Research Article
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Year 2025, Volume: 16 Issue: 55, 70 - 76, 18.08.2025
https://doi.org/10.17944/interdiscip.1627263

Abstract

References

  • Cheng E, George AA, Bansal SK, Nicoski P, Amin S. Neonatal Hypocalcemia: Common, Uncommon, and Rare Etiologies. Neoreviews. 2023; 1;24(4):e217-e228. https://doi.org/10.1542/neo.24-4-e217 Pillai SS, Foster CA, Ashraf AP. Approach to Neonatal Hypocalcemia. Newborn. 2022;1(1):190-6. https://doi.org/10.5005/jp-journals-11002-0017
  • Vuralli D. Clinical approach to hypocalcemia in newborn period and infancy: who should be treated? Int J Pediatr. 2019;2019(1):4318075. https://doi.org/10.1155/2019/4318075 lsary AY, Elgameel AA, Mohammed WS, Zaki OM, Taha SA. Neonatal hypocalcemia and its relation to vitamin D and calcium supplementation. Saudi Med J. 2018;39(3):247. https://doi.org/10.15537/smj.2018.3.21679
  • Adán Lanceta V, Martín Ruiz N, Benito Costey S, Alijarde Lorente R, Martínez de Zabarte Fernández JM. A neonatal hypocalcemia due to maternal vitamin D deficiency. Reviewing supplementation. An Pediatr (Engl Ed). 2022;96(2):153-4. https://doi.org/10.1016/j.anpede.2020.09.015
  • Xu X, Ma H, Cheng S, Xue J. Effect of early preventive supplementation with calcium and phosphorus on metabolic bone disease in premature infants. BMC Pediatr. 2024;24(1):171. https://doi.org/10.1186/s12887-024-04654-w
  • Shin BS, Shin SH, Kim EK, Kim HS. Factors associated with early onset hypocalcemia: A retrospective cohort study. Pediatr Int. 2025;67(1):e15849. https://10.1111/ped.15849
  • Chacham S, Pasi R, Chegondi M, Ahmad N, Mohanty SB. Metabolic Bone Disease in Premature Neonates: An Unmet Challenge. J Clin Res Pediatr Endocrinol. 2020;12(4):332-9. https://10.4274/jcrpe.galenos.2019.2019.0091
  • Cho WI, Yu HW, Chung HR, Shin CH, Yang SW, Choi CW, et al. Clinical and laboratory characteristics of neonatal hypocalcemia. Ann Pediatr Endocrinol Metab. 2015;20(2):86-91. https://doi.org/10.6065/apem.2015.20.2.86
  • Yılmaz B, Aygün C, Çetinoğlu E. Vitamin D levels in newborns and association with neonatal hypocalcemia. J Matern Fetal Neonatal Med 2018;31(14):1889-93. https://doi.org/10.1080/14767058.2017.1331430
  • Kamate M, Sharma K, Patil V. Prevalence of hypocalcemia in seizures in infancy. Indian J Pediatr 2018;85(4):307-8. https://doi.org/10.1007/s12098-017-2546-3
  • Wang Y-h, Bhandari A, Yang F, Zhang W, Xue L-j, Liu H-g, et al. Risk factors for hypocalcemia and hypoparathyroidism following thyroidectomy: a retrospective Chinese population study. Cancer Manag Res. 2017;9:627-35. https://doi.org/10.2147/CMAR.S148090
  • Hetaimish B. Neonatal Calcinosis Cutis After Treatment of Hypocalcemia with Calcium Gluconate: A Report of 2 Cases. Am J Case Rep. 2024; 25:e943397. https://10.12659/AJCR.943397
  • Nabiel N, Nugroho HW, Moelyo AG. Vitamin D Deficiency is Associated with Hypocalcemia in Preterm Infants. Mol Cell Biomed Sci 2024;8(2):90-5. https://doi.org/10.21705/mcbs.v8i2.473 Holick MF. Vitamin D: extraskeletal health. Endocrinol Metab Clin North Am 2010;39(2):381-400. https://doi.org/10.1016/j.ecl.2010.02.016
  • Wagner CL, Greer FR, Breastfeeding So, Nutrition Co. Prevention of rickets and vitamin D deficiency in infants, children, and adolescents. Pediatrics. 2008;122(5):1142-52. https://doi.org/10.1542/peds.2008-1862
  • Patel P, Bhatia J, editors. Total parenteral nutrition for the very low birth weight infant. Seminars in fetal and neonatal medicine; 2017: Elsevier.
  • Hosseini SM, Panahi-Azar A, Sheybani-Arani MH, Morovatshoar R, Mirzadeh M, Asl AS, et al. Vitamins, Minerals and Their Maternal Levels’ Role in Brain Development: An Updated Literature-Review. Clinical Nutr ESPEN. 2024. https://doi.org/10.1016/j.clnesp.2024.05.011
  • Paterson CR. Bone disease and fractures in early childhood. In: Turner RA, Rogers HO, editors. Child Abuse. New York: Nova Science Publishers, Inc.; 2012. p. 27-52.
  • Hansen AR, Stark AR, Eichenwald EC, Martin CR. CLoherty and Stark’s Manual of neonatal care: Lippincott Williams & Wilkins; 2022.
  • Goyal A, Anastasopoulou C, Ngu M, Singh S. Hypocalcemia. In: StatPearls. Treasure Island (FL): StatPearls Publishing; October 15, 2023.
  • Liu Y, Chai Y, Rong Z, Chen Y. Prognostic Value of Ionized Calcium Levels in Neonatal Sepsis. Ann Nutr Metab. 2020;76(3):193-200. https://10.1159/000508685
  • Kozgar SAM, Chay P, Munns CF. Screening of vitamin D and calcium concentrations in neonates of mothers at high risk of vitamin D deficiency. BMC Pediatr. 2020;20(1):332. https://doi.org/10.1186/s12887-020-02204-8
  • Akirov A, Gorshtein A, Shraga-Slutzky I, Shimon I. Calcium levels on admission and before discharge are associated with mortality risk in hospitalized patients. Endocrine. 2017;57:344-51. https://doi.org/10.1007/s12020-017-1353-y
  • Kovacs CS. Maternal mineral and bone metabolism during pregnancy, lactation, and post-weaning recovery. Physiol Rev. 2016. https://doi.org/10.1152/physrev.00027.2015 Rosli NFH, Mohd Nor NS, Adnan RA, Sheikh Abdul Kadir SH. A review of vitamin D deficiency and vitamin D receptor polymorphisms in endocrine-related disorders. Clin Exp Pediatr. 2025 Jan;68(1):30-52. https://10.3345/cep.2024.00227

Evaluation of clinical and laboratory related factors of early-onset hypocalcemia in term neonates

Year 2025, Volume: 16 Issue: 55, 70 - 76, 18.08.2025
https://doi.org/10.17944/interdiscip.1627263

Abstract

Objective: Early-onset hypocalcemia (EOH) is a common metabolic disorder in neonates, which occurs during the first three days of life. The purpose of the study is to define the hypocalcemia characteristics, its clinical presentations, laboratory findings, and treatment for early-onset hypocalcemia in newborns.
Method: This is a cross sectional study obtaining the patient’s data retrospectively from the Neonatal Intensive Care Unit at İzmir Buca Seyfi Demirsoy Training and Research Hospital. Fifty-one neonates born with ≥ 37 weeks of gestation who were diagnosed with hypocalcemia within the first three days of life between 2022-2024 were included in the study. The study analyzed demographic characteristics, laboratory values, timing and severity of hypocalcemia, treatment methods, and discharge details.
Results: The study found no significant association between 25-OH vitamin D levels and birth weight or gestational age in neonates with EOH. Neonatal hypocalcemia onset on the 2nd and 3rd days of life showed higher initial calcium levels, suggesting early calcium levels may play a role. No significant association was found between 25-OH vitamin D levels and serum calcium, ionized calcium, or albumin levels, and hospitalization length. The use of calcium or vitamin D supplements did not influence 25-OH vitamin D levels or hypocalcemia outcomes.
Conclusion: Gestational age and initial calcium levels are predictive of the timing and severity of EOH. However, 25-OH vitamin D levels were not significantly associated with birth weight, blood calcium, ionized calcium, or albumin levels in this population. These findings suggest that other factors influencing vitamin D metabolism in neonates with EOH require further investigation.

References

  • Cheng E, George AA, Bansal SK, Nicoski P, Amin S. Neonatal Hypocalcemia: Common, Uncommon, and Rare Etiologies. Neoreviews. 2023; 1;24(4):e217-e228. https://doi.org/10.1542/neo.24-4-e217 Pillai SS, Foster CA, Ashraf AP. Approach to Neonatal Hypocalcemia. Newborn. 2022;1(1):190-6. https://doi.org/10.5005/jp-journals-11002-0017
  • Vuralli D. Clinical approach to hypocalcemia in newborn period and infancy: who should be treated? Int J Pediatr. 2019;2019(1):4318075. https://doi.org/10.1155/2019/4318075 lsary AY, Elgameel AA, Mohammed WS, Zaki OM, Taha SA. Neonatal hypocalcemia and its relation to vitamin D and calcium supplementation. Saudi Med J. 2018;39(3):247. https://doi.org/10.15537/smj.2018.3.21679
  • Adán Lanceta V, Martín Ruiz N, Benito Costey S, Alijarde Lorente R, Martínez de Zabarte Fernández JM. A neonatal hypocalcemia due to maternal vitamin D deficiency. Reviewing supplementation. An Pediatr (Engl Ed). 2022;96(2):153-4. https://doi.org/10.1016/j.anpede.2020.09.015
  • Xu X, Ma H, Cheng S, Xue J. Effect of early preventive supplementation with calcium and phosphorus on metabolic bone disease in premature infants. BMC Pediatr. 2024;24(1):171. https://doi.org/10.1186/s12887-024-04654-w
  • Shin BS, Shin SH, Kim EK, Kim HS. Factors associated with early onset hypocalcemia: A retrospective cohort study. Pediatr Int. 2025;67(1):e15849. https://10.1111/ped.15849
  • Chacham S, Pasi R, Chegondi M, Ahmad N, Mohanty SB. Metabolic Bone Disease in Premature Neonates: An Unmet Challenge. J Clin Res Pediatr Endocrinol. 2020;12(4):332-9. https://10.4274/jcrpe.galenos.2019.2019.0091
  • Cho WI, Yu HW, Chung HR, Shin CH, Yang SW, Choi CW, et al. Clinical and laboratory characteristics of neonatal hypocalcemia. Ann Pediatr Endocrinol Metab. 2015;20(2):86-91. https://doi.org/10.6065/apem.2015.20.2.86
  • Yılmaz B, Aygün C, Çetinoğlu E. Vitamin D levels in newborns and association with neonatal hypocalcemia. J Matern Fetal Neonatal Med 2018;31(14):1889-93. https://doi.org/10.1080/14767058.2017.1331430
  • Kamate M, Sharma K, Patil V. Prevalence of hypocalcemia in seizures in infancy. Indian J Pediatr 2018;85(4):307-8. https://doi.org/10.1007/s12098-017-2546-3
  • Wang Y-h, Bhandari A, Yang F, Zhang W, Xue L-j, Liu H-g, et al. Risk factors for hypocalcemia and hypoparathyroidism following thyroidectomy: a retrospective Chinese population study. Cancer Manag Res. 2017;9:627-35. https://doi.org/10.2147/CMAR.S148090
  • Hetaimish B. Neonatal Calcinosis Cutis After Treatment of Hypocalcemia with Calcium Gluconate: A Report of 2 Cases. Am J Case Rep. 2024; 25:e943397. https://10.12659/AJCR.943397
  • Nabiel N, Nugroho HW, Moelyo AG. Vitamin D Deficiency is Associated with Hypocalcemia in Preterm Infants. Mol Cell Biomed Sci 2024;8(2):90-5. https://doi.org/10.21705/mcbs.v8i2.473 Holick MF. Vitamin D: extraskeletal health. Endocrinol Metab Clin North Am 2010;39(2):381-400. https://doi.org/10.1016/j.ecl.2010.02.016
  • Wagner CL, Greer FR, Breastfeeding So, Nutrition Co. Prevention of rickets and vitamin D deficiency in infants, children, and adolescents. Pediatrics. 2008;122(5):1142-52. https://doi.org/10.1542/peds.2008-1862
  • Patel P, Bhatia J, editors. Total parenteral nutrition for the very low birth weight infant. Seminars in fetal and neonatal medicine; 2017: Elsevier.
  • Hosseini SM, Panahi-Azar A, Sheybani-Arani MH, Morovatshoar R, Mirzadeh M, Asl AS, et al. Vitamins, Minerals and Their Maternal Levels’ Role in Brain Development: An Updated Literature-Review. Clinical Nutr ESPEN. 2024. https://doi.org/10.1016/j.clnesp.2024.05.011
  • Paterson CR. Bone disease and fractures in early childhood. In: Turner RA, Rogers HO, editors. Child Abuse. New York: Nova Science Publishers, Inc.; 2012. p. 27-52.
  • Hansen AR, Stark AR, Eichenwald EC, Martin CR. CLoherty and Stark’s Manual of neonatal care: Lippincott Williams & Wilkins; 2022.
  • Goyal A, Anastasopoulou C, Ngu M, Singh S. Hypocalcemia. In: StatPearls. Treasure Island (FL): StatPearls Publishing; October 15, 2023.
  • Liu Y, Chai Y, Rong Z, Chen Y. Prognostic Value of Ionized Calcium Levels in Neonatal Sepsis. Ann Nutr Metab. 2020;76(3):193-200. https://10.1159/000508685
  • Kozgar SAM, Chay P, Munns CF. Screening of vitamin D and calcium concentrations in neonates of mothers at high risk of vitamin D deficiency. BMC Pediatr. 2020;20(1):332. https://doi.org/10.1186/s12887-020-02204-8
  • Akirov A, Gorshtein A, Shraga-Slutzky I, Shimon I. Calcium levels on admission and before discharge are associated with mortality risk in hospitalized patients. Endocrine. 2017;57:344-51. https://doi.org/10.1007/s12020-017-1353-y
  • Kovacs CS. Maternal mineral and bone metabolism during pregnancy, lactation, and post-weaning recovery. Physiol Rev. 2016. https://doi.org/10.1152/physrev.00027.2015 Rosli NFH, Mohd Nor NS, Adnan RA, Sheikh Abdul Kadir SH. A review of vitamin D deficiency and vitamin D receptor polymorphisms in endocrine-related disorders. Clin Exp Pediatr. 2025 Jan;68(1):30-52. https://10.3345/cep.2024.00227
There are 22 citations in total.

Details

Primary Language English
Subjects Paediatrics (Other)
Journal Section Research Articles
Authors

Mustafa Törehan Aslan 0000-0002-3966-4635

Sezgin Güneş 0000-0001-9589-6118

Begüm Cezayir This is me

Zehra Neşeli

Suzan Şahin

Publication Date August 18, 2025
Submission Date January 26, 2025
Acceptance Date April 18, 2025
Published in Issue Year 2025 Volume: 16 Issue: 55

Cite

Vancouver Aslan MT, Güneş S, Cezayir B, Neşeli Z, Şahin S. Evaluation of clinical and laboratory related factors of early-onset hypocalcemia in term neonates. Interdiscip Med J. 2025;16(55):70-6.