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KMID : 0816120140170010047
Korean Journal of Pediatric Gastroenterolology and Nutrition
2014 Volume.17 No. 1 p.47 ~ p.51
Neonatal Late-onset Hypocalcemia: Is There Any Relationship with Maternal Hypovitaminosis D?
Do Hyun-Jeong

Park Ji-Sook
Seo Ji-Hyun
Lee Eun-Shin
Park Chan-Hoo
Woo Hyang-Ok
Youn Hee-Shang
Abstract
Purpose: Neonatal late-onset hypocalcemia is defined as hypocalcemia developed after postnatal 3 days and asso-ciated with hypoparathyroidism, high phosphate diets and vitamin D deficiency. We experienced the increment of neonatal late onset hypocalcemia over 1 year. We tried to evaluate the relationship between late onset hypocalcemia and maternal hypovitaminosis D.

Methods: The medical records in the neonates with late-onset hypocalcemia during January 2007 to July 2008 were retrospectively reviewed. Among those patients, 17 paired sera of mothers and neonates had collected. The levels of 25-OH vitamin D (25OHD) and intact parathyroid hormone (iPTH) were measured and were compared with neo-nate and the mother.

Results: The mean gestational age was 38+1 weeks, and the mean body weight was 2,980 g. The onset time of hypo-calcemia was 5.9 days of age. Most of them (88.2%) were feeding with formula and no one was only breast milk feeding. Of the 17 patients, 13 were born in spring or in winter. The median levels of calcium, phosphorus, alkaline phosphatase, iPTH and 25OHD were 7.0 mg/dL, 8.6 mg/dL, 191.0 U/L, 57.2 pg/mL and 24.0 ng/mL in neonates. The levels of 25OHD of 6 neonates were £¼20 ng/mL. A total of 16 mothers were considered vitamin D-deficient (£¼20 ng/mL), and vitamin D insufficient (20£¼25OHD£¼30 ng/mL).

Conclusion: Neonatal late-onset hypocalcemia in our study seems to be influenced by maternal vitamin D deficiency and insufficiency. Sun tanning and vitamin D supplements from winter to spring would be helpful to prevent maternal vitamin D deficiency, one of the causes of neonatal late-onset hypocalcemia.
KEYWORD
Vitamin D deficiency, Mother-newborn pair, Neonatal late-onset hypocalcemia
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