Neonatal Vitamin D Status Is Associated with the Severity of Brain Injury in Neonatal Hypoxic–Ischemic Encephalopathy: A Pilot Study

Elizabeth A. McGinn; Andria Powers; Madeline Galas; Elizabeth Lyden; Eric S. Peeples

doi:10.1055/s-0040-1708535

Neuropediatrics, Table of Contents

Neuropediatrics 2020; 51(04): 251-258
DOI: 10.1055/s-0040-1708535

Original Article

Georg Thieme Verlag KG Stuttgart · New York

Neonatal Vitamin D Status Is Associated with the Severity of Brain Injury in Neonatal Hypoxic–Ischemic Encephalopathy: A Pilot Study

Elizabeth A. McGinn

¹Division of Neonatology, Department of Pediatrics, University of Nebraska Medical Center, Omaha, Nebraska, United States

,

Andria Powers

²Department of Radiology, Children's Hospital & Medical Center, Omaha, Nebraska, United States

,

Madeline Galas

³Munroe-Meyer Institute, University of Nebraska Medical Center, Omaha, Nebraska, United States

,

Elizabeth Lyden

⁴Department of Biostatistics, University of Nebraska Medical Center, Omaha, Nebraska, United States

,

Eric S. Peeples

¹Division of Neonatology, Department of Pediatrics, University of Nebraska Medical Center, Omaha, Nebraska, United States

› Author Affiliations

Abstract

Objective The primary aim of this study was to evaluate the association between 25-hydroxyvitamin D (25OHD) concentration at birth and the short-term outcomes in neonatal hypoxic–ischemic encephalopathy (HIE). Our secondary aim was to evaluate the effect of postnatal vitamin D supplementation on outcomes in the perinatal period after hypoxic injury.

Study Design This retrospective cohort study included all infants ≥35 weeks gestation admitted to a regional level IV neonatal intensive care unit and diagnosed with moderate or severe HIE. Spearman correlation coefficients were used to evaluate associations between clinical outcomes including standardized brain magnetic resonance imaging (MRI) scores and either 25OHD concentrations in the first 48 hours of life or total vitamin D supplementation.

Result A total of 43 infants met inclusion criteria; 22 had 25OHD concentrations drawn within the first 48 hours. There was a significant inverse association between 25OHD concentration and brain injury on MRI (p = 0.017). There was a trend toward decreased ventilator days in infants receiving higher doses of vitamin D in the first week of life (p = 0.062), but there was no association between vitamin D dosing and MRI injury.

Conclusion These results support an association between lower vitamin-D levels and early adverse outcomes in HIE, including radiographic severity of brain injury.

Keywords

25-hydroxyvitamin D - magnetic resonance imaging - outcomes

Full Text

References

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