Comparison of two regimens of vitamin D supplementation for vitamin D-deficient neonates

<p><b>INTRODUCTION</b>Vitamin D deficiency is common in pregnant women, and supplementation of vitamin D is necessary for the infants of these women. This study explored the efficacy of an alternative way of vitamin D supplementation in an area with a high prevalence of vitamin D deficiency in mothers.</p><p><b>METHODS</b>This was a non-randomised clinical trial conducted in 2010 in Yazd, Iran. Full-term healthy infants born to vitamin D-deficient mothers (n = 82) were divided into the high-dose regimen (HDR; single oral bolus 30,000 IU vitamin D3, n = 34) and the standard-dose regimen (SDR; 400 IU/day vitamin D3 within two weeks of life, n = 48) groups. 25-hydroxyvitamin D (25OHD) was measured using chemiluminescent immunoassays, and 25OHD level > 20 ng/mL was deemed sufficient.</p><p><b>RESULTS</b>Over 90% of infants in the HDR group attained vitamin D sufficiency within one month, while comparable sufficiency was reached in the SDR group only after four months. At two months, the proportion of infants attaining 25OHD > 30 ng/mL was 93.3% and 27.9% in the HDR and SDR groups, respectively (p = 0.003). None of our infants achieved 25OHD levels > 100 ng/mL.</p><p><b>CONCLUSION</b>For infants born to vitamin D-deficient mothers, oral supplementation of 30,000 IU vitamin D3 during the first month of life, followed by a routine recommended dose of 400 IU/day, should be considered. The four-month lag for attaining vitamin D sufficiency in 90% of infants in the SDR group may have clinical implications and should be further investigated.</p>

role of maternal thyroid stimulating hormone receptor blocking antibodies in the etiology of congenital hypothyroidism in Isfahan, Iran

Considering the role of maternal thyroid stimulating hormone [TSH] receptor blocking antibody [TRAb] in the etiology of congenital hypothyroidism [CH], this study aimed to determine TRAb among patients with CH in Isfahan, Iran. In this case-control study, patients with CH and their mothers were compared with a group of healthy neonates and their mothers. Venous blood samples were obtained for measurement of TRAb using enzyme-linked immunosorbent assay [ELISA] method among mothers and their neonates. TSH of mothers was also determined. The case group consisted of 65 patients with CH and their mothers; controls were 148 healthy neonates and their mothers. The prevalence of positive TRAb in patients with CH and their mothers was higher than in the control group [81.5% vs. 1.3% in mothers and 80% vs. 0% in neonates, respectively, P<0.05]. The relationship between the TRAb and occurrence of CH was significant [P<0.05], whereas the corresponding figure was not significant for TRAb and the level of maternal and neonatal TSH in case and control groups [P>0.05]. It seems that autoimmunity has an important role in the etiology of CH. Further studies are necessary to determine other autoantibodies in CH patients