PROSPECTIVE STUDY ON THE ASSOCIATION BETWEEN CORD BLOOD VITAMIN D LEVELS AND EARLY ONSET NEONATAL SEPSIS

Abstract

Vitamin D is a fat-soluble vitamin. Very few foods naturally contain vitamin D (fatty fish livers are the exception), so dermal synthesis is the major natural source of the vitamin. Dietary intake or dermal synthesis is physiologically inactive and requires enzymatic conversion to active metabolites. By way of its endocrine actions, Vitamin D plays a significant role in bone mineralization and calcium metabolism. The recent research focused on Vitamin D on its role in extra skeletal manifestations including immunity. Many studies have been conducted to investigate the role of Vitamin D deficiency in acute respiratory tract infections. Only few studies and less literature is available on role of Vitamin D in neonatal sepsis hence this study was conducted to determine the relationship between cord blood vitamin D levels and early onset sepsis (EOS). OBJECTIVES: 1. To measure cord blood vitamin D levels in term neonates with and without Early onset sepsis 2. To find out the association between cord blood Vitamin D levels and Early onset sepsis. MATERIALS AND METHODS: A Prospective observational study included 107 neonates with any one or more maternal risk factors. Detailed maternal history and neonatal examination were done and recorded. Cord blood Vitamin D levels, sepsis screen and blood culture were sent. Neonates were divided into EOS positive group and EOS negative group, or healthy neonates based on sepsis screen. EOS group was subdivided into probable sepsis (only sepsis screen positive) and definitive XII sepsis( culture positive) group. The study is to find the association of cord blood vitamin D levels and EOS. RESULTS: Our study included 107 neonates who met the inclusion criteria. Among study population cord blood Vitamin D levels were deficient in 47.7% neonates, insufficient in 42.1% neonates and sufficient in only 10.3% neonates. In the study population of 107 neonates, 53.3% had EONS, with just 2% having sufficient Vitamin D levels; the remaining 37% and 61% had insufficiency and deficiency, respectively, whereas neonates without EOS had sufficiency at 20%, deficiency at 32%, and insufficiency at 48%. With a p value of 0.001, there was a significant correlation between cord blood Vitamin D levels and EOS. CONCLUSION: In our study, we found statistical significance between cord blood Vitamin D levels and EOS, with a p value of 0.001. Maternal sun exposure and infant birth weight had a significant association with Cord blood Vitamin D levels, whereas there was a negative correlation between cord blood Vitamin D levels and maternal age, maternal oral Vitamin D intake, socioeconomic status, and neonate gender.