الفهرس 
NEONATAL JAUNDICEOnly 14 pages are availabe for public view
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Abstract
Jaundice is the most common clinical sign in neonatal medicine. About 60 % of healthy term infants and 80 % of premature infants develop clinically visible jaundice in the first week of life.
Vitamin D is a steroidal prohormone, the active type which plays a significant role in absorption of calcium and phosphate. It reaches the body through skin synthesis via ultraviolet rays when the sun exposure is adequate and can be ingested through food. Vitamin D undergoes two hydroxylation steps before becoming an active hormone: the first step occurs in the liver and results in the production of 25-hydroxy vitamin D (25 (OH) D). The second hydroxylation step takes place mainly in kidneys and also to some extent in innate immune cells such as monocytes and macrophages to form 1α, 25-hydroxy vitamin D. The liver tissue is not only involved in vitamin D synthesis, but also plays a role in converting indirect bilirubin to direct bilirubin.
The aim of this work was to investigate the relationship between serum vitamin D levels and hyperbilirubinemia in full term neonates.
The present study included 90 neonates that have been classified into two groups.
group I (patient group): 60 jaundiced healthy fullterm neonates with indirect hyperbilirubinemia.
group II (controls group): 30 non-jaundiced healthy fullterm neonates’ age and sex matched.
Both patient and control groups have been subjected to history taking, complete clinical examination and routine laboratory investigations for neonates including: CBC, reticulocytes, serum total bilirubin, direct bilirubin and CRP.
Serum vitamin D samples were withdrawn from all jaundiced neonates at admission with age ranging from 2 to 10 days and from control group at the time of examination before starting the phototherapy.
Our results showed that:
• No significant difference between both groups regarding gestational age, postnatal age, sex, mode of deliveries and anthropometric measurements.
• Regarding maternal age, body mass index (BMI), number of deliveries and abortions no significant difference between both groups.
• Highly significant decrease of vitamin D levels among patients than controls.
• No significant association between vitamin D levels and sex, mode of delivery.
• Significant decrease in vitamin D level among patients with history of no or irregular maternal intake of vitamin D and calcium during pregnancy than patients with their mothers on regular intake of calcium and vitamin D during pregnancy.
• Significant decrease of vitamin D levels among illiterate and less than high school mothers than high school mothers.
• Significant negative correlation between vitamin D levels and total serum bilirubin.
• Roc curve for the performance at cut off point < 20.07 (pg/ml), vitamin D had sensitivity 98.3%, specificity 96.7%, PPV 98.3%, NPV 96.7%, accuracy 96.7%.