{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T21:52:07Z","timestamp":1789595527489,"version":"build-2803163510"},"reference-count":33,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2025,5,30]],"date-time":"2025-05-30T00:00:00Z","timestamp":1748563200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Maharaj Nakorn Chiang Mai Hospital","award":["68\/2567"],"award-info":[{"award-number":["68\/2567"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Background and Aims: Preterm newborns are particularly susceptible to hypovitaminosis D, potentially impairing bone mineralization. In Thailand, data on its prevalence and standardized supplementation protocols remain limited. This study aimed to compare the efficacy of two vitamin D3 dosages (400 IU\/day vs. 800 IU\/day) in improving serum vitamin D concentrations and metabolic bone parameters in preterm newborns. Methods: A randomized controlled trial was conducted in preterm newborns born at \u226432 weeks\u2019 gestation or with birth weight \u22641500 g. Preterm newborns were randomized to receive either 400 IU or 800 IU\/day of vitamin D3. Serum 25-hydroxyvitamin D (25(OH)D) was measured using electrochemiluminescence immunoassay (ECLIA). Metabolic bone parameters\u2014including calcium, phosphorus, alkaline phosphatase, and albumin\u2014were assessed at baseline and again at six weeks of age. Results: Of the 38 enrolled infants, baseline 25(OH)D levels were comparable between groups (14.8 \u00b1 4.8 ng\/mL in the 800 IU\/day group vs. 14.7 \u00b1 6.9 ng\/mL in the 400 IU\/day group). At six weeks, the 800 IU group demonstrated significantly higher 25(OH)D levels (47.3 \u00b1 21.0 ng\/mL vs. 32.0 \u00b1 14.2 ng\/mL; p = 0.013), with a large effect size (Cohen\u2019s d = 0.85) and the difference-in-differences of +15.7 ng\/mL. The prevalence of hypovitaminosis D declined from 89% to 5% in the 800 IU\/day group and from 74% to 32% in the 400 IU\/day group (p = 0.036). No significant differences in metabolic bone parameters or signs of toxicity were observed. Conclusions: Vitamin D3 supplementation at 800 IU\/day significantly improved vitamin D status and reduced hypovitaminosis D in preterm newborns, without observed toxicity.<\/jats:p>","DOI":"10.3390\/nu17111888","type":"journal-article","created":{"date-parts":[[2025,6,2]],"date-time":"2025-06-02T05:09:12Z","timestamp":1748840952000},"page":"1888","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Improving Vitamin D Status in Preterm Newborns: A Randomized Trial of 800 vs. 400 IU\/Day"],"prefix":"10.3390","volume":"17","author":[{"given":"Nawinda","family":"Rueang-amnat","sequence":"first","affiliation":[{"name":"Division of Neonatology, Department of Pediatrics, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9612-5048","authenticated-orcid":false,"given":"Kulnipa","family":"Kittisakmontri","sequence":"additional","affiliation":[{"name":"Division of Pediatric Nutrition, Department of Pediatrics, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Varangthip","family":"Khuwuthyakorn","sequence":"additional","affiliation":[{"name":"Division of Neonatology, Department of Pediatrics, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shanika","family":"Kosarat","sequence":"additional","affiliation":[{"name":"Division of Neonatology, Department of Pediatrics, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satit","family":"Manopunya","sequence":"additional","affiliation":[{"name":"Division of Neonatology, Department of Pediatrics, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7203-5067","authenticated-orcid":false,"given":"Mallika","family":"Pomrop","sequence":"additional","affiliation":[{"name":"Division of Neonatology, Department of Pediatrics, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,5,30]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1038\/s41574-021-00593-z","article-title":"The health effects of vitamin D supplementation: Evidence from human studies","volume":"18","author":"Bouillon","year":"2022","journal-title":"Nat. Rev. Endocrinol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"e1676","DOI":"10.1542\/peds.2013-0420","article-title":"Calcium and vitamin D requirements of enterally fed preterm infants","volume":"131","author":"Abrams","year":"2013","journal-title":"Pediatrics"},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Anderson-Berry, A., Thoene, M., Wagner, J., Lyden, E., Jones, G., Kaufmann, M., Van Ormer, M., and Hanson, C. (2017). Randomized trial of two doses of vitamin D3 in preterm infants < 32 weeks: Dose impact on achieving desired serum 25(OH)D3 in a NICU population. PLoS ONE, 12.","DOI":"10.1371\/journal.pone.0185950"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1159\/000508421","article-title":"Vitamin D in Preterm and Full-Term Infants","volume":"76","author":"Abrams","year":"2020","journal-title":"Ann. Nutr. Metab."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"394","DOI":"10.1210\/jc.2015-2175","article-title":"Global Consensus Recommendations on Prevention and Management of Nutritional Rickets","volume":"101","author":"Munns","year":"2016","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1111\/j.1365-3016.2012.01283.x","article-title":"Vitamin D during pregnancy and maternal, neonatal and infant health outcomes: A systematic review and meta-analysis","volume":"26","author":"Fawzi","year":"2012","journal-title":"Paediatr. Perinat. Epidemiol."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Ruangkit, C., Suwannachat, S., Wantanakorn, P., Sethaphanich, N., Assawawiroonhakarn, S., and Dumrongwongsiri, O. (2021). Vitamin D status in full-term exclusively breastfed infants versus full-term breastfed infants receiving vitamin D supplementation in Thailand: A randomized controlled trial. BMC Pediatr., 21.","DOI":"10.1186\/s12887-021-02849-z"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1007\/s11154-017-9424-1","article-title":"The vitamin D deficiency pandemic: Approaches for diagnosis, treatment and prevention","volume":"18","author":"Holick","year":"2017","journal-title":"Rev. Endocr. Metab. Disord."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1541","DOI":"10.1007\/s00431-018-3210-2","article-title":"Prevalence of vitamin D deficiency in cord blood of newborns and the association with maternal vitamin D status","volume":"177","author":"Ariyawatkul","year":"2018","journal-title":"Eur. J. Pediatr."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"e628","DOI":"10.1542\/peds.2012-3395","article-title":"Trial of daily vitamin D supplementation in preterm infants","volume":"133","author":"Natarajan","year":"2014","journal-title":"Pediatrics"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"126","DOI":"10.1111\/j.1365-2265.2012.04470.x","article-title":"Maternal vitamin D status, its associated factors and the course of pregnancy in Thai women","volume":"78","author":"Charatcharoenwitthaya","year":"2013","journal-title":"Clin. Endocrinol."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Pratumvinit, B., Wongkrajang, P., Wataganara, T., Hanyongyuth, S., Nimmannit, A., Chatsiricharoenkul, S., Manonukul, K., and Reesukumal, K. (2015). Maternal Vitamin D Status and Its Related Factors in Pregnant Women in Bangkok, Thailand. PLoS ONE, 10.","DOI":"10.1371\/journal.pone.0131126"},{"key":"ref_13","first-page":"167","article-title":"Prevalence of Maternal Hypovitaminosis D and Obstetric Outcomes at Chonprathan Hospital, Nonthaburi, Thailand","volume":"28","author":"Lersbuasin","year":"2020","journal-title":"Thai J. Obstet. Gynaecol."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Kasemsripitak, S., Jaruratanasirikul, S., Boonrusmee, S., Saengkaew, T., and Sriplung, H. (2022). Prevalence and risk factors for vitamin D insufficiency in 6\u201312-month-old infants: A cross-sectional study in Southern Thailand. BMC Pediatr., 22.","DOI":"10.1186\/s12887-022-03797-y"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"S36","DOI":"10.1017\/S0007114513002110","article-title":"SEANUTS: The nutritional status and dietary intakes of 0.5\u201312-year-old Thai children","volume":"110","author":"Rojroongwasinkul","year":"2013","journal-title":"Br. J. Nutr."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"248","DOI":"10.1097\/MPG.0000000000003642","article-title":"Enteral Nutrition in Preterm Infants (2022): A Position Paper From the ESPGHAN Committee on Nutrition and Invited Experts","volume":"76","author":"Embleton","year":"2023","journal-title":"J. Pediatr. Gastroenterol. Nutr."},{"key":"ref_17","first-page":"1147","article-title":"How much vitamin D for neonates?","volume":"145","author":"Pittard","year":"1991","journal-title":"Am. J. Dis. Child."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"156","DOI":"10.1017\/S0007114512004722","article-title":"Vitamin D nutritional status in preterm infants and response to supplementation","volume":"110","author":"McCarthy","year":"2013","journal-title":"Br. J. Nutr."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"661","DOI":"10.1097\/MPG.0000000000000296","article-title":"Vitamin D status and adequacy of standard supplementation in preterm neonates from South India","volume":"58","author":"Tergestina","year":"2014","journal-title":"J. Pediatr. Gastroenterol. Nutr."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1016\/j.jpeds.2016.03.028","article-title":"A Comparison of 3 Vitamin D Dosing Regimens in Extremely Preterm Infants: A Randomized Controlled Trial","volume":"174","author":"Fort","year":"2016","journal-title":"J. Pediatr."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"763","DOI":"10.1038\/jp.2016.70","article-title":"A randomized double-blind controlled trial comparing two regimens of vitamin D supplementation in preterm neonates","volume":"36","author":"Tergestina","year":"2016","journal-title":"J. Perinatol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1016\/j.earlhumdev.2017.07.016","article-title":"Multi-dose vitamin d supplementation in stable very preterm infants: Prospective randomized trial response to three different vitamin D supplementation doses","volume":"112","author":"Bozkurt","year":"2017","journal-title":"Early Hum. Dev."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Ko\u0142odziejczyk-Nowotarska, A., Bokiniec, R., and Seliga-Siwecka, J. (2021). Monitored Supplementation of Vitamin D in Preterm Infants: A Randomized Controlled Trial. Nutrients, 13.","DOI":"10.20944\/preprints202108.0507.v1"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1357","DOI":"10.3945\/ajcn.111.031070","article-title":"Comparison of vitamin D2 and vitamin D3 supplementation in raising serum 25-hydroxyvitamin D status: A systematic review and meta-analysis","volume":"95","author":"Tripkovic","year":"2012","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Faienza, M.F., D\u2019Amato, E., Natale, M.P., Grano, M., Chiarito, M., Brunetti, G., and D\u2019Amato, G. (2019). Metabolic Bone Disease of Prematurity: Diagnosis and Management. Front. Pediatr., 7.","DOI":"10.3389\/fped.2019.00143"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"332","DOI":"10.4274\/jcrpe.galenos.2019.2019.0091","article-title":"Metabolic Bone Disease in Premature Neonates: An Unmet Challenge","volume":"12","author":"Chacham","year":"2020","journal-title":"J. Clin. Res. Pediatr. Endocrinol."},{"key":"ref_27","unstructured":"Thai Society for Pediatric Endocrinology (2025, April 19). Recommendations for the Prevention and Treatment of Vitamin D Deficiency in Infants, Children, and Adolescents 2023. Available online: https:\/\/thaipedendo.org\/vitamin-d-deficiency."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"266","DOI":"10.1056\/NEJMra070553","article-title":"Vitamin D deficiency","volume":"357","author":"Holick","year":"2007","journal-title":"N. Engl. J. Med."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"353","DOI":"10.3945\/an.111.000950","article-title":"Maternal vitamin D status: Effect on milk vitamin D content and vitamin D status of breastfeeding infants","volume":"3","author":"Dawodu","year":"2012","journal-title":"Adv. Nutr."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"520S","DOI":"10.1093\/ajcn\/88.2.520S","article-title":"Vitamin D in pregnancy and lactation: Maternal, fetal, and neonatal outcomes from human and animal studies","volume":"88","author":"Kovacs","year":"2008","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Brescia, V., Lovero, R., Fontana, A., Zerlotin, R., Colucci, S.C., Grano, M., Cazzolla, A.P., Di Serio, F., Crincoli, V., and Faienza, M.F. (2025). Reference Intervals (RIs) of the Bone Turnover Markers (BTMs) in Children and Adolescents: A Proposal for Effective Use. Biomedicines, 13.","DOI":"10.3390\/biomedicines13010034"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1143","DOI":"10.1152\/physrev.00014.2014","article-title":"Bone development and mineral homeostasis in the fetus and neonate: Roles of the calciotropic and phosphotropic hormones","volume":"94","author":"Kovacs","year":"2014","journal-title":"Physiol. Rev."},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Motlagh, A.J., Davoodvandi, A., and Saeieh, S.E. (2023). Association between vitamin D level in mother\u2019s serum and the level of vitamin D in the serum of pre-term infants. BMC Pediatr., 23.","DOI":"10.1186\/s12887-023-03854-0"}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/17\/11\/1888\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T17:44:32Z","timestamp":1760031872000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/17\/11\/1888"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,30]]},"references-count":33,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2025,6]]}},"alternative-id":["nu17111888"],"URL":"https:\/\/doi.org\/10.3390\/nu17111888","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5,30]]}}}