Does vitamin D deficiency affect placental inflammation or infections among very low birth weight infants?

Effects of vitamin D on neonatal sepsis: A systematic review and meta-analysis

Vitamin D deficiency is a major public health concern of pregnant women and neonates worldwide, affecting more than half of neonates. Studies report inconsistent and inconclusive effects of vitamin D treatment on neonatal sepsis. This study aimed to provide conclusive evidence regarding the effect of maternal and cord blood vitamin D levels on neonatal sepsis. Data were retrieved from the electronic database (Web of Science, Scopus, CINAHL [EBSCOhost], ProQuest, EMBASE [Ovid], PubMed, Emcare, MEDLINE [Ovid], and gray literature sources [World cat, Mednar, Google scholar and Google]). Joanna Briggs Institute quality assessment tool was utilized for quality assessment while analysis was performed using Open Meta-analyst, Comprehensive Meta-analysis version 3.3.070, and Review Manager version 5.3 software. From the 18 studies included in the study, the overall prevalence of vitamin D deficiency among neonates was 61% (95% CI: 44.3, 77.7); 79.4% (95% CI: 71.6, 87.3) of neonates with sepsis were vitamin D deficient as were 43.7% (23.4, 63.9) of sepsis-free neonates. Neonates born from mothers with low vitamin D levels were at greater risk of developing neonatal sepsis with a weighed mean difference of -8.57 ng/ml (95% CI: -13.09, -4.05). Similarly, neonates with low cord vitamin D levels were at risk for neonatal sepsis with a mean difference of -8.78 ng/ml (95% CI:-11.58, -5.99). The incidence of EONS in full-term newborns was significantly associated with low maternal and cord blood vitamin D levels with weighed mean differences of -11.55ng/ml (95% CI: -17.63, -5.46) & -11.59 ng/ml (95% CI:-16.65, -6.53), respectively. Low levels of vitamin D both in the cord blood and maternal blood were significantly associated with neonatal sepsis. Hence, vitamin D supplementation for pregnant women and newborns could decrease neonatal sepsis.

The Association Between Low Levels of Vitamin D and Clinical Outcomes in Critically-Ill Children: A Systematic Review and Meta-Analysis

Background: We conducted a meta-analysis to investigate the possible effects of vitamin D deficiency on clinical outcomes of critically-ill children.Methods: We searched Scopus-Embase and PubMed-Medline databases to find eligible observational articles. Odds ratios (ORs) and 95% confidence intervals (CIs) were used to estimate the strength of associations.Results: Seventeen articles (eighteen studies) involving 2987 critically ill patients met our inclusion criteria. Vitamin D deficiency was not associated with increased mortality. A significant association was only observed in very high developed countries between vitamin D deficiency and risk of sepsis [OR (95%CIs): 2.65 (1.30, 5.41)] and ventilation support requirement [OR (95%CIs): 1.35 (1.03, 1.77)].Conclusion: Our findings suggest that vitamin D deficiency is not associated with higher mortality among critically ill children but increases susceptibility to sepsis and the need for ventilator support in critical care settings.

Vitamin D Effects on the Immune System from Periconception through Pregnancy

Vitamin D is a well-known secosteroid and guardian of bone health and calcium homeostasis. Studies on its role in immunomodulatory functions have expanded its field in recent years. In addition to its impact on human physiology, vitamin D influences the differentiation and proliferation of immune system modulators, interleukin expression and antimicrobial responses. Furthermore, it has been shown that vitamin D is synthesized in female reproductive tissues and, by modulating the immune system, affects the periconception period and reproductive outcomes. B cells, T cells, macrophages and dendritic cells can all synthesize active vitamin D and are involved in processes which occur from fertilization, implantation and maintenance of pregnancy. Components of vitamin D synthesis are expressed in the ovary, decidua, endometrium and placenta. An inadequate vitamin D level has been associated with recurrent implantation failure and pregnancy loss and is associated with pregnancy-related disorders like preeclampsia. This paper reviews the most important data on immunomodulatory vitamin D effects in relation to the immune system from periconception to pregnancy and provides an insight into the possible consequences of vitamin D deficiency before and during pregnancy.

The role of vitamin D in perinatology. An up-to-date review

The role of vitamin D in perinatology is a subject of major interest in current medicine. There is growing evidence about the role of maternal vitamin D levels in pregnancy outcomes. The aim of this review is to summarize the current literature about the role of vitamin D in perinatology. Evidence from this review suggests associations between low levels of maternal vitamin D and higher risk of certain obstetrical complications. Vitamin D has been found to be related to preeclampsia, gestational diabetes mellitus, low birth weight, and preterm birth. The current literature supports vitamin D supplementation in pregnant women, but more high-quality data are necessary. The problem that remains is how to achieve an optimal 25-hydroxyvitamin D level. To determine the real benefits of vitamin D supplementation in pregnancy, we need high-quality trials in larger groups.