The Role of Low 25-Hydroxyvitamin D Levels in Preterm Infants with Late-Onset Sepsis

Mediation Effect of Social Distancing on Neonatal Vitamin D Status and Related Clinical Outcomes during the Coronavirus Disease-19 Pandemic

BACKGROUND

We analyzed the impact of social distancing (SD) on vitamin D status and associated morbidity in neonates during the coronavirus disease (COVID-19) pandemic.

METHODS

Serum levels of 25-hydroxy vitamin D (25OHD) and clinical characteristics of newborn infants before (2019) and during SD (2021) were compared.

RESULTS

A total of 526 neonates (263 in 2019 and 263 in 2021) were included. The rate of vitamin D deficiency in neonates (47.1% vs. 35.4 %, p = 0.008) decreased and the rate of maternal vitamin D intake increased (6.8% vs. 37.6%, p < 0.001), respectively, during SD compared to those in 2019. The rates of hypocalcemia (12.5% vs. 3.8%, p < 0.001) and respiratory illness (57.0% vs. 43.0%, p = 0.002) decreased during SD. Neonatal vitamin D deficiency during SD was associated with maternal vitamin D supplementation (odds ratio [OR] = 0.463, p = 0.003) but was not associated with SD (OR = 0.772, p = 0.189). The mediation effect of SD on neonatal morbidity by neonatal vitamin D status was statistically insignificant.

CONCLUSIONS

SD might affect the increased maternal vitamin D intake and decreased neonatal vitamin D deficiency. However, neonatal morbidity was not affected by SD, even with neonatal vitamin D status changes.

Influence of umbilical cord vitamin D serum levels on the growth of preterm infants

OBJECTIVE

The aim of this study was to evaluate the influence of serum 25-hydroxyvitamin D [25(OH)D] levels at birth in postnatal growth at discharge and 12 mo of corrected age in preterm infants.

METHODS

This prospective cohort included 63 preterm newborns born before 34 gestational weeks evaluated from birth until 12 mo of corrected age. The serum 25(OH)D levels in umbilical cord blood and from their mothers were evaluated at delivery.

RESULTS

The mean 25(OH)D levels in preterm newborns were higher than maternal levels (24.8 ± 13.3 ng/mL versus 21 ± 10.2 ng/mL, P < 0.001) and showed a moderate correlation between (r = 0.548; P < 0.001). Considering the body mass index Z-score at 12 mo, 3 (10%), 25 (83%), and 2 (7%) of the preterm infants were thin, had normal body mass index, and were overweight, respectively. The 25(OH)D levels in the umbilical cord did not influence the anthropometric indicators at hospital discharge and 12 mo of corrected age. We observed improvement in all anthropometric indicators assessed over the months, and there was no difference between preterm infants with 25(OH)D levels >20 ng/mL and <20 ng/mL in the umbilical cord.

CONCLUSIONS

The results of this study suggested that the 25(OH)D serum levels in the umbilical cord did not influence postnatal growth from birth to the first year of life in preterm infants. There was a direct association between maternal and umbilical cord serum 25(OH)D levels.

The Relationship Between Vitamin-D Deficiency and Protein Oxidation Among Obese Children

Aim: The aim of the study is to examine the relationship between obesity, Vitamin-D deficiency, and protein oxidation. Methods: Thiol-disulfide homeostasis, Vitamin-D, ischemia modified albumin, insulin, and lipid levels were compared among obese, pre-obese and normal-weight healthy children. Results: A total of 136 children (69 boys and 67 girls) were included in the study. The vitamin-D levels of obese children were lower than those of pre-obese and normal weight (p < 0.05). In the normal weight group, total thiol and native thiol were lower in the pubertal period than in adolescence; were higher in those with sufficient Vitamin-D level than those with insufficient and deficient Vitamin-D (p < 0.05). Vitamin-D level was lower in pre-obese girls than boys (p < 0.05). Those with high triglycerides had high disulfide/total thiol, disulfide, and disulfide/native thiol and low native thiol/total thiol (p < 0.05). Conclusion: Thiol-disulfide homeostasis is negatively affected by low vitamin D levels, pubertal period and high triglyceride levels.

Vitamin D status was associated with sepsis in critically ill children: A PRISMA compliant systematic review and meta-analysis

BACKGROUND

Sepsis leads to the high mortality in critically ill infants and children. It is still controversial whether vitamin D deficiency was associated with the incidence of sepsis. Thus we designed the systematic review and meta-analysis.

METHODS

The Ovid Medline, Embase, PubMed, and Cochrane library were systematically searched until April 5, 2020. The 25 hydroxyvitamin D (25-OHD) level was recorded and set 20 ng/mL as cut-off in cohort study to divide the lower and higher 25-OHD group. The odds ratio (OR) and 95% confidence intervals (CIs) were calculated for comparing the impact of vitamin D deficiency on the incidence of sepsis in critically ill children.

RESULTS

A total of 27 studies were included with 17 case-control studies and 10 cohort studies. In those case-control studies, the maternal 25-OHD level and neonatal 25-OHD level in sepsis group was significant lower than non-sepsis group (P < .001). The percentage of severe vitamin D deficiency was significant higher in sepsis group comparing to non-sepsis group (odds ratio [OR] = 2.66, 95% CI = 1.13-6.25, P < .001). In those cohort studies, the incidence of sepsis in lower 25-OHD group was 30.4% comparing with 18.2% in higher 25-OHD level group. However, no statistical significant difference in terms of mechanical ventilation rate and 30-day mortality.

CONCLUSION

We demonstrated that critically ill infants and children with sepsis could have a lower 25-OHD level and severe vitamin D deficiency comparing to those without sepsis. Future studies should focus on the association of vitamin D supplement and the occurrence of sepsis in critically ill children.