Abstract
Objective:To evaluate the maternal and neonatal 25-hydroxyvitamin D [25(OH)D] levels and the effect of 25(OH)D levels on the development of neonatal sepsis.Methods:This prospective study was performed in the neonatal intensive care unit of Medicine Hospital/Biruni University between November 2017 and September 2018. Fifty one term infants with sepsis group and 56 term infants with control group were included in this study. Blood samples for whole blood count, CRP, Ca, P, ALP, 25(OH)D and culture were obtained from all neonates.Results:Mean vitamin D levels for the neonates and their mothers were found to be 12.4±8.5 ng/ml and 13±8.7 ng/ml, respectively. There was a significant correlation between maternal and newborn 25(OH)D levels (r=0.72, p<0.01). The number of the newborns with vitamin D deficiency was significantly higher in the sepsis group (n=31, 60.8%) than in the control group (n=30, 53.6%; p=0.00), corresponding to significantly lower levels of vitamin D in the sepsis group (11±5.5 ng/ml vs. 13.8±10.6 ng/ml; p=0.012). Similarly, maternal vitamin D levels was significantly lower in the sepsis group than in the control group (10.8±5.6 ng/ml vs. 14.9±10 ng/ml; p=0.001).Conclusion:Our findings suggest that there may be an association between vitamin D deficiency and neonatal sepsis
Highlights
Vitamin D is a lipid-soluble prohormone produced in the human skin exposure to ultraviolet radiation
In some studies of children, Pak J Med Sci March - April 2019 Vol 35 No 2 www.pjms.org.pk 420 significant associations have been shown between vitamin D deficiency and respiratory tract infections and sepsis. 7,8 there are limited data on the role of vitamin D in neonatal sepsis
Blood samples for the whole blood count, C-reactive protein (CRP), and culture were obtained from all neonates with suspected sepsis at admission and the hematologic parameters were evaluated according to the Manroe and Rodwell scoring systems.[12,13]
Summary
Vitamin D is a lipid-soluble prohormone produced in the human skin exposure to ultraviolet radiation. It plays an important role in calcium and phosphorus homeostasis.[1,2] its deficiency is generally linked to the disorders of bone mineralization, there is some evidence suggesting that vitamin D plays a role in the immune function.[3,4] Vitamin D receptors are widely expressed in the epithelial tissue and cells of the immune system. Neonatal sepsis refers to bacteremia and associated clinical signs and symptoms occurring in the first month of life.[9,10] It is among the leading causes of morbidity and mortality in newborns. As the immune system of newborns has not fully developed at birth, they are relatively immunocompromised, rendering them vulnerable to infections.[11]
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