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The Association between Vitamin D Levels and Neonatal Early-onset Sepsis : A Systematic Review and Meta-analysis

비타민 D 농도와 신생아 조기 패혈증의 연관성에 대한 체계적 문헌고찰 및 메타분석

  • Received : 2018.03.19
  • Accepted : 2018.03.26
  • Published : 2018.03.02

Abstract

Background: Vitamin D has been associated with sepsis in pediatric and adult patients. The association with neonates is unclear. This systematic review and meta-analysis examined the effect of neonatal and maternal vitamin D levels on neonatal early-onset sepsis. Methods: We searched studies published up to November 2017 in PubMed/Medline, Embase, and the Cochrane Library databases. All studies that reported 25-hydroxyvitamin D levels in neonates with or without early-onset sepsis were included. Meta-analysis was performed using RevMan 5.3 software. Results: Four studies were eligible. The weighted mean difference of 25-hydroxyvitamin D levels in neonates with early-onset sepsis and controls was -7.27 ng/mL (95% confidence interval = -7.62, -6.92). Maternal vitamin D levels in neonates with early-onset sepsis were significantly lower than those in controls (weighted mean difference -7.24 ng/mL, 95% confidence interval -8.45, -6.03). All neonates with early onset sepsis had vitamin D deficiency (25-hydroxyvitamin D <20 ng/mL). Conclusion: Lower neonatal and maternal 25-hydroxyvitamin D levels were associated with neonatal early-onset sepsis. Vitamin D supplementation during pregnancy may be helpful to prevent neonatal early-onset sepsis. The effects of vitamin D supplementation on early-onset sepsis in neonates warrant further study.

Keywords

References

  1. Shane AL, Sanchez PJ, Stoll BJ. Neonatal sepsis. Lancet 2017; 390(10104):1770-80.
  2. Lawn JE, Cousens S, Zupan J. 4 million neonatal deaths: when? Where? Why? Lancet 2005;365(9462):891-900. https://doi.org/10.1016/S0140-6736(05)71048-5
  3. Black RE, Cousens S, Johnson HL, et al. Global, regional, and national causes of child mortality in 2008: a systematic analysis. Lancet 2010; 375(9730):1969-87. https://doi.org/10.1016/S0140-6736(10)60549-1
  4. Santamaria C, Bi WG, Leduc L, et al. Prenatal vitamin D status and offspring's growth, adiposity and metabolic health: a systematic review and meta-analysis. Br J Nutr 2018:1-10.
  5. Upala S, Sanguankeo A, Permpalung N. Significant association between vitamin D deficiency and sepsis: a systematic review and meta-analysis. BMC anesthesiol 2015;15:84. https://doi.org/10.1186/s12871-015-0063-3
  6. DeLuca HF. Overview of general physiologic features and functions of vitamin D. Am J Clin Nutr 2004;80(6 Suppl):S1689-6.
  7. Di Rosa M, Malaguarnera M, Nicoletti F, et al. Vitamin D3: a helpful immuno-modulator. Immunology 2011;134(2):123-39. https://doi.org/10.1111/j.1365-2567.2011.03482.x
  8. Dinlen N, Zenciroglu A, Beken S, et al. Association of vitamin D deficiency with acute lower respiratory tract infections in newborns. J Matern Fetal Neonatal Med 2016;29(6):928-32. https://doi.org/10.3109/14767058.2015.1023710
  9. Cerone JB, Santos RP, Tristram D, et al. Incidence of respiratory viral infection in infants with respiratory symptoms evaluated for late-onset sepsis. J Perinatol 2017;37(8):922-26. https://doi.org/10.1038/jp.2017.69
  10. Moher D, Liberati A, Tetzlaff J, et al. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. J Clin Epidemiol 2009;62(10):1006-12. https://doi.org/10.1016/j.jclinepi.2009.06.005
  11. Wells G, Shea B, O'connell D, et al. The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomized studies in meta-analysis. 2011. Available from http://www ohri ca/programs/clinical_epidemiology/oxford asp. 2016. Assessed January 30, 2018.
  12. Higgins JPT, Green S. Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011]. Available from www.handbook.cochrane.org. Assessed January 22, 2018.
  13. Wan X, Wang W, Liu J, et al. Estimating the sample mean and standard deviation from the sample size, median, range and/or interquartile range. BMC Med Res Methodol 2014;14:135. https://doi.org/10.1186/1471-2288-14-135
  14. Gamal TS, Madiha AS, Hanan MK, et al. Neonatal and Maternal 25-OH Vitamin D Serum Levels in Neonates with Early-Onset Sepsis. Children (Basel, Switzerland) 2017;4(5):37.
  15. Cizmeci MN, Kanburoglu MK, Akelma AZ, et al. Cord-blood 25-hydroxyvitamin D levels and risk of early-onset neonatal sepsis: a casecontrol study from a tertiary care center in Turkey. Eur J pediatr 2015;174(6):809-15. https://doi.org/10.1007/s00431-014-2469-1
  16. Cetinkaya M, Cekmez F, Buyukkale G, et al. Lower vitamin D levels are associated with increased risk of early-onset neonatal sepsis in term infants. J Perinatol 2015;35(1):39-45. https://doi.org/10.1038/jp.2014.146
  17. Yang LR, Li H, Yang TY, et al. Relationship between vitamin D deficiency and early-onset neonatal sepsis. Zhongguo dang dai er ke za zhi 2016;18(9):791-5.
  18. Holick MF. Vitamin D deficiency. N Engl J Med 2007;357(3):266-81.
  19. Palacios C, Gonzalez L. Is vitamin D deficiency a major global public health problem? J Steroid Biochem Mol Biol 2014;144:138-45. https://doi.org/10.1016/j.jsbmb.2013.11.003
  20. Youssef DA, Miller CW, El-Abbassi AM, et al. Antimicrobial implications of vitamin D. Dermatoendocrinol 2011;3(4):220-9. https://doi.org/10.4161/derm.3.4.15027
  21. Hewison M. Vitamin D and the intracrinology of innate immunity. Mol Cell Endocrinol 2010;321(2):103-11. https://doi.org/10.1016/j.mce.2010.02.013
  22. de Haan K, Groeneveld AB, de Geus HR, et al. Vitamin D deficiency as a risk factor for infection, sepsis and mortality in the critically ill: systematic review and meta-analysis. Crit Care 2014;18(6):660. https://doi.org/10.1186/s13054-014-0660-4
  23. Wagner CL, Greer FR. Prevention of rickets and vitamin D deficiency in infants, children, and adolescents. Pediatrics 2008;122(5):1142-52. https://doi.org/10.1542/peds.2008-1862
  24. Braegger C, Campoy C, Colomb V, et al. Vitamin D in the healthy European paediatric population. J Pediatr Gastroenterol Nutr 2013;56(6):692-701. https://doi.org/10.1097/MPG.0b013e31828f3c05
  25. Zhou J, Du J, Huang L, et al. Preventive Effects of Vitamin D on Seasonal Influenza A in Infants: A Multicenter, Randomized, Open, Controlled Clinical Trial. Pediatr Infect Dis J. 2018 Jan 8. doi: 10.1097/INF.0000000000001890. [Epub ahead of print]
  26. Fort P, Salas AA, Nicola T, et al. A Comparison of 3 Vitamin D Dosing Regimens in Extremely Preterm Infants: A Randomized Controlled Trial. J Pediatr 2016;174:132-8. https://doi.org/10.1016/j.jpeds.2016.03.028
  27. Cekmez F, Aydemir G, Yildirim S, et al. Diagnostic value of 25-hydroxyvitamin D level and new cytokines in neonatal sepsis. Eur J Inflamm 2014;12(2):297-304. https://doi.org/10.1177/1721727X1401200209
  28. Say B, Uras N, Sahin S, et al. Effects of cord blood vitamin D levels on the risk of neonatal sepsis in premature infants. Korean J Pediatr 2017;60(8):248-53.
  29. Anderson DM, Hollis BW, LeVine BR, et al. Dietary assessment of maternal vitamin D intake and correlation with maternal and neonatal serum vitamin D concentrations at delivery. J Perinatol 1988;8(1):46-8.
  30. Moukarzel S, Ozias M, Kerling E, et al. Maternal Vitamin D Status and Infant Infection. Nutrients 2018;10(2).
  31. Christensen N, Sondergaard J, Fisker N, et al. Infant Respiratory Tract Infections or Wheeze and Maternal Vitamin D in Pregnancy: A Systematic Review. Pediatr Infect Dis J 2017;36(4):384-91. https://doi.org/10.1097/INF.0000000000001452