Neonatal hypocalcaemia (NH) is a well described phenomena with values of 22.25 mmol/l seen at 24 h of age after the cessation of transfer of transplancental calcium. Levels then increase to normal by 2 weeks of life. Calcium levels below 2.0 mmol/l in infants >1.5 kg is considered to be pathological hypocalcaemia. The role of vitamin D in NH is unclear and not well studied in both neonate and mother.
Aim: To present the features of neonates with hypocalcaemia focussing on their vitamin D concentration along with maternal levels in a large district general hospital.
Method: A retrospective study of all admissions (notes and investigations) to Whiston Hospital neonatal unit over a 6 month period September 2016February 2017, to identify neonates with hypocalcaemia (Adjusted calcium <2.0 mmol/l), their vitamin D levels and risk factors for NH.
Results: Five patients were identified. All were born prematurely but in the third trimester. All neonates were deficient in vitamin D (<30 nmol/l) with one infant severely deficient (<20 nmol/l). Three of the mothers were severely deficient. No neonates had associated hypomagnesemia. PTH was appropriately elevated. None of the mothers had gestational diabetes and there was no history of birth asphyxia.
|Patient||Gestation (weeks)||Weight (kg)||Calcium (mmol/l)||Phosphate (mmol/l)||Magnesium (mmol/l)||ALP (U/L)||Vitamin D (nmol/l)||PTH (pmol/l)||Maternal Calcium (mmol/l)||Maternal Vit D (nmol/l)|
|n.a., not available.|
Conclusion: In this short case series of premature babies, low neonatal vitamin D appears to be associated with NH with no other risk factors present. There was also associated maternal Vitamin D deficiency, which could have resulted in low neonatal calcium and vitamin D.
22 - 24 Nov 2017
British Society for Paediatric Endocrinology and Diabetes