Impact of serum level of vitamin D on term neonates with early onset sepsis

Abstract

Background: Neonatal sepsis a major health challenge associated with major morbidity and mortality. Neonatal care improved recently. However, different challenges regarding management still exist. Vitamin D deficiencies was proposed as a predictor of neonatal sepsis. Objective: To highlight the impact of vitamin D levels on early onset sepsis in full term neonates. Methodology: This is a case control which carried out at the neonatal intensive care unit of Al-Azhar university hospital (Damietta), from March to April 2019. It included 50 full-term neonates with probable sepsis and 50 healthy controls of matched age and sex with no signs of sepsis. Results: vitamin D level showed significant negative correlation with sepsis, Creactive protein (CRP), positive blood cultures; and significant positive correlations with Apgar score, hemoglobin concentration and platelets count. Regression analysis revealed that, higher CRP and lower vitamin D were associated risks of neonatal sepsis in univariate analysis. Multivariable regression analysis revealed that only lower vitamin D level is the predictor for early neonatal sepsis. Conclusions: Vitamin D levels were significantly lower in septic neonates with high sensitivity and specificity. Vitamin D supplementation to mothers during pregnancy could prevent early onset neonatal sepsis.

Association of low vitamin D level and full-term early-onset neonatal sepsis; a case-control study

“…This fact reveals the association between vitamin D deficiency and inflammation, infection, and septic shock [ 25 ]. The current study identified an association between low vitamin D levels and high neonatal serum CRP, in line with previous studies that found an inverse relationship between CRP levels in septic neonates and blood vitamin D levels [ 17 , 26 , 27 ]. While, Grzanka et al, concluded that there was no significant relationship between vitamin D concentrations and CRP and attributed this finding to the small sample size and single evaluation of vitamin D concentration [ 28 ].…”

“…This result was consistent with other researches which concluded that full-term newborns with low serum vitamin D levels were more prone to the risk of infection [ 5 , 17 , 29 , 30 ]. According to Soliman et al, a multivariate logistic regression analysis used to predict neonatal sepsis showed that a decline in serum vitamin D levels was substantially related to the risk of sepsis in newborns [ 26 ]. Another study explained this association by the disruption of the macrophage function and the inflammatory cytokines generation that can result from a vitamin D deficit [ 7 ] .…”

“…The cutoff value of vitamin D as a measure of the risk of developing neonatal sepsis was reported by Behera et al to be 15.48 ng/ml, with 80% sensitivity and 99.9% specificity [ 36 ]. Additionally, Soliman et al observed that vitamin D, at a cutoff point of 18.75 ng/ml, had a 100% sensitivity, and 80% specificity for the diagnosis of newborn sepsis [ 26 ]. Another case–control study which recruited sixty-two infants with EOS and the same number as a control group, revealed that vitamin D levels were considerably lower in EOS with a cutoff value of 25 ng/ml, 88.7% sensitivity, and 79% specificity [ 4 ].…”

Role of Vitamin - D Deficiency in Term Neonates with late-onset sepsis at Benha University Hospitals

“…Furthermore, the bacteriological culture profile of patients is unrelated to vitamin D insufficiency. Serum vitamin D levels were shown to have a substantial negative link with CRP; significant positive relationships with Apgar score, haemoglobin concentration, and platelet count in a study of term newborns with early onset sepsis by Soliman et al (13) . Our findings were consistent with those of Mutlu et al (14) , who compared 25hydroxy Vitamin D levels in babies with pathologic and physiological hyperbilirubinemia and discovered that there are substantial disparities between the case and control groups.…”

“…The optimal cut off value of 25(OH)D in ROC analysis was revealed to be 15.45 ng/ml with 91.3% sensitivity and 71.7% specificity (AUC = 0.824, 95% confidence range 0.7370.912, p 0.001) for predicting LOS, which is consistent with the findings of Bilgin & Gonulal (12) . The ROC curve of blood vitamin D was also used to differentiate between septic and control groups in research by Soliman et al (13) . At a cutoff value of 18.75ng/ml, the AUC was 0.907, the sensitivity was 100%, the specificity was 80%, the PPV was 83.3%, the NPV was 100%, and the accuracy was 100%.90%.…”