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. 2020 Oct 5;15(10):e0239603.
doi: 10.1371/journal.pone.0239603. eCollection 2020.

The prevalence and determinants of vitamin D deficiency in Indonesian infants at birth and six months of age

Vicka Oktaria  1   2   3 , Stephen M Graham  1 , Rina Triasih  2   3 , Yati Soenarto  2   3 , Julie E Bines  1 , Anne-Louise Ponsonby  1 , Michael W Clarke  4   5 , Rizka Dinari  3 , Hera Nirwati  3   6 , Margaret Danchin  1
Affiliations

The prevalence and determinants of vitamin D deficiency in Indonesian infants at birth and six months of age

Vicka Oktaria et al. PLoS One. .

Abstract

Background: Vitamin D deficiency in infants has been associated with an increased risk of a number of diseases but there are limited data on the prevalence and determinants of vitamin D deficiency from tropical settings with high infant morbidity and mortality.

Objective: To determine the prevalence and determinants of vitamin D deficiency in infants at birth and at six months of age in Yogyakarta province, Indonesia.

Design: Serum vitamin D of eligible infants was measured in cord blood at birth and at six months of age. Factors associated with vitamin D deficiency (serum 25-hydroxyvitamin D <50 nmol/L) were collected prospectively monthly from birth and concentrations measured by liquid chromatography-tandem mass spectrometry. Independent risk factors were identified by multiple logistic regression.

Results: Between December 2015 to December 2017, 350 maternal-newborn participants were recruited and followed up. Vitamin D deficiency was detected in 90% (308/344) of cord blood samples and 13% (33/255) of venous blood samples at six months. Longer time outdoors (≥2 hours per day) and maternal multivitamin intake containing vitamin D during pregnancy were protective against vitamin D deficiency at birth (AOR: 0.10, 95% CI: 0.01-0.90 and AOR: 0.21, 95% CI: 0.06-0.68, respectively). Risk factors for vitamin D deficiency at six months included lower cumulative skin-sun exposure score (AOR: 1.12, 95% CI: 1.04-1.20), severe vitamin D deficiency at birth (AOR: 7.73, 95% CI: 1.20-49.60) and exclusive breastfeeding (AOR: 2.64, 95% CI: 1.07-6.49) until six months. Among exclusively breast fed (EBF) infants, a higher skin-sun exposure score was associated with reduced vitamin D deficiency risk.

Conclusion: In equatorial regions, the role of 'safe' morning sun exposure in infants and mothers in populations with medium to dark brown skin pigmentation and effective interventions to prevent vitamin D deficiency in newborns and EBF infants, need further consideration and evaluation.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Flow diagram depicts sample collection for vitamin D measurement and inclusion in the final analyses.
Fig 2
Fig 2. The prevalence of vitamin D deficiency at birth and at 6 months of age.
Fig 3
Fig 3. Correlation between vitamin D concentration at birth and at 6 months of age.
Pearson’s rho = 0.23, p-value = 0.03.
See this image and copyright information in PMC

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