Evidence map›Paper›PMID 41593566›Full record

ArticleBMC pediatrics2026

Maternal-infant vitamin D coupling and neonatal hypocalcemia: a six-year cohort integrating preterm risk, onset timing, and pandemic effects.

Hasan Avşar, Ali Bülbül, Evrim Kıray Baş, Hasan Sinan Uslu, Ebru Türkoğlu Ünal, Alper Divarcı, Ahmet Yaşar Tellioğlu, Bülent Güzel, Duygu Besnili Acar, Muammer Kazdal

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Article in BMC pediatrics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

10 authors.

Hasan AvşarGaziantep Liv Hospital, Department of Neonatology, Gaziantep, Turkey. dr.hasanavsar88@gmail.com.
Ali BülbülUniversity of Health Sciences, Şişli Hamidiye Etfal Education and Research Hospital, Department of Neonatology, Istanbul, Turkey.ORCID 0000-0002-3510-3056
Evrim Kıray BaşUniversity of Health Sciences, Şişli Hamidiye Etfal Education and Research Hospital, Department of Neonatology, Istanbul, Turkey.ORCID 0000-0001-5230-8718
Hasan Sinan UsluUniversity of Health Sciences, Şişli Hamidiye Etfal Education and Research Hospital, Department of Neonatology, Istanbul, Turkey.ORCID 0000-0002-2004-0419
Ebru Türkoğlu ÜnalUniversity of Health Sciences, Şişli Hamidiye Etfal Education and Research Hospital, Department of Neonatology, Istanbul, Turkey.ORCID 0000-0003-0171-7858
Alper DivarcıUniversity of Health Sciences, Şişli Hamidiye Etfal Education and Research Hospital, Department of Neonatology, Istanbul, Turkey.ORCID 0000-0001-8754-2504
Ahmet Yaşar TellioğluUniversity of Health Sciences, Sakarya Education and Research Hospital, Department of Neonatology, Istanbul, Turkey.ORCID 0000-0001-7531-1821
Bülent GüzelUniversity of Health Sciences, Sancaktepe Education and Research Hospital, Department of Neonatology, Istanbul, Turkey.ORCID 0000-0002-8485-5422
Duygu Besnili AcarUniversity of Health Sciences, Gaziosmanpaşa Education and Research Hospital, Department of Neonatology, Istanbul, Turkey.ORCID 0000-0002-3623-2618
Muammer KazdalUniversity of Health Sciences, Şişli Hamidiye Etfal Education and Research Hospital, Department of Neonatology, Istanbul, Turkey.ORCID 0000-0002-7792-0628

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundNeonatal hypocalcemia is among the most common metabolic abnormalities in early life, particularly in preterm and critically ill infants. Maternal and neonatal vitamin D deficiency, sepsis, and perinatal factors play central roles in its pathogenesis. The COVID-19 pandemic may have further influenced vitamin D status and hypocalcemia frequency.

aimsThis study aimed to determine the incidence, etiological factors, biochemical characteristics, and treatment outcomes of neonatal hypocalcemia over a six-year period and to evaluate the impact of the COVID-19 pandemic on vitamin D status and hypocalcemia burden.

methodsThis retrospective cohort included all neonates admitted to the NICU between January 2017 and January 2023 (Ethics Approval No: 3987). Hypocalcemia was defined as total calcium < 8 mg/dL in term infants or < 7 mg/dL in preterm infants and/or ionized calcium < 1.1 mmol/L. Maternal and neonatal demographic, clinical, and biochemical parameters were reviewed. Subgroup analyses compared term vs. preterm infants and early- (< 72 h) vs. late-onset (≥ 72 h) hypocalcemia, as well as pre-pandemic and pandemic periods.

resultsAmong 3,364 NICU admissions, 322 neonates (9.57%) had hypocalcemia, of whom 72.7% were preterm. Maternal vitamin D deficiency or insufficiency was present in 50.0%, and neonatal deficiency in 72.3%. Sepsis occurred in 50.9% of cases and was significantly more frequent in preterm infants. Late-onset hypocalcemia was characterized by lower 25(OH)D levels and higher parathyroid hormone (PTH) concentrations compared with early-onset cases (both p < 0.05). During the COVID-19 period, the incidence of hypocalcemia increased, maternal and neonatal vitamin D deficiency became more prevalent, and the duration of calcium therapy was longer (all p < 0.05).

conclusionsNeonatal hypocalcemia was frequent, particularly among preterm infants, and was strongly associated with maternal–infant vitamin D deficiency. The distinct biochemical profile of late-onset hypocalcemia and the pandemic-related worsening of vitamin D status underscore the importance of adequate maternal supplementation and vigilant neonatal monitoring.

Indexed as

COVID-19HypocalcemiaInfant, Premature, DiseasesVitamin DVitamin D DeficiencyCalciumFemaleHumansIncidenceInfant, NewbornInfant, PrematureMalePregnancyRetrospective StudiesRisk FactorsSARS-CoV-2CalciumVitamin DCalcitriolCOVID-19Ionized calciumMagnesiumNeonatal hypocalcemiaParathyroid hormonePreterm infantSepsisVitamin d deficiency

Identifiers

PMID41593566
PMCPMC12917991

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.