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The Relation Between Maternal / Neonatal Vitamin D Levels and Early Onset Neonatal Sepsis

Received: 12 January 2020    Accepted: 17 February 2020    Published: 26 February 2020
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Abstract

In addition to its classical role in bone metabolism, vitamin D also has an immunomodulatory effects on immune function. Our aim was to determine the relation between serum 25-hydroxy vitamin D(25(OH)D) concentrations in newborns and their mothers with early onset neonatal sepsis (EOS). Also we aim to study the effect of severity of vitamin D deficiency on incidence of EOS. The design comprises a hospital- based case- control study. The study group consisted of 50 newborns with EOS who was admitted to neonatal intensive care unit and their mothers. Controls were 50 healthy newborns of the same age as the study group and their mothers. The study subjects were divided into insufficient, moderate and severe deficiency according to vitamin D level. There is no significant statistical difference between study and control groups in gestational week, birth weight, birth height, head circumference and age. The mean serum 25(OH)D concentrations in the study group newborns were significantly lower than those of the control group (11.58±4.883 ng/ml and 28.78±6.453 ng/ml respectively). The 25(0H)D concentrations of newborns were highly correlated with mothers’ serum in both groups. Severe vitamin D deficiency was significantly more common in the sepsis group. Data shows that 25(OH)D concentrations of the newborns were highly correlated with the level of CRP, duration of hospital stay, and complications caused by sepsis. Our findings suggest that newborns with vitamin D deficiency may have an increased risk of suffering from EOS. Newborns with more vitamin D deficiency were found to have higher CRP levels, a longer hospital stay, and a higher incidence of complications. The strong positive correlation between newborns’ and their mothers’ 25(OH)D concentrations makes that adequate vitamin D supplementation of mothers during pregnancy is of great importance, through a proper ante-natal care, especially in winter months.

Published in American Journal of Pediatrics (Volume 6, Issue 1)
DOI 10.11648/j.ajp.20200601.18
Page(s) 46-51
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Neonatal, Vitamin D, Early Onset Sepsis

References
[1] Aarras SN, Shah I, Petroczi A, Goulis DG, Bili H, 2013- biomedcentral.com. An observational study reveals that neonatal vitamin D is primarily determined by maternal contributions.
[2] Baeke F, Takiishi T, Korf H, Gysemans C, Mathieu C. Vitamin D: modulator of the immune system. Curr Opin Pharmacol 2010 Aug; 10 (4): 482-96.
[3] - Barnett ED, Klein JO (2006). Bacterial infections of the respiratory tract. In: Remington JS, Klein JO, Wilson CB, Baker CJ (eds). Infectious Diseases of the fetus and newborn infant. WB Saunders Philadelphia, pp 297-316.
[4] Bodnar LM, Simhan HN, Powers RW, Frank MP, Cooperstein E, Roberts JM (2007). High prevalence of vitamin D deficiency in black and white pregnant women residing in the northen United States and their neonates. J Nutr 137, 447-452.
[5] Cetinkaya M, Cekmez F, Buyukkale G, Erener-Ercan T, Demir F, Tunc T, Aydin N and G Aydemir. Lower vitamin D levels are associated with increased risk of early onset neonatal sepsis in term infants. Journal of perinatology (2015) 35, 39-45.
[6] Cetinkaya M, Kanuni Sultan Suleyman Training and Research 2013. Comparison of maternal and neonatal vitamin D levels in term neonates with/ without early onset sepsis.
[7] Di Rosa M, Malaguarnera M., Nicoletti F., Malaguarnera L. 25 OH Vitamin D3: A helpful immune-modulator. Immunology. 2011; 134: 123-139. Doi: 10.1111/j.1365-2667.2011.03482.x.
[8] Gitto E, Karbownik M, Reiter RJ, Tan DX, Cuzzocrea S, Chiurazzi P et al. effect of melatonin treatment in septic newborns. Pediatr Res 2011; 50: 756-760.
[9] Grant WB, Garland CF, Holick MF (2005). Comparison of estimated economic burdens due to insfficient solar ultraviolet irradiance and vitamin D and excess solar UV irradiance for the United States. Photochem photobiol 81, 1276-1286.
[10] Grant WB, Holick MF (2005). Benefits and requirements of vitamin D for optimal health: a review. Altern Med Rev 10, 94-111.
[11] Holick MF (2004). Sunlight and vitamin D for bone health and prevention of autoimmune diseases, cancers, and cardiovascular disease. Am J Clin Nutr 80 (Suppl, 6), s1752-s1688.
[12] Hollis BW (2005). Circulating 25-hydroxy vitamin D levels indicative of vitamin D sufficiency: implications for establishing a new effective dietary intake recommendation for vitamin D. J Nutr 135, 317-322.
[13] Hollis BW, Wagner CL (2004). Vitamin D requirements during lactation: high-dose maternal supplementation as therapy to prevent hypovitaminosis D for both the mother and the nursing infant. Am J Clin Nutr 80 (suppl, 6), S1752-1758.
[14] Hollis BW, Wagner CL (2006). Vitamin D deficiency during pregnancy: an ongoing epidemic. Am J Clin Nutr 84, 273.
[15] Jeng L, YamshchikovAV, Judd S. Alterations in vitamin Dstatus and anti-microbial peptide levels in patients in the intensive care unit with sepsis. J Transl Med, 2009; 7: 28.
[16] Karatekin G, Kaya A, Salihoglu O, Balci H, Nuhoglu A. Association of subclinical vitamin D deficiency in newborns with acute lower respiratory infection and their mothers. European Journal of Clinical Nutrition (2009) 63, 473-477.
[17] karras SN, Fakhoury H, Muscogiuri G. Maternal vitamin D levels during pregnancy and neonatal health: evidence to date and clinical implications. The Adv Musculoskelet Dis. 2016; 8: 124-35.
[18] Kempker J. A., Han J. E., Tangpricha V., Ziegler T. R., Martin G. S. 25- OH Vitamin D and sepsis: An emerging relationship. Dermato-endocrinol. 2012; 4: 101-108. dio: 10.4161/derm.19859.
[19] Lee JM, Smith JR, Philipp BL, Chen TC, Mathiue J, Holick MF (2007). Vitamin D deficiency in a healthy group of mothers and newborn infants. Clin Pediatr (phila) 46, 42-44.
[20] Liu N, Kaplan AT, Low J, Nguyeny L, Liu GY, Equils O. Vitamin D induces innate antibacterial responses in human trophoblasts via an intracrine pathway. Boil Reprod 2009; 80: 398-406.
[21] Madden K, Feldman HA, Smith EM, Gordon CM, Keisling SM, Sullivan RM et al. vitamin D deficiency in critically ill children. Pediatrics 2012; 130: 421-428.
[22] Manson J. E., Brannon P. M., Rosen C. J., Taylor C. L. Vitamin D Deficiency- Is There Really a Pandemic? N. Engl. J. Med. 2016; 375: 1817-1820.
[23] Moller S, Laigaard F, Olgaard K, Hemmingsen C. Effect 1,25-dihydroxy-vitamin D3 in experimental sepsis. Int J Med Sci 2007; 4: 190-195.
[24] Munns C. F., Shaw N., Kiely M, Specker B. L., TGlobal Consensus Recommendations on Prevention and Management of Nutritional Rickets. J. Clin. Endocrinol. Metab. 2016; 101: 394-415. Doi: 10.1210/jc.2015-2175.
[25] Ross A. C., Manson J. E., Abrams S. A., Aloia J. F., Brannon P. M., Clinton S. K., Durazo- Arvizu R. A., Gallagher J. C., Gallo R. L., Jones G., et al. the 2011 Reports on Dietary Reference Intakes for Calcium and Vitamin D from the Institutes of Medicine: What clinicians need to know. J. Clin. Endocrinol. Metab. 2011; 96: 53-58. doi: 10.1210/jc.2010-2704.
[26] Say B, Uras N, Sahin S. Effects of cord blood vitamin D levels on the risk of neonatal sepsis in premature infants. Korean, J Pediatr. 2017; 60: 248-53.
[27] Schrag SJ, Stoll BJ: Early-onset neonatal sepsis in the era of widespread intrapartum chemoprophylaxis. Pediatr Infect Dis J 2006; 251: 259.
[28] Valdivielso JM, Fernandez E (2006). Vitamin D receptor polymorphisms and diseases. Clin Chim Acta 371, 1-12.
[29] Von Websky, Hasan AA, Reichetzeder C, et al. Impact of vitamin D on pregnancy-related disorders and on offspring outcome. J Steroid Biochem Mol Biol. 2018; 51-64.
[30] Wang TT, Nestel FB, Bourdeau V, Nagi Y, Wang Q, Liao J et al. (2004). 1,25-Dihydroxyvitamin D3 is a direct inducer of antimicrobial peptide gene expression. J Immunol 173, 2909-2912.
[31] Watkins R. R., Lemonovich T. L., Salata R. A. An update on the association of Vitamin D deficiency with common infectious diseases. Can. J. Physiol. Pharmacol. 2015; 93: 363-368. Doi: 10.1139/cjpp-2014-03520.
[32] World Health Report 2005: http://www.who.int/whr/2005/annex/en/index.html.
[33] Yamshchikov AV, Desi NS, Blumberg HM, Ziegler TR, Tangpricha V. Vitamin D for treatment and prevention of infectious diseases: a systemic review of randomized controlled trials. Endocr Pract. 2009; 15 (5): 438-449.
[34] Yang LR, Li H, Yang TY, et al. relationship between vitamin D defiency and early onset neonatal sepsis. Zhongguo Dang Dai Er Ke Za Zhi. 2016; 18: 791-5.
[35] Youssef DA, Miller CW, El-Abbassi AM, Cutchin DC, Cutchins C, Grant WB et al. antimicrobial implications of vitamin D. dermoendocrinol 2011; 3: 220-3229.
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  • APA Style

    Dina Kamal Ali, Iman Abdel Mohsen Shaheen. (2020). The Relation Between Maternal / Neonatal Vitamin D Levels and Early Onset Neonatal Sepsis. American Journal of Pediatrics, 6(1), 46-51. https://doi.org/10.11648/j.ajp.20200601.18

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    ACS Style

    Dina Kamal Ali; Iman Abdel Mohsen Shaheen. The Relation Between Maternal / Neonatal Vitamin D Levels and Early Onset Neonatal Sepsis. Am. J. Pediatr. 2020, 6(1), 46-51. doi: 10.11648/j.ajp.20200601.18

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    AMA Style

    Dina Kamal Ali, Iman Abdel Mohsen Shaheen. The Relation Between Maternal / Neonatal Vitamin D Levels and Early Onset Neonatal Sepsis. Am J Pediatr. 2020;6(1):46-51. doi: 10.11648/j.ajp.20200601.18

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  • @article{10.11648/j.ajp.20200601.18,
      author = {Dina Kamal Ali and Iman Abdel Mohsen Shaheen},
      title = {The Relation Between Maternal / Neonatal Vitamin D Levels and Early Onset Neonatal Sepsis},
      journal = {American Journal of Pediatrics},
      volume = {6},
      number = {1},
      pages = {46-51},
      doi = {10.11648/j.ajp.20200601.18},
      url = {https://doi.org/10.11648/j.ajp.20200601.18},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajp.20200601.18},
      abstract = {In addition to its classical role in bone metabolism, vitamin D also has an immunomodulatory effects on immune function. Our aim was to determine the relation between serum 25-hydroxy vitamin D(25(OH)D) concentrations in newborns and their mothers with early onset neonatal sepsis (EOS). Also we aim to study the effect of severity of vitamin D deficiency on incidence of EOS. The design comprises a hospital- based case- control study. The study group consisted of 50 newborns with EOS who was admitted to neonatal intensive care unit and their mothers. Controls were 50 healthy newborns of the same age as the study group and their mothers. The study subjects were divided into insufficient, moderate and severe deficiency according to vitamin D level. There is no significant statistical difference between study and control groups in gestational week, birth weight, birth height, head circumference and age. The mean serum 25(OH)D concentrations in the study group newborns were significantly lower than those of the control group (11.58±4.883 ng/ml and 28.78±6.453 ng/ml respectively). The 25(0H)D concentrations of newborns were highly correlated with mothers’ serum in both groups. Severe vitamin D deficiency was significantly more common in the sepsis group. Data shows that 25(OH)D concentrations of the newborns were highly correlated with the level of CRP, duration of hospital stay, and complications caused by sepsis. Our findings suggest that newborns with vitamin D deficiency may have an increased risk of suffering from EOS. Newborns with more vitamin D deficiency were found to have higher CRP levels, a longer hospital stay, and a higher incidence of complications. The strong positive correlation between newborns’ and their mothers’ 25(OH)D concentrations makes that adequate vitamin D supplementation of mothers during pregnancy is of great importance, through a proper ante-natal care, especially in winter months.},
     year = {2020}
    }
    

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  • TY  - JOUR
    T1  - The Relation Between Maternal / Neonatal Vitamin D Levels and Early Onset Neonatal Sepsis
    AU  - Dina Kamal Ali
    AU  - Iman Abdel Mohsen Shaheen
    Y1  - 2020/02/26
    PY  - 2020
    N1  - https://doi.org/10.11648/j.ajp.20200601.18
    DO  - 10.11648/j.ajp.20200601.18
    T2  - American Journal of Pediatrics
    JF  - American Journal of Pediatrics
    JO  - American Journal of Pediatrics
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    PB  - Science Publishing Group
    SN  - 2472-0909
    UR  - https://doi.org/10.11648/j.ajp.20200601.18
    AB  - In addition to its classical role in bone metabolism, vitamin D also has an immunomodulatory effects on immune function. Our aim was to determine the relation between serum 25-hydroxy vitamin D(25(OH)D) concentrations in newborns and their mothers with early onset neonatal sepsis (EOS). Also we aim to study the effect of severity of vitamin D deficiency on incidence of EOS. The design comprises a hospital- based case- control study. The study group consisted of 50 newborns with EOS who was admitted to neonatal intensive care unit and their mothers. Controls were 50 healthy newborns of the same age as the study group and their mothers. The study subjects were divided into insufficient, moderate and severe deficiency according to vitamin D level. There is no significant statistical difference between study and control groups in gestational week, birth weight, birth height, head circumference and age. The mean serum 25(OH)D concentrations in the study group newborns were significantly lower than those of the control group (11.58±4.883 ng/ml and 28.78±6.453 ng/ml respectively). The 25(0H)D concentrations of newborns were highly correlated with mothers’ serum in both groups. Severe vitamin D deficiency was significantly more common in the sepsis group. Data shows that 25(OH)D concentrations of the newborns were highly correlated with the level of CRP, duration of hospital stay, and complications caused by sepsis. Our findings suggest that newborns with vitamin D deficiency may have an increased risk of suffering from EOS. Newborns with more vitamin D deficiency were found to have higher CRP levels, a longer hospital stay, and a higher incidence of complications. The strong positive correlation between newborns’ and their mothers’ 25(OH)D concentrations makes that adequate vitamin D supplementation of mothers during pregnancy is of great importance, through a proper ante-natal care, especially in winter months.
    VL  - 6
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Author Information
  • Department of Pediatrics, Faculty of Medicine, Cairo University, Cairo, Egypt

  • Department of Clinical Pathology, Faculty of Medicine, Cairo University, Cairo, Egypt

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