Effects of vitamin D on neonatal sepsis: A systematic review and meta-analysis.

Abstract

Vitamin D deficiency is a major public health concern of pregnant women and neonates worldwide, affecting more than half of neonates. Studies report inconsistent and inconclusive effects of vitamin D treatment on neonatal sepsis. This study aimed to provide conclusive evidence regarding the effect of maternal and cord blood vitamin D levels on neonatal sepsis. Data were retrieved from the electronic database (Web of Science, Scopus, CINAHL [EBSCOhost], ProQuest, EMBASE [Ovid], PubMed, Emcare, MEDLINE [Ovid], and gray literature sources [World cat, Mednar, Google scholar and Google]). Joanna Briggs Institute quality assessment tool was utilized for quality assessment while analysis was performed using Open Meta‐analyst, Comprehensive Meta‐analysis version 3.3.070, and Review Manager version 5.3 software. From the 18 studies included in the study, the overall prevalence of vitamin D deficiency among neonates was 61% (95% CI: 44.3, 77.7); 79.4% (95% CI: 71.6, 87.3) of neonates with sepsis were vitamin D deficient as were 43.7% (23.4, 63.9) of sepsis‐free neonates. Neonates born from mothers with low vitamin D levels were at greater risk of developing neonatal sepsis with a weighed mean difference of −8.57 ng/ml (95% CI: −13.09, −4.05). Similarly, neonates with low cord vitamin D levels were at risk for neonatal sepsis with a mean difference of −8.78 ng/ml (95% CI:‐11.58, −5.99). The incidence of EONS in full‐term newborns was significantly associated with low maternal and cord blood vitamin D levels with weighed mean differences of −11.55ng/ml (95% CI: −17.63, −5.46) & −11.59 ng/ml (95% CI:‐16.65, −6.53), respectively. Low levels of vitamin D both in the cord blood and maternal blood were significantly associated with neonatal sepsis. Hence, vitamin D supplementation for pregnant women and newborns could decrease neonatal sepsis.