145 To determine if Vitamin D prophylaxis decreases the incidence of maternal and neonatal infection

Abstract

To determine if Vitamin D prophylaxis decreases the incidence of maternal and neonatal infection. A secondary analysis assessing maternal and neonatal infection was performed on a RCT in which pregnant women received Vitamin D3 3000 IU daily or no supplement. Women with a confirmed intrauterine pregnancy 12-16 weeks without a history of Vitamin D use or malabsorption disorder were included. Maternal 25-hydroxyvitamin D (25(OH)D) levels were assessed at the time of enrollment and admission for delivery. Neonatal 25(OH)D level was assessed via cord blood. Outcomes collected included clinical chorioamnionitis (temperature > 38.0°C + maternal leukocytosis, purulent cervical discharge, or fetal tachycardia), endometritis (temperature > 38.0°C + uterine tenderness on exam), neonatal infection (as documented by NICU staff), neonatal sepsis (+ blood culture) and histologic chorioamnionitis (polymorphonucleocytes in the placental amnion and chorion). Parametric and nonparametric statistics were used to compare groups. A P value of <0.05 was statistically significant. Of the 412 women enrolled, 392 (95.1%) had completed pregnancies for analysis. Demographic characteristics, including baseline 25(OH)D levels, were similar between groups. Table 1. Compared to women who did not receive Vitamin D prophylaxis, those who did had a significantly higher 25(OH)D delivery (29.18 +/- 11.87 ng/mL vs. 23.79 +/- 9.29 ng/mL; P<0.001) and cord blood levels (33.73 +/- 13.68 ng/mL vs. 26.06 +/- 9.72 ng/mL; P<0.001). Vitamin D prophylaxis did not decrease the incidence of clinical chorioamnionitis, endometritis, neonatal infection, and neonatal sepsis. Table 2. Stratification by Vitamin D deficiency status revealed a higher incidence of clinical chorioamnionitis in those who did not receive intervention and remained Vitamin D deficient at delivery (9.7% vs. 1.6%; RR 5.9 95% CI 1.3-21.7; P=0.010). Vitamin D prophylaxis does not decrease the incidence of maternal or neonatal infection. Persistent Vitamin D deficiency in pregnancy may be associated with a risk for clinical chorioamnionitis.View Large Image Figure ViewerDownload Hi-res image Download (PPT)