Retrospective cohort study on the correlation between serum 25(OH)D, vitamin A and neonatal respiratory distress syndrome (NRDS) in premature infants.

Background: Premature infants are at high risk for neonatal respiratory distress syndrome (NRDS) due to underdeveloped lungs. Understanding serum 25-hydroxyvitamin D [25(OH)D] and vitamin A's roles may improve early intervention strategies. This study explores the correlation between NRDS and serum 25(OH)D and vitamin A levels in premature infants. Methods: A retrospective cohort study was conducted involving 148 premature infants. The characteristics of infants diagnosed with NRDS were compared to those without NRDS. Statistical analyses included logistic regression to evaluate the interaction between serum 25(OH)D and vitamin A levels. Results: Premature infants with NRDS exhibited significantly lower levels of both 25(OH)D and vitamin A compared to those without NRDS. There was no significant difference in serum vitamin A and D deficiency between premature infants whose mothers received and did not receive glucocorticoid treatment before delivery. The risk of developing NRDS was 10.5 times greater in infants with low levels of both vitamins as opposed to those with high levels. Furthermore, the interaction of these two vitamins was shown to contribute an additional 47.54% to the risk of NRDS. A nomogram model created for predicting NRDS risk demonstrated high predictive accuracy with a C-index of 0.961 (95% confidence interval: 0.931-0.990). Conclusions: The findings suggest that adequate serum levels of 25(OH)D and vitamin A may play a crucial role in mitigating the risk of NRDS in premature infants. Monitoring and intervention strategies regarding these vitamins could enhance clinical outcomes and reduce the incidence of NRDS.