Neonatal Vitamin D Status And Related Factors And The Effects On The Neonatal Outcome

Vitamin D is an essential a fat-soluble vitamin of the body,mainly promote intestinal calcium phosphorus absorption,regulate cell function,maintain bone health,and so on.Observational studies from all over the world continue to find high prevalence rates of vitamin D insufficiency and deficiency in many populations,including pregnant women and newborn.Beyond its classical function as a regulator of calcium and phosphate metabolism,vitamin D elicits numerous effects in the human body.Vitamin D deficiency linked to increased risk of cancer,autoimmune cardiovascular disorder and mental illness.Moreover,vitamin D insufficiency during pregnancy has consistently been associated with adverse maternal,neonatal and infant outcomes.This study aims to investigate the vitamin D status of neonate and related factors and the effects of 25-hydroxy vitamin D status on the neonatal outcome.Part one:Neonatal vitamin D status and related factors in the city of WenzhouObjective:To assess the vitamin D status in our region and to explore the related factors.Methods:This study was a population-based birth cohort study that recruited total 1010 eligible mother-and-singleton-offspring pairs.Results:There were 675 cases of the vitamin D deficiency in the 1010 infants.Neonatal vitamin D deficiency elevates the risks of small for gestational age infants.Stepwise regression analysis suggested that age stratification,birth season,and educational level of pregnant women had a significant effect on neonatal 25(OH)D level(D).Conclusion:In Wenzhou,there is a high incidence of neonatal vitamin D deficiency.Birth season,mother's age,and mother's education level are all independent influencing factors of serum 25(OH)D level of newborns at birth.Part two:The impact of vitamin D on neonatal lung diseaseObjective:The purpose of vitamin D may be involved in the pathogenesis of neonatal lung disease through immune regulation.Methods:A total of 80 eligible preterm infants were enrolled in this study.Prospective studies were performed to compare the association of neonatal hyaline membrane disease or neonatal bronchopulmonary dysplasia with vitamin D levels.Results:Low neonatal vitamin D level is associated with neonatal respiratory distress syndrome but for neonatal bronchopulmonary dysplasia had nothing to do.Conclusions:We need a multicenter randomized intervention trial to assess the effect of optimal vitamin D status on preterm infant outcomes,especially respiratory outcomes.Part three:The heating and humidifying high-flow nasal catheter ventilation in the treatment of neonatal respiratory distress syndromeObjective:To evaluate the efficacy and safety of neonatal respiratory distress syndrome(NRDS)receiving heating and humidifying high-flow nasal catheter ventilation(HHHFNC)and nasal continuous positive airway pressure(NCPAP)as the main non-invasive respiratory support.Methods:A total of 128 eligible preterm infants were enrolled in the cross-sectional study.The primary assessment of failure rate within 7 days of non-invasive respiratory support(defined as requiring endotracheal intubation and mechanical ventilation).Results:The failure rates of HHHFNC group and NCPAP group were not statistically significant.The incidence of nasal damage between the two groups was statistically significant.Conclusions:HHHFNC is a very effective and well-tolerated strategy compared with NCPAP as the initial mode of respiratory support to mild to moderate RDS in preterm infants older than 28 weeks' GA.Part four:Role of vitamin D on inflammatory response in cell sepsis model.Objective:This study selected neonatal and adult mononuclear cells as the research object,using lipopolysaccharide(LPS)as the stimulating factor to explore the intervention of vitamin D(VD)on monocyte inflammatory response and related mechanisms for the prevention and treatment of neonatal sepsis.The aim of this study is to further research the therapy of neonatal sepsis..Methods:Cell sepsis model was established.Monocytes were pretreated with different concentrations of vitamin D,and MyD88 siRNA and TRIF siRNA were transfected by blocking antibodies or monocytes with TLR4 antibody to detect the levels of inflammatory cytokines and the expression of TLR4,MyD88 and TRIF mRNA Level.Results:Successful establishment of a cellular sepsis model VD reduced LPS-induced inflammation-associated cytokines and TLR4 signaling.VD treatment significantly inhibited the effects of LPS stimulation on inflammation-related cytokines and TLR4/MyD88/TRIF signaling pathway.In addition,we found these feedback regulation between TLR4,MyD88 and TRIF present in the sepsis cell model.Conclusion:VD can effectively reduce the release of inflammatory cytokines by inhibiting the TLR4/MyD88/TRIF signaling pathway and may be a promising adjunct to sepsis therapy.