الفهرس 
Neonatal sepsisOnly 14 pages are availabe for public view
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Abstract
Neonatal sepsis is still a major cause of morbidity and mortality despite major advances in neonatal intensive care units. Early-onset sepsis (EOS) is an infection of the blood acquired vertically from the mother and manifests shortly after birth.
Vitamin D, especially its active metabolite 1,25 Di-hydroxy vitamin D3, plays an important role not only in calcium homeostasis and bone remodeling, but also in the control of hormone secretion, immune dysfunction, cell-proliferation and differentiation. It has been well established that low levels of circulating 25-OH vitamin D have been shown to be strongly associated with infectious diseases. Vitamin D also has immunomodulatory effects on immune function. It was suggested that it might have a role in the optimal functioning of the innate immune system by inducing antimicrobial peptides in epithelial cells, neutrophils and macrophages.
The objective of this study is to assess the vitamin D status in neonates with Early onset sepsis (EOS) and evaluate the influence of different doses of vitamin D3 (800 IU/d versus 400 IU/d), in these infants.
A randomized controlled trial (RCT) was conducted on sixty (66) full term newborns with clinical and laboratory findings of early onset of sepsis (EOS) and were admitted to the Neonatal Intensive Care Unit of El-Demerdash hospital of Ain Shams university and El Ahrar teaching hospital in Zagazig.
we excluded preterm newborn, NPO neonates, infants with maternal risk factors , such as chorioamnionitis, neonates delivered at home ,neonates to mothers with premature rupture of membrane, and major congenital abnormalities which may be predisposing factors for development of EOS.
All patients were assessed according to Newborn Scale of Sepsis. Any neonate with a total clinical score greater than 10 was considered sick.
In our study we found the majority 52 cases (78%) of fullterm infants with EOS had insufficient vitamin D level with mean ±SD 18.12±3.6 ng/ml. Significant difference between surviving and dead cases as regard initial vitamin D level. Significant relation between the mean of serum vitamin D in recovery and vitamin D supplementation for the newborns, 55 % of the patients of group A who took 400 IU became sufficient on recovery and 75 % of the patients of group B who took 800 IU became sufficient on recovery.
The magnitude of change in serum 25(OH)D was greater in the 800 IU (group B) compared with the 400 IU (group A).
Significant difference in age of recovery between group B and group C. Duration of hospital admission of the newborns who took 800 IU is less than the other 2 groups. Also, newborns who took 400 IU needed less numbers of days than the group C, but with no statistically significant difference between the three groups regarding duration of recovery.
Conclusion
Vitamin D supplementation has a role in the survival of full term neonates suffering from sepsis and decrease the duration of hospital admission. Significant correlation between the mean of serum vitamin D level in recovery and vitamin D supplementation for the newborns.
Recommendations
Further studies with larger sample size and duration of vitamin D supplementation are needed in full term with sepsis. In addition, larger studies are required to confirm safety of larger doses of vitamin D in full term neonates with sepsis.