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KMID : 0869620210380040273
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Journal of Korean Society of Hospital Pharmacists
2021 Volume.38 No. 4 p.273 ~ p.487
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Association of Serum Vitamin D Levels with Hypoxic-Ischemic Encephalopathy in Neonates : A Systematic Review and Meta-Analysis
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Jang Se-Won
Lee So-Yeon
An Sook-Hee
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Abstract
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Background : Neonatal hypoxic-ischemic encephalopathy (HIE) may lead to permanent brain injury or even death and vitamin D plays a role in neuroprotection from hypoxia. This study aimed to evaluate the association between neonatal and maternal serum vitamin D levels and neonatal HIE.
Methods : The studies reporting serum 25-hydroxyvitamin D levels in neonates with HIE and published within March, 2021 were included through a systematic literature search in PubMed/Medline, Embase, Cochrane Library, and Google Scholar databases.
Results : Six studies on 344 neonates were included in this study. The serum 25-hydroxyvitamin D levels in neonates with HIE were significantly lower than those in neonates without HIE (weighted mean difference -17.16 ng/mL, 95% confidence interval (CI) -26.47 to -7.84, p<0.001). Neonates with severe HIE had significantly lower serum 25-hydroxyvitamin D levels than neonates with mild to moderate HIE (ratio of means 0.79, 95% CI 0.65 to 0.98, p=0.03). Among the 214 neonates with HIE, 150 neonates were vitamin D deficient; however, among the 90 neonates without HIE, only 27 neonates were vitamin D deficient. Maternal serum 25-hydroxyvitamin D level in neonates with HIE was 36% reduced than that in neonates without HIE (ratio of means 0.64, 95% CI 0.53 to 0.78, p<0.001).
Conclusion : These results showed that neonatal serum vitamin D levels were significantly associated with neonatal HIE occurrence and severity. Serum vitamin D levels should be carefully monitored in neonates with HIE and they might require vitamin D supplementation. Further long-term follow-up studies are needed to confirm the association between neonatal serum vitamin D levels and neurodevelopmental outcomes in neonates with HIE.
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KEYWORD
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Neonates, Hypoxic-ischemic encephalopathy, Vitamin D, Meta-analysis
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