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Calcium (ca),Phosphorus( P) and 25-hydroxyvitamin D(25OHD)] in Infants Born ≤ 32 PMA Gestational Weeks (GA)

Phase 3
Conditions
Infant, Premature, Diseases
Interventions
Dietary Supplement: Cholecalciferol 800
Dietary Supplement: Cholecalciferol 400
Registration Number
NCT03691896
Lead Sponsor
Centre of Postgraduate Medical Education
Brief Summary

It has not yet been established the optimal dose of vit. D for preterm infants in Poland. It is not known what dose of vit. D will provide the correct concentration of vit. D and the optimal development of the skeleton of the premature.

The study will try to determine the optimal supplementation of vitamin D and the supply of Ca and P for normal growth and development of a child born prematurely.

In addition, the investigators will evaluate any risk factors for deficiency and excess of vitamin D and the consequences of its deficiency and overdose. Simultaneously the study would make possible the determination of an optimal schedule for controlling the Ca-P levels in the group of the youngest infants born prematurely. In addition, the study will assess the relationship between maternal and newborn vitamin D resources right after birth, and the incidence of vitamin D deficiency in infants born prematurely. Preterm infants will be randomized in 3 groups assigned to different doses of vit. D. The study will investigate the metabolism of calcium, phosphorus, the health of bones and development of the premature babies till the age of 2.

Detailed Description

The participants of the study will be prematures, born ≤32 GA, hospitalized in the Department of Neonatology, in the neonatal intensive care unit. Hospitalized patients who meet the inclusion criteria will be randomized in 3 groups assigned to different doses of vit. D (400, 800 or 1200 units(UNT) of vitamin D).

At defined age points of postnatal life, parameters of calcium and phosphorus metabolism and vitamin D level will be tested, along with the health of bones, health status and development.

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
200
Inclusion Criteria
  • gestational age ≤32 weeks at birth
  • hospitalization in the department no later than at the age of 7 days (for infants born outside the center)
  • No birth defects or diseases permanently affecting the ability to accept enteral feeding
  • Anticipated possibility of continuous monitoring of the course of treatment in hospital until discharge
  • Consent of Parents / legal guardians for the participation in the study.

Exclusion criteria

  • gestational age> 32 weeks at birth
  • the beginning of hospitalization in the department later than the age of 7 days (for infants born outside the center)
  • presence of congenital defects or diseases permanently affecting the ability to accept enteral feeding (e.g.oesophageal atresia, anal atresia, congenital umbilical hernia, gastroschisis, syndromes genetically determined)
  • significant interruption (> 1 week) of the hospitalization in the center
  • lack of consent of the Parents / legal guardians to participation in the study
Exclusion Criteria

Not provided

Study & Design

Study Type
INTERVENTIONAL
Study Design
CROSSOVER
Arm && Interventions
GroupInterventionDescription
Higher doseCholecalciferol 1200cholecalciferol 1200UNT, oral solution,
Middle doseCholecalciferol 800cholecalciferol 800UNT, oral solution
Lower doseCholecalciferol 400cholecalciferol 400UNT, oral solution
Primary Outcome Measures
NameTimeMethod
Serum 25OHD levels in cord blood in Polish preterm infantsday of labour

assessment of 25OH D levels in children deficiency: \<10ng/ml, insufficient level: 10-30ng/ml, sufficient level: 30-50ng/ml

Secondary Outcome Measures
NameTimeMethod
Impact of dosage of Vit D3 (400/800/1200 UNT /per day) on urinary Ca excretion4,8,12 weeks of life,1 and 2 years of age

assessment of urinary calcium/creatinine index

Impact of dosage of Vit D3 (400/800/1200 UNT /per day) on urinary P excretion4,8,12 weeks of life,1 and 2 years of age

assessment of urinary P/creatinine index (mg/mg)

impact of total annual Vit D3 dose and bone calcification in childrenaverage of 1 and 2 years of age

assessment of bone status :Densitometry (DEXA)

Impact of dosage of Vit D3 (400/800/1200 UNT per day) on serum 25OH D levels in preterm children4,8,12 weeks of life,1 and 2 years of age

assessment of serum 25OH D levels in children deficiency: \<10ng/ml, insufficient level: 10-30ng/ml, sufficient level: 30-50ng/ml; high level \> 60ng/ml, toxic level \> 100ng/ml

Impact of dosage of Vit D3 (400/800/1200 UNT /per day) on P serum levels4,8,12 weeks of life,1 and 2 years of age

assessment of P serum levels in children

impact of cord blood 25OHD level on birth weight1st day of life of age

assessment of percentile of birth weight (Fenton 2013) hypotrophy \<3p, eutrophy 3-97p, hypertrophy \>97p

Impact of supplementation of Vit. D during pregnancy on 25OHD serum level in Polish mothersday of labour

assessment of 25OH D levels in mothers deficiency: \<10ng/ml, insufficient level: 10-30ng/ml, sufficient level: 30-50ng/ml

Impact of dosage of Vit D3 (400/800/1200 UNT /per day) on Ca serum levels4,8,12 weeks of life,1 and 2 years of age

assessment of Ca serum levels in children

correlation of cord blood 25OHD level and GA1st day of life

birth \<24 GA, 24-28GA, 28-32GA

Trial Locations

Locations (1)

SPSK im. prof. W.Orłowskiego CMKP Neonatology Departament

🇵🇱

Warszawa, Mazowieckie, Poland

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