| Title: |
Maternal–infant vitamin D coupling and neonatal hypocalcemia: a six-year cohort integrating preterm risk, onset timing, and pandemic effects |
| Authors: |
Hasan Avşar; Ali Bülbül; Evrim Kıray Baş; Hasan Sinan Uslu; Ebru Türkoğlu Ünal; Alper Divarcı; Ahmet Yaşar Tellioğlu; Bülent Güzel; Duygu Besnili Acar; Muammer Kazdal |
| Source: |
BMC Pediatrics, Vol 26, Iss 1 (2026) |
| Publisher Information: |
BMC |
| Publication Year: |
2026 |
| Collection: |
Directory of Open Access Journals: DOAJ Articles |
| Subject Terms: |
Neonatal hypocalcemia; Vitamin d deficiency; Parathyroid hormone; Preterm infant; Ionized calcium; Sepsis; Pediatrics; RJ1-570 |
| Description: |
Background Neonatal hypocalcemia is among the most common metabolic abnormalities in early life, particularly in preterm and critically ill infants. Maternal and neonatal vitamin D deficiency, sepsis, and perinatal factors play central roles in its pathogenesis. The COVID-19 pandemic may have further influenced vitamin D status and hypocalcemia frequency. Aims This study aimed to determine the incidence, etiological factors, biochemical characteristics, and treatment outcomes of neonatal hypocalcemia over a six-year period and to evaluate the impact of the COVID-19 pandemic on vitamin D status and hypocalcemia burden. Methods This retrospective cohort included all neonates admitted to the NICU between January 2017 and January 2023 (Ethics Approval No: 3987). Hypocalcemia was defined as total calcium < 8 mg/dL in term infants or < 7 mg/dL in preterm infants and/or ionized calcium < 1.1 mmol/L. Maternal and neonatal demographic, clinical, and biochemical parameters were reviewed. Subgroup analyses compared term vs. preterm infants and early- (< 72 h) vs. late-onset (≥ 72 h) hypocalcemia, as well as pre-pandemic and pandemic periods. Results Among 3,364 NICU admissions, 322 neonates (9.57%) had hypocalcemia, of whom 72.7% were preterm. Maternal vitamin D deficiency or insufficiency was present in 50.0%, and neonatal deficiency in 72.3%. Sepsis occurred in 50.9% of cases and was significantly more frequent in preterm infants. Late-onset hypocalcemia was characterized by lower 25(OH)D levels and higher parathyroid hormone (PTH) concentrations compared with early-onset cases (both p < 0.05). During the COVID-19 period, the incidence of hypocalcemia increased, maternal and neonatal vitamin D deficiency became more prevalent, and the duration of calcium therapy was longer (all p < 0.05). Conclusions Neonatal hypocalcemia was frequent, particularly among preterm infants, and was strongly associated with maternal–infant vitamin D deficiency. The distinct biochemical profile of late-onset ... |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| Relation: |
https://doi.org/10.1186/s12887-026-06532-z; https://doaj.org/toc/1471-2431; https://doaj.org/article/50d0ea29445d44dbb002cdc236319e1c |
| DOI: |
10.1186/s12887-026-06532-z |
| Availability: |
https://doi.org/10.1186/s12887-026-06532-z; https://doaj.org/article/50d0ea29445d44dbb002cdc236319e1c |
| Accession Number: |
edsbas.13445558 |
| Database: |
BASE |