ビタミンとミネラル

Vitamin D Levels in Early Onset Neonatal Sepsis without Maternal Risk Factors: A Case-Control Study

Abstract

Sarwade AB, Gosai MM and Gohil JR

Objective: Vitamin D is an immune modulator affecting innate and cell mediated immunity. Neonates are susceptible to infections as both innate and adaptive immune systems are not developed. This prospective study compares serum vitamin D among neonates with and without early onset sepsis without maternal risk factors (EOSWMRF) and blood culture positivity.

Methods: This observational study included 60 neonates <24 hours of age, who were divided into cases with sepsis and controls. Cases were with possible, probable and highly probable sepsis as based on sepsis criterion and blood culture among neonates without maternal risk factors (EOSWMRF). On the third day of life serum vitamin D levels (ng/ml) were measured and neonates were subdivided into having severely deficient, inadequate and adequate levels.

Results: Possible, probable and highly probable sepsis was found among 14, 9 and 7 cases. Mean vitamin D levels (ng/ml) among the case and control group was 13.43 ± 3.43 and 21.53 ± 6.6 respectively (p<0.001). Severe deficiency was found among 5/6 of culture positive neonates. Among neonates, who died during study, culture positive was 5/6 and severely vitamin D deficient were 5/9. Inadequate levels were found among 86% (n=44) of discharged neonates. Strong positive correlation was seen among Vitamin D deficient levels and deaths (p<0.001).

Conclusion: Severe vitamin D deficiency was associated with culture positive sepsis (p <0.001) and deaths (p<0.001) among cases. Among controls 20% were having adequate and 80% were having inadequate and no patient had severely deficient vitamin D levels.