A Review on the Relation between Sepsis and Vitamin D Level among Neonatal Intensive Care Unit Infants

Abstract

Background Neonatal sepsis is a critical condition caused by a generalized bacterial infection in the first month of life. The present study aimed to investigate the relationship between serum vitamin D levels and neonatal sepsis. Materials and Methods: A search of online databases (Medline, Cochrane Library, Web of Science, EMBASE-Ovid, and Scopus) were carried out for randomized control trials and non-randomized prospective or retrospective clinical studies published in English till April 2020. Two reviewers selected the studies. Results: In the first study, the level of 25-hydroxyvitamin D [25(OH)D] in the cord-blood sample of infants in the Early-Onset Neonatal Sepsis (EONS) group was significantly lower compared to the control group. 25(OH)D level (19 ng/ml) in the control group were significantly higher compared to the 25(OH) level (8.6 ng/ml) in the sepsis group. In the third study, the serum 25(OH) level showed a significant decrease in the affected neonates (6.4 nmol/L) compared to healthy neonates (42.5 nmol/L). In the fourth study, the sepsis and control group had a significant difference in the level of 25(OH)D (69±7.5ng/ml and 35±19ng/ml). According to the fifth study, the serum 25(OH)D level was insufficient in the case group and sufficient in the control group (p <0.0001). In the sixth study, the odds of very-early-onset neonatal sepsis among the neonates who had the serum 25-hydroxyvitamin D deficiency were lower compared to the odds among neonates who did not have serum 25-hydroxyvitamin D deficiency. Conclusion The level of 25-hydroxyvitamin D in the blood sample of infants in the sepsis group was significantly lower compared to the control group; further studies required to confirm the results by considering more confounders.