Division of Neonatology, Department of Pediatrics, University of Nebraska Medical Center, Omaha, Nebraska, United States.
Department of Radiology, Children's Hospital & Medical Center, Omaha, Nebraska, United States.
Neuropediatrics. 2020 Aug;51(4):251-258. doi: 10.1055/s-0040-1708535. Epub 2020 Mar 16.
The primary aim of this study was to evaluate the association between 25-hydroxyvitamin D (25OHD) concentration at birth and the short-term outcomes in neonatal hypoxic-ischemic encephalopathy (HIE). Our secondary aim was to evaluate the effect of postnatal vitamin D supplementation on outcomes in the perinatal period after hypoxic injury.
This retrospective cohort study included all infants ≥35 weeks gestation admitted to a regional level IV neonatal intensive care unit and diagnosed with moderate or severe HIE. Spearman correlation coefficients were used to evaluate associations between clinical outcomes including standardized brain magnetic resonance imaging (MRI) scores and either 25OHD concentrations in the first 48 hours of life or total vitamin D supplementation.
A total of 43 infants met inclusion criteria; 22 had 25OHD concentrations drawn within the first 48 hours. There was a significant inverse association between 25OHD concentration and brain injury on MRI ( = 0.017). There was a trend toward decreased ventilator days in infants receiving higher doses of vitamin D in the first week of life ( = 0.062), but there was no association between vitamin D dosing and MRI injury.
These results support an association between lower vitamin-D levels and early adverse outcomes in HIE, including radiographic severity of brain injury.
本研究的主要目的是评估出生时 25-羟维生素 D（25OHD）浓度与新生儿缺氧缺血性脑病（HIE）短期结局之间的关系。我们的次要目的是评估产后维生素 D 补充对缺氧损伤后围产期结局的影响。
这是一项回顾性队列研究，纳入了所有胎龄≥35 周、被诊断为中重度 HIE 并入住区域性四级新生儿重症监护病房的婴儿。采用 Spearman 相关系数评估临床结局（包括标准化脑磁共振成像 [MRI] 评分）与出生后前 48 小时内的 25OHD 浓度或总维生素 D 补充之间的关联。
共有 43 名婴儿符合纳入标准；其中 22 名婴儿在出生后前 48 小时内进行了 25OHD 浓度检测。25OHD 浓度与 MRI 上的脑损伤呈显著负相关（ = 0.017）。在生命的第一周接受更高剂量维生素 D 的婴儿中，呼吸机使用天数呈下降趋势（ = 0.062），但维生素 D 剂量与 MRI 损伤之间无关联。
这些结果支持较低的维生素 D 水平与 HIE 的早期不良结局之间存在关联，包括脑损伤的放射学严重程度。
