Vitamin D Screening of Healthy Newborns in Montreal
Notice bibliographique
Résumé
National data on vitamin D status is lacking for neonates in Canada. The Institute of Medicine defines vitamin D deficiency as <30 nmol/L of 25(OH)D and recommends that 25(OH)D be at least 50 nmol/L to support bone health. The Canadian Paediatric Society suggests 25(OH)D be between 75 to 225 nmol/L. One out of four healthy term-born infants born to healthy mothers from Quebec City had cord serum 25-hydroxyvitamin D (25(OH)D) concentrations <50 nmol/L. Identifying infants with insufficient vitamin D status at birth will inform health professionals and parents of the need to establish good vitamin D stores early in life. The aim of this study was to assess the feasibility of newborn screening for vitamin D status within 24–36 h of birth. Mothers and their infants from a hospital in the greater Montreal area were studied. A capillary sample (500 μl) was obtained at the same time as other standard screening tests for measurement of total 25(OH)D using a chemiluminescent assay (Liaison, Diasorin). A researcher administered a questionnaire to the mothers to survey ethnicity and immigration status, income, education, supplement use and sun exposure. Inclusion criteria were any singleton healthy term-born infant of appropriate weight for gestational age based on the Arbuckle Canadian growth reference and born to a healthy mother of any race. Mothers were excluded if they had any form of diabetes, preeclampsia, celiac disease, inflammatory bowel disease or took medications that impact vitamin D/mineral metabolism. Data was collected from March to November 2016. Data are mean ± SD or proportions. Relative to all births 30.0% (292/971) did not meet the eligibility criteria. Of the remaining eligible mothers, 52.3% (355/679) agreed to screening. Complete data and blood samples were successfully obtained from 86.5 % (307/355) of participants. Mothers were 32 ± 5.4 years of age, 64.8% identified as white, 60.5% were born in Canada, 56.7% were university educated, 38.5% took a multivitamin during the 3 months before they became pregnant and 92.8% took a multivitamin during pregnancy. Neonates (n=159 male; n=148 female) were born at 40.0 ± 1.0 weeks gestation and had a weight of 3428 ± 378 g with a corresponding weight-for-age z-score of 0.2 ± 0.8. Serum 25(OH)D concentration was 48.0 ± 19.0 nmol/L; National Institutes of Standards and Technology vitamin D control 972a-Level 1 (73.3 +/− 2.8 nmol/L) was measured monthly and was within 2.3% of the reference value. Fifty-six percent (172/307) had a 25(OH)D concentration below 50 nmol/L, 18.2% (56/307) were below 30 nmol/L and 9.8% (30/307) were at or above 75 nmol/L (Figure 1). Overall, screening for vitamin D status was feasible in terms of a high acceptance rate by parents and sufficient sample volume. Given that such a large proportion of the infants were born insufficient warrants further examination into screening for vitamin D status at birth and current supplementation recommendations during pregnancy and for the neonate. Support or Funding Information Supported through a grant from the Canadian Institutes for Health Research, Canada Foundation for Innovation and the Canada Research Chairs Program. Histogram of serum 25(OH)D concentrations from healthy term-born infants of appropriate weight for gestational age (n=307).
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Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,002 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».