A case control study on maternal serum 25- hydroxyvitamin D3 levels and the risk of very early onset neonatal sepsis in Mulago Hospital

Abstract

INTRODUCTION Low serum 25-hydroxyvitamin-D3 levels in pregnancy have been associated with an increased risk of adverse fetal outcomes including an increased risk of early-onset-neonatalsepsis in the full-term infant. In this study we determined the association between maternal and neonatal serum 25-hydroxyvitamin-D3 levels and the risk of very-early-onset-neonatalsepsis in Mulago hospital; we also determined the correlation between maternal and neonatal serum 25-hydroxyvitamin-D3 levels. METHODS This was a case control study; the study population comprised of mother/baby pairs, the babies were full-term neonates’ aged 0-72hours. A total of 73 neonates (cases) with clinical/laboratory evidence of very-early-onset neonatal sepsis and 73 neonates (controls) without clinical/laboratory evidence of very-early-onset neonatal sepsis were recruited. Serum 25-hydroxyvitamin-D3 levels were determined for the Mother/Baby pairs. Logistic regression was used to determine association between very-early-onset neonatal sepsis and maternal/neonatal serum 25-hydroxyvitamin-D3 levels. Correlation between maternal and neonatal serum 25-hydroxyvitamin-D3 levels was quantified using Spearman’s correlation coefficient at a 0.05 level of significance. RESULTS There was positive correlation between the maternal and neonatal serum 25-hydroxyvitamin- D3 levels (Spearman’s correlation coefficient-0.77, p-value-0.001). The odds of developing very-early-onset neonatal sepsis among the neonates whose mothers were serum 25- hydroxyvitamin-D3 deficient was 46% lower compared to the odds among neonates whose mothers were not serum 25-hydroxyvitamin-D3 deficient (Odds ratio-0.54, CI 0.25-1.16, p value-0.12). The odds of developing very-early-onset neonatal sepsis among the neonates who were serum 25-hydroxyvitamin-D3 deficient was 60% lower compared to the odds among neonates who were not serum 25-hydroxyvitamin-D3 deficient (Odds ratio-0.40, CI 0.13-1.15, p-value 0.059). CONCLUSION The positive correlation between maternal and neonatal serum 25-hydroxyvitamin D3 levels confirms the fact that a mother needs to have adequate levels during pregnancy for her neonate to have the normal levels. In vivo serum 25-hydroxyvitamin-D3 levels alone may not be responsible for an increase in the risk of very-early-onset neonatal sepsis.