premature infants divided into two groups of 54 with gestational age of ≤ 32 weeks born between 2020-2021 in Shahid Beheshti and Al-Zahrai hospitals in Isfahan. In the rst group, daily vitamin D was 400 units from the 7th day of birth, and in the second group, it was 600 units. At the age of 5 weeks, levels of calcium, phosphorus, alkaline phosphatase and vitamin D were evaluated. If the alkaline phosphatase level was above 1000, the wrist radiography was requested. Also, the baby was examined for clinical symptoms of rickets at the age of 5 weeks. The data were analyzed by SPSS software version 26 and P-value<0.05 was considered signi cant. Results In the present study, there was no signi cant difference between the level of alkaline phosphatase in the two groups (p=0.596), but the level of vitamin D was signi cantly higher in 600 units group (p<0.001). The level of calcium was higher in 400 units group, but this difference was slightly signi cant (p=0.062). The level of phosphorus in 600 units group was higher than the 400 units, and the difference was slightly signi cant (P=0.062). Conclusion The present study showed that daily 600 and 400 units of vitamin D in infants with gestational age of ≤ 32 weeks had no effect on the incidence of clinical symptoms and radiological ndings of rickets at the age of 5 weeks.
Prophylactic Effect of Low Dose Vitamin D in Osteopenia of Prematurity: a Clicinical Trial Study
Osteopenia of prematurity (OOP) is a preventable disease. Improved survival of premature newborns is associated with an increased incidence of OOP. The purpose of this study was to compare the prophylactic effects of two low doses of vitamin D (200 and 400 IU/Day) on the clinical, biochemical and radiological indices of the rickets of prematurity. In a randomized clinical trial, 60 preterm newborns with birth weight < 2000 g and gestational age < 37 weeks were randomly divided in two groups. Thirtynewborns received 200 IU/d of vitamin D in group one and 30 ones received 400 IU/day of vitamin D in group two. On the 6th to8th weeks of life, serum calcium, phosphate, alkaline phosphates, and 25-hydroxy vitamin D concentrationswere measured and x-ray of left wrist and physical examination were performed. Both groups had no difference in biochemical, radiological or clinical presentationof rickets. Currentstudy indicated that low dose vitamin D (200 IU/Day) is enough for prevention...
Prophylactic effect of low dose vitamin D in osteopenia of prematurity: a clinical trial study
Acta medica Iranica, 2014
Osteopenia of prematurity (OOP) is a preventable disease. Improved survival of premature newborns is associated with an increased incidence of OOP. The purpose of this study was to compare the prophylactic effects of two low doses of vitamin D (200 and 400 IU/Day) on the clinical, biochemical and radiological indices of the rickets of prematurity. In a randomized clinical trial, 60 preterm newborns with birth weight < 2000 g & gestational age < 37 weeks were randomly divided in two groups. Thirty newborns received 200 IU/d of vitamin D in group one and 30 ones received 400 IU/day of vitamin D in group two. On the 6th to 8th weeks of life, serum calcium, phosphate, alkaline phosphates, and 25-hydroxy vitamin D concentrations were measured and x- ray of left wrist and physical examination were performed. Both groups had no difference in biochemical, radiological or clinical presentation of rickets. Current study indicated that low dose vitamin D (200 IU/Day) is enough for preven...
Journal of Research in Nursing and Midwifery, 2013
The aim of this study is to confirm our original hypothesis that maternal deficiency of vitamin D is a major factor in development of rickets in her breastfeeding infant and review the literature. In six months from October 2008 to March 2009 out of 136 infants with diagnosis of clinical rickets, seen in Medinah Maternty and Chlidrens Hospital, 40 infants and their mothers were included in this study. Sochioeconomical data were recorded. Blood samples were collected for biochemical and for parathormone and vitamin D (25OHD) levels from both mother and baby. Radiology of wrist was done for each infant. All cases were divided to three age groups. Results from pairs were available. On comparing parathormone (MPTH) in mothers of children (CPTH) with active rickets and healed rickets. MPTH was 94.8 and CPTH 199.9, this was considered significant at P value .0104. As for children with healed rickets and their mother's PTH the mean PTH was 199.8 in active rickets and 60.8 in healed rickets, the P value is 0.002 which is very significant. The 25OHD levels in mother and breastfed infants with active rickets were very low in infants with active rickets and low in their mothers. In the healed group 25OHD was significantly high in infants but not in mothers. The hypothesis that maternal vitamin D deficiency is a major factor in pathogenesis of their infants was further confirmed. Vitamin D supplementation during pregnancy and lactation for the mother and breastfeeding infants is recommended to prevent vitamin D deficiency and rickets and their serious complications.
Maternal Vitamin D Status: Implications for the Development of Infantile Nutritional Rickets
Endocrinology and Metabolism Clinics of North America, 2010
Infantile nutritional rickets is re-emerging as a worldwide health problem despite having been nearly eradicated in many countries, including the United States, in the 1930s and 1940s with the introduction of foods fortified with vitamin D, such as milk. 1 The resurgence of vitamin D deficiency and rickets in developed countries and its continued presence in many developing countries have raised considerable concern and questions about the epidemiology and prevention of vitamin D deficiency rickets during infancy.
Vitamin D Deficiency in Pregnant Women and Newborn
IntechOpen eBooks, 2021
Vitamin-D is not only an essential element in bone health, but it is also a pro-hormone. Deficiency of vitamin D is the most common cause of rickets and is also known to increase the risk of respiratory distress syndrome, lower respiratory infections, food sensitivities, asthma, type I diabetes, autism and schizophrenia. Vitamin D deficiency limits the effective absorption of dietary calcium and phosphorus. Vitamin D status in newborns is entirely dependent on maternal supply during pregnancy. Low maternal vitamin D status during pregnancy is a major risk factor for rickets in infants. Rickets in children is caused by severe, chronic vitamin D deficiency with apparent skeletal abnormalities, but neonates with vitamin D insufficiency have no overt skeletal or calcium metabolism defects. Rickets was a global disease in the early twentieth century. It has nearly disappeared in developed countries after its causal pathway was understood and fortification of milk with the hormone vitamin D was introduced at the population level. Surprisingly, rickets is re-emerging per recent evidence. Vitamin D deficiency is prevalent in both developed and developing countries. The chapter will review the prevalence of vitamin D deficiency in pregnant women and newborn population and its adverse effects on pregnancy and infant's health. The chapter also describes evidence-based recommendations to prevent vitamin D deficiency in these vulnerable population.
Epidemiology of nutritional rickets in children
Saudi Journal of Kidney …, 2009
In most developing countries, nutritional rickets is a major health problem. The aim of this study was to explore the magnitude of nutritional rickets among Saudi infants, and the various clinical presentations, as well as to address the possible operating risk factors behind the disease. We carried out a retrospective study at King Abdulaziz Medical City-King Fahad National Guard Hospital in Riyadh, Saudi Arabia. The records of Saudi infants under the age of 14 months over a 10-year period (between January 1990 and January 2000) were reviewed. Information collected included age, sex, clinical presentations, biochemical, radiological findings, infant nutrition, presence of other nutritional deficiencies and exposure to sunlight. There were 283 infants diagnosed with nutritional rickets due to Vitamin D deficiency (67% males) who were between 6 and 14 months of age. Among the total, 70% were exclusively breast-fed, and 23% were breast-fed until the age of 1 year. The most frequent clinical presentation was hypo-calcemic convulsions (34%) followed by chest infections (33%) and gastroenteritis (25%). In conclusion, nutritional rickets is still prevalent in Saudi Arabia with the primary etiology being vitamin D deficiency. Therefore we recommend that every infant, who is exclusively on breast-feeding, has routine supplement of vitamin D in the range of 200 IU/day (alone or as apart of multivitamin), started soon after birth until the time of weaning.