Dhandai Rajeshwari, Jajoo Mamta, Singh Amitabh, Mandal Anirban, Jain Rahul
a Department of Pediatrics , Chacha Nehru Bal Chikitsalaya , New Delhi , India.
b Sitaram Bhartia Institute of Science and Research , New Delhi , India.
Paediatr Int Child Health. 2018 Aug;38(3):193-197. doi: 10.1080/20469047.2018.1477388. Epub 2018 Jul 13.
Vitamin D deficiency in mothers and neonates is being recognised increasingly as a leading cause of many adverse health effects in the newborn infant, including sepsis.
A prospective observational study was conducted at a tertiary care Paediatric teaching hospital in northern India to assess vitamin D deficiency as a possible risk factor for late-onset sepsis (LOS) in term and late preterm neonates and also to examine the correlation between maternal and infant vitamin D levels during the neonatal period. Late-onset sepsis (LOS) was defined as the development of signs and symptoms of severe sepsis after 72 h of life and a positive sepsis screen. All term and late preterm neonates admitted with LOS between September 2015 and February 2016 who had not been previously admitted for >48 h and had not been prescribed antibiotics or vitamin D were included in the study. Matched controls were recruited from otherwise healthy neonates admitted with physiological hyperbilirubinaemia. Serum 25(OH) vitamin D was assessed in neonates in both groups and their mothers.
A total of 421 neonates were admitted to the neonatal intensive care unit during the study period, 120 of whom satisfied the inclusion criteria, and 60 were recruited as cases. Sixty neonates were recruited as controls who were similar in gender, gestational age, age at admission and anthropometry. The study group had significantly lower mean (SD) vitamin D levels [15.37 ng/ml (10.0)] than the control group [21.37 ng/ml (9.53)] (p = 0.001). The odds ratio was 1.7 (95% CI 0.52-5.51) for LOS in vitamin D-deficient neonates. Mothers of septic neonates also had significantly lower mean (SD) vitamin D levels [17.87 (11.89)] than the mothers of non-septic neonates [23.65 ng/ml (9.55)] (p = 0.004). Maternal vitamin D levels strongly correlated to neonatal vitamin D levels in both groups.
Neonates with vitamin D deficiency are at greater risk of LOS than those with sufficient vitamin D levels.
母亲和新生儿维生素D缺乏日益被认为是新生儿许多不良健康影响的主要原因，包括败血症。
在印度北部一家三级护理儿科教学医院进行了一项前瞻性观察研究，以评估维生素D缺乏作为足月儿和晚期早产儿晚发性败血症（LOS）的可能危险因素，并研究新生儿期母婴维生素D水平之间的相关性。晚发性败血症（LOS）定义为出生72小时后出现严重败血症的体征和症状且败血症筛查呈阳性。2015年9月至2016年2月期间因LOS入院、此前未入院超过48小时且未使用过抗生素或维生素D的所有足月儿和晚期早产儿均纳入研究。从因生理性高胆红素血症入院的健康新生儿中招募匹配对照。对两组新生儿及其母亲进行血清25（OH）维生素D评估。
研究期间共有421名新生儿入住新生儿重症监护病房，其中120名符合纳入标准，60名被招募为病例。招募了60名新生儿作为对照，他们在性别、胎龄、入院年龄和人体测量学方面相似。研究组的平均（标准差）维生素D水平[15.37 ng/ml（10.0）]显著低于对照组[21.37 ng/ml（9.53）]（p = 0.001）。维生素D缺乏的新生儿发生LOS的比值比为1.7（95%可信区间0.52 - 5.51）。败血症新生儿的母亲平均（标准差）维生素D水平[17.87（11.89）]也显著低于非败血症新生儿的母亲[23.65 ng/ml（9.55）]（p = 0.004）。两组中母亲的维生素D水平与新生儿的维生素D水平密切相关。
维生素D缺乏的新生儿发生LOS的风险高于维生素D水平充足的新生儿。
