Maternal hypovitaminosis D: a cause of neonatal hypocalcemic seizures
Keywords:Hypocalcemia, Maternal hypovitaminosis D, Neonatal seizures, Vitamin D deficiency
Neonatal late onset hypocalcemia is the one which occurs after 72 hours of life. 1,25 (OH)2- vitamin D and Parathormone (PTH) play crucial role in regulation of calcium and phosphorus homeostasis in the body. Vitamin D helps in the absorption of calcium and phosphorus from the gut. PTH promotes absorption of calcium from thick ascending loop of henle and distal tubule whereas it increases excretion of phosphorus. During hypocalcemia, parathormone level shoot up in the body to maintain normal calcium levels. In a patient with poor resources of vitamin D, there is disturbance of Calcium, phosphorus homeostasis leading on to clinical manifestations. Exclusively breast-fed infants without vitamin D supplementation and infants born to mothers with Vitamin D deficiency are at risk to develop Hypovitaminosis D and manifest symptoms of hypocalcemia.
Balasubramanian S. Vitamin D deficiency in breastfed infants and the need for routine vitamin D supplementation. Indian J Medic Res. 2011;133(3):250-2.
Craig M, Zacharin MR, Rodda CP, Batch JA, Morley R, Cranswick NE et al. Prevention and treatment of infant and childhood vitamin D deficiency in Australia and New Zealand: a consensus statement. Med J Australia. 2006;185(5):268-72.
Camadoo L, Tibbott R, Isaza F. Maternal vitamin D deficiency associated with neonatal hypocalcaemic convulsions. Nutrit J. 2007;6:23.
Khalessi N, Kalani M, Araghi M, Farahani Z. The Relationship between Maternal Vitamin D Deficiency and Low Birth Weight Neonates. J Fam Reprod Health. 2015;9(3):113-7.
Karras SN, Fakhoury H, Muscogiuri G. Maternal vitamin D levels during pregnancy and neonatal health: evidence to date and clinical implications. Therapeu Adv Musculoskeletal Dis. 2016;8(4):124-35.
Khalesi N, Bahaeddini SM, Shariat M. Prevalence of maternal vitamin D deficiency in neonates with delayed hypocalcaemia. Acta Med Iran. 2012;50(11):740-5.
Teaema FH. Nineteen cases of symptomatic neonatal hypocalcemia secondary to vitamin d deficiency: a 2-year study. J Trop Pediatr. 2009;56(2):108-10.
Junichi O. Hypocalcemic focal seizures in a one-month-old infant of a mother with a low circulating level of vitamin D. Brain Develo. 1991;13(2):132-4.
Tripathi S, Taneja S, Vohra S. Hypovitaminosis D in an infant with hypocalcemic seizures secondary to maternal vitamin D deficiency. Pediatric Oncall. 2012;9. Art #25. Available at http://www.pediatriconcall.com/Journal/Article/FullText.aspx?artid=475&type=J&tid=&imgid=&reportid=83&tbltype.