Maternal/neonatal vitamin D deficiency: a new risk factor for necrotizing enterocolitis in preterm infants?

OBJECTIVE: The objective of the study was to investigate the possible association between maternal/neonatal 25-hydroxy vitamin D (25-OHD) levels and development of necrotizing enterocolitis (NEC). STUDY DESIGN: One hundred and forty-five preterm infants ⩽36 weeks of gestation were enrolled. 25-OHD levels were determined in maternal/neonatal blood samples that were obtained at the time of admission to the neonatal intensive care unit. RESULTS: Of the 145 enrolled patients, 26 (18%) developed NEC. Maternal/neonatal 25-OHD levels in the NEC group were significantly lower than those of the no-NEC group (P=0.001 and 0.004, respectively). In univariate logistic regression analysis, both maternal/neonatal vitamin D levels were a significant predictor of NEC (odds ratio (OR): 0.92 and 0.89; P<0.001 and P<0.005, respectively). However, multivariate logistic regression analysis revealed that only maternal vitamin D level was a significant predictor of NEC (OR: 0.86, P<0.0009). CONCLUSION: This is the first study to propose a possible association between maternal/neonatal 25-OHD levels and subsequent development of NEC in preterm infants.

Maternal/neonatal vitamin D deficiency: a risk factor for bronchopulmonary dysplasia in preterms?

OBJECTIVE: The objective of this study was to investigate the possible association between maternal/neonatal 25-hydroxy vitamin D (25-OHD) levels and development of bronchopulmonary dysplasia. STUDY DESIGN: One hundred and thirty-two preterm infants ⩽32 weeks of gestation who were diagnosed with respiratory distress syndrome were enrolled. 25-OHD levels were determined in maternal/neonatal blood samples that were obtained at the time of admission to the neonatal intensive care unit. RESULT: A total of 100 infants were included and 31 (31%) developed bronchopulmonary dysplasia (BPD). Both maternal and neonatal 25-OHD levels in the BPD group were significantly lower compared with those in the no-BPD group (P=0.0001). A positive correlation was detected between maternal and neonatal 25-OHD levels. All of the infants with BPD had a 25-OHD level <10 ng ml(-1), which represented severe deficiency. Univariate logistic regression analysis revealed that maternal/neonatal vitamin D levels were a significant predictor of BPD (odds ratio (OR): 0.76 and 0.61, respectively, P<0.001). CONCLUSION: We demonstrated for the first time that lower maternal and neonatal vitamin 25-OHD levels were associated with BPD development in preterm infants. However, further studies with larger sample sizes are needed to delineate the possible link between vitamin D deficiency and BPD.

Limb deformity in a newborn. Is rifampicin just an innocent bystander?

OBJECTIVE: The first-line antituberculous agents for use during pregnancy have minimal teratogenic effects. The possibility of limb deformity during rifampin use, however, was reported by some researchers. CASE REPORT: A male newborn was born with a hypoplastic right forearm to a mother with tuberculosis who used isoniazid and rifampicin in the first two months of her pregnancy. CONCLUSIONS: The limb anomaly in our case might be attributed to rifampicin usage during the first 2 months of pregnancy. Caution should be given with regard to possible congenital malformations which could be associated with the treatment of pregnant women with antituberculous drugs.

Lower vitamin D levels are associated with increased risk of early-onset neonatal sepsis in term infants.

OBJECTIVE: To evaluate the effect of vitamin D levels on early-onset sepsis (EOS) in term infants. STUDY DESIGN: Fifty term infants with clinical and laboratory findings of EOS (study group) and 50 healthy infants with no signs of clinical/laboratory infection (control group) were enrolled. Blood was drawn at the time of admission during the first 3 postnatal days of life in both groups for measurement of 25-hydroxyvitamin D (25-OHD) levels. RESULT: Maternal and neonatal 25-OHD levels (22.2/8.6 ng ml(-1), respectively) in the study group were significantly lower than those of the control group (36.2/19 ng ml(-1), respectively, P<0.001). A positive correlation was detected between maternal and neonatal 25-OHD levels. Severe vitamin D deficiency was significantly more common in the sepsis group. CONCLUSION: Lower maternal and neonatal 25-OHD levels are associated with EOS. These data suggest that adequate vitamin D supplementation during pregnancy may be helpful to prevent EOS in term neonates.