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Serum Vitamin D Levels in Premature Neonates With Retinopathy of Prematurity; Prevalence, Severity, and Types of Treatments; a Cross-Sectional Study From Iran, 2019-2020 Publisher



Mosayebi Z1, 2 ; Sagheb S3 ; Zarkesh MR1, 4 ; Maddah M5 ; Shariat M1
Authors
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Authors Affiliations
  1. 1. Maternal, Fetal, and Neonatal Research Center, Family Health Research Institute, Tehran University of Medical Sciences, Tehran, Iran
  2. 2. Department of Pediatrics, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
  3. 3. Department of Neonatology, Shariaty Hospital, Tehran University of Medical Sciences, Tehran, Iran
  4. 4. Department of Neonatology, Yas Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
  5. 5. Clinical Research Development Center, Mahdieh Educational Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran

Source: Iranian Journal of Neonatology Published:2025


Abstract

Background: Retinopathy of prematurity (ROP) is the leading cause of preventable blindness in premature infants. 1, 25-dihydro vitamin D (Vitamin D) is a critical metabolite for the homeostasis, growth, and development, with its receptors widely present in the structure of the eyes. This study aimed to investigate the potential relationships between serum vitamin D level and the prevalence, severity, and treatment types of ROP among neonates admitted to the neonatal intensive care unit (NICU). Methods: A cross-sectional study was conducted in Tehran, Iran, from 2019 to 2020. Seventy-five preterm neonates, either with a birth weight of ≤2000 grams or unstable conditions, were included in the study. Serum vitamin D levels were measured for all neonates immediately upon admission to the NICU. Additionally, a comprehensive eye examination was performed for ROP screening. Neonates who developed ROP were categorized into two groups: Type 1 (required treatment) and Type 2 (required no treatment or only close monitoring). The relationships between vitamin D levels and the severity and type of ROP treatment were then analyzed. Results: Among 75 newborns, ROP developed in zone 1 in 10 cases (13%), zone 2 in 50 cases (67%), and zone 3 in 15 cases (20%). Of all, 18 cases (24%) were classified as Type 1 and required treatment. The mean gestational age of neonates with Type 1 ROP was significantly lower than that of neonates in the other group (P= 0.028). Of all neonates, 38 (51%) had sufficient vitamin D levels, 15 (20%) had insufficient levels, and 22 (29%) were vitamin D deficient. When comparing vitamin D status between the groups, the results showed that the mean vitamin D level was lower in neonates with Type 1 ROP compared to those with Type 2 ROP. Additionally, the mean vitamin D level in neonates with zone 3 ROP was significantly higher (P=0.04) than in those with zones 1 and 2. Conclusion: The results of this study demonstrated a positive relationship between vitamin D levels and the zones affected by ROP. This finding suggests that prenatal vitamin D supplementation may have a beneficial effect in preventing abnormal angiogenesis and reducing the involvement of the posterior retinal pole. Copyright© 2025 Mosayebi Z et al.