Investigation of multiple factors which may contribute to vitamin D levels of bedridden pregnant women and their preterm neonates.

OBJECTIVE: 25-Hydroxyvitamin D (25-OH-D) is the marker, which indicates vitamin D levels. The aim of this study was to investigate the possible factors, which contribute to serum 25-OH-D levels in bedridden mothers and their preterm neonates. METHODS: Twenty-six preterm neonates born during the period of 24-33 weeks of gestational age and 20 mothers (who experienced pregnancy complications) were recruited to the study. RESULTS: Five major results were obtained. (i) The 25-OH-D serum levels for preterm neonates and their mothers were found to possess strong correlation (ii) and both differed significantly in comparison with the optimal levels. (iii) An increase of mothers' 25-OH-D serum levels was associated with an increased possibility that the neonates would be measured to have normal 25-OH-D levels. (iv) Sex was not a key factor to neonates' 25-OH-D levels. (v) No correlation was found between mothers' 25-OH-D levels and their vitamin D3 supplement (400 IU/d during pregnancy). CONCLUSIONS: Due to insufficient exposure to sunlight and a diet not enriched with vitamin D, bedridden pregnant women suffer from vitamin D deficiency and pregnancy complications lead often to birth of preterm neonates with the same deficiency. Mothers should increase the total amount of vitamin D intake (food and supplement).

Cholestasis, bronchopulmonary dysplasia, and lipid profile in preterm infants receiving MCT/ω-3-PUFA-containing or soybean-based lipid emulsions.

BACKGROUND: This study aimed to compare the effect of 2 lipid emulsions (LEs), a medium-chain triglyceride (MCT)/ω-3-polyunsaturated fatty acid (PUFA)-containing LE and a soybean-based LE, on the incidence of neonatal cholestasis, bronchopulmonary dysplasia (BPD), and lipid profile of preterm infants. Patients and METHODS: In this prospective, observational study, 2 groups of preterm neonates, the very low birth weight (VLBW) (n = 129) and the low birth weight (LBW) groups (n = 153), which received parenteral LEs for at least 7 days, were included. Infants received either MCT/ω-3-PUFA-containing LE (SMOFlipid, subgroup I) or soybean-based LE (Intralipid, subgroup II) according to the attending neonatologist's preference and availability. Full biochemical assessment was performed on days of life 15, 30, and 45 and on discharge. RESULTS: Of the VLBW infants, 7.4% and 13.3% of infants in subgroups I and II, respectively, developed cholestasis (P = .39; odds ratio [OR], 0.52; 95% confidence interval [CI], 0.15-1.76). The duration of LE administration was independently associated with cholestasis (P < .001; OR, 0.925; 95% CI, 0.888-0.963). The maximum amounts of lipids administered ranged between 1.6 and 3.6 g/kg/d in both VLBW subgroups. The VLBW subgroup I had lower incidence of BPD, lower alkaline phosphatase and phosphate, higher high-density lipoprotein (HDL), and lower cholesterol-to-HDL ratio on discharge than the VLBW subgroup II. The type of LE was independently associated with BPD and alkaline phosphatase. In the LBW group, the type of LE was not associated with clinical and biochemical parameters. CONCLUSION: In VLBW infants, the MCT/ω-3-PUFA-containing LE administration is associated with decreased BPD and more favorable lipoprotein profile. Although a trend toward a lower incidence of cholestasis was observed, a preventive effect of MCT/ω-3-PUFA-containing LE on parenteral nutrition-associated cholestasis is not supported.

Effects of a nutritional intervention in obese postmenopausal women on atypical antipsychotics.

OBJECTIVES: To investigate the effects of a nutritional intervention on the body weight, body composition, blood glucose and lipid levels of obese postmenopausal women taking atypical antipsychotics in Greece. STUDY DESIGN: In a case-control design, 25 obese postmenopausal women treated with antipsychotic medications and 28 obese healthy comparisons were followed for 3 months. A nutritional program was individually designed for each participant. MAIN OUTCOME MEASURES: At baseline and at 3 months of the study, anthropometric, body composition, blood glucose and lipid measurements were performed. RESULTS: Significant reductions in body weight, body mass index (BMI), fat and waist circumference were found both in the patients and their healthy comparisons from baseline to 3 months (P<0.05). Patients reduced significantly less their BMI (P=0.044) and body fat percentage compared to the healthy women (P=0.023). Waist circumference was significantly reduced in both subject groups, with no significant difference found between them (P=0.07). Glucose and lipid levels were not altered during the intervention in the patients' group, while significant changes were observed in the healthy women in total cholesterol (P=0.016), low density lipoprotein cholesterol (P=0.022) and triglycerides (P=0.042). CONCLUSIONS: Obese postmenopausal women on atypical antipsychotic medication appear to respond favorably to a nutritional program. The improvements seen in BMI and body fat are attenuated in the patients compared to their healthy counterparts; moreover no change in lipid levels was found in the patients' group. These findings suggest that atypical antipsychotics may play an adverse role in fat loss and lipid metabolism in this population.

Comparison of two types of TPN prescription methods in preterm neonates.

OBJECTIVE: Total parenteral nutrition is commonly used in neonates' intensive care units for nutritional support of preterm neonates. Adequacy and safety of parenteral nutrition support are amongst the major concerns of neonates' therapy. Parenteral nutrition prescription in Greek hospitals is not based on standardized protocols, thus resulting in wide diversity of formulations. In this study, the results of utilization of standardized computerized parenteral nutrition protocols and regimens for neonates are compared to the results of protocols and regimens prescribed by individual neonatologists on neonates' outcome (weight changes, adequacy of parenteral nutrition, days of hospitalization, clinical outcome). SETTING: The study took place at "Mitera" Maternity Hospital of Greece. METHOD: Two groups of 30 preterm infants (28-36 weeks) with respiratory failure were recruited for the study. They were admitted in a Greek maternity hospital and they all received total parenteral nutrition support in neonates' intensive care unit. Standardized, computer based protocols were applied for the prescription of parenteral nutrition formulations in the first group, while on the other, regimens prescribed by neonatologists were used. MAIN OUTCOME MEASURES: Macro- and micronutrients provided by the different total parenteral nutrition protocols were recorded. Body weight was measured, blood count and biochemical profile were performed at the beginning and at the end of parenteral nutrition support. The number of days of total parenteral nutrition support as well as the total number of days of hospitalization was recorded. RESULTS: Standardized protocols provided more energy (P-value: 0.05), protein (P-value: 0.023) and micronutrients than the non-standardised. Neonates that receive standardized total parenteral nutrition gained weight (+44 +/- 114 g) and had better blood count and biochemical values during total parenteral nutrition support compared to the other group, that lost weight during total parenteral nutrition support (-53 +/- 156 g). These differences were also statistically significant (P value < 0.05). Regarding the total days of hospitalization, no differences were found between the two groups. CONCLUSION: The use of standardized protocols in preterm neonates resulted in more adequate provision of nutrients, weight gain and better blood count profile compared with protocols prescribed by individual physicians.