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Differential low uptake of free vitamin D supplements in preterm infants: the Quebec experience.

Fatani T, Sharma AK, Weiler HA, Sheehy O, Bérard A, Rodd C - BMC Pediatr (2014)

Bottom Line: The number of infants obtaining supplements was the primary outcome and their characteristics were compared across gestational age groups.Additionally, there was a significant decline in program participation over time (OR = 0.90/year, 95% CI: 0.89-0.90) regardless of gestational age.A prescription from a pediatrician significantly increased the odds of obtaining the supplement.

View Article: PubMed Central - PubMed

ABSTRACT

Background: Vitamin D is essential for bone mineralization, particularly in premature infants. For nearly 20 years, Quebec has offered a program of free vitamin D supplements via its public medication insurance plan Régie de l'Assurance Maladie du Québec (RAMQ). The objective of this study is to evaluate the number of preterm infants that obtained at least one bottle (50 doses) of vitamin D supplement through this program and to determine if uptake varied by gestational age.

Methods: This was a retrospective cohort study of preterm infants covered by RAMQ and born from 1998 to 2008; all infants had 1 year of follow-up data regarding supplement use. Data were extracted from the Quebec Pregnancy Cohort, a linked administrative database and were stratified by early (<34 weeks) or late gestational age premature infants. The number of infants obtaining supplements was the primary outcome and their characteristics were compared across gestational age groups. Predictors for participation (obtaining at least 1 bottle) or adherence (2 or more bottles) were identified via logistic regression (GEE).

Results: 10288 infants were eligible; the percentage exposed to vitamin D was 24.5% (37.4%- early; 20.7%-late preterm infants, p < 0.001). The median number of bottles obtained was 2 for early and 1 for late preterms. For all premature infants, there was an apparent geometric decline in the infants obtaining subsequent bottles of supplements over the 12 month period. Additionally, there was a significant decline in program participation over time (OR = 0.90/year, 95% CI: 0.89-0.90) regardless of gestational age. Older or more educated mothers were positive predictors for participation. A prescription from a pediatrician significantly increased the odds of obtaining the supplement.

Conclusion: Early preterm infants were more likely to obtain the supplement post-discharge; uptake was low and decreased with time for both age categories. Specifically, targeting late preterm infants and young mothers with less education could improve vitamin D uptake.

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Related in: MedlinePlus

Number of bottles of vitamin D supplements obtained over infancy in all preterm infants.
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Related In: Results  -  Collection

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Fig1: Number of bottles of vitamin D supplements obtained over infancy in all preterm infants.

Mentions: The Figure 1 presents the number of infants obtaining 1 or more bottles; a steep drop was noted in the number of infants obtaining 2 or more bottles over a 12 mo. period.


Differential low uptake of free vitamin D supplements in preterm infants: the Quebec experience.

Fatani T, Sharma AK, Weiler HA, Sheehy O, Bérard A, Rodd C - BMC Pediatr (2014)

Number of bottles of vitamin D supplements obtained over infancy in all preterm infants.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4260192&req=5

Fig1: Number of bottles of vitamin D supplements obtained over infancy in all preterm infants.
Mentions: The Figure 1 presents the number of infants obtaining 1 or more bottles; a steep drop was noted in the number of infants obtaining 2 or more bottles over a 12 mo. period.

Bottom Line: The number of infants obtaining supplements was the primary outcome and their characteristics were compared across gestational age groups.Additionally, there was a significant decline in program participation over time (OR = 0.90/year, 95% CI: 0.89-0.90) regardless of gestational age.A prescription from a pediatrician significantly increased the odds of obtaining the supplement.

View Article: PubMed Central - PubMed

ABSTRACT

Background: Vitamin D is essential for bone mineralization, particularly in premature infants. For nearly 20 years, Quebec has offered a program of free vitamin D supplements via its public medication insurance plan Régie de l'Assurance Maladie du Québec (RAMQ). The objective of this study is to evaluate the number of preterm infants that obtained at least one bottle (50 doses) of vitamin D supplement through this program and to determine if uptake varied by gestational age.

Methods: This was a retrospective cohort study of preterm infants covered by RAMQ and born from 1998 to 2008; all infants had 1 year of follow-up data regarding supplement use. Data were extracted from the Quebec Pregnancy Cohort, a linked administrative database and were stratified by early (<34 weeks) or late gestational age premature infants. The number of infants obtaining supplements was the primary outcome and their characteristics were compared across gestational age groups. Predictors for participation (obtaining at least 1 bottle) or adherence (2 or more bottles) were identified via logistic regression (GEE).

Results: 10288 infants were eligible; the percentage exposed to vitamin D was 24.5% (37.4%- early; 20.7%-late preterm infants, p < 0.001). The median number of bottles obtained was 2 for early and 1 for late preterms. For all premature infants, there was an apparent geometric decline in the infants obtaining subsequent bottles of supplements over the 12 month period. Additionally, there was a significant decline in program participation over time (OR = 0.90/year, 95% CI: 0.89-0.90) regardless of gestational age. Older or more educated mothers were positive predictors for participation. A prescription from a pediatrician significantly increased the odds of obtaining the supplement.

Conclusion: Early preterm infants were more likely to obtain the supplement post-discharge; uptake was low and decreased with time for both age categories. Specifically, targeting late preterm infants and young mothers with less education could improve vitamin D uptake.

Show MeSH
Related in: MedlinePlus