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신생아의 저산소성 허혈성 뇌병증과 혈중 비타민 D 농도의 연관성: 체계적 문헌고찰 및 메타분석

Association of Serum Vitamin D Levels with Hypoxic-Ischemic Encephalopathy in Neonates : A Systematic Review and Meta-Analysis

이소연|안숙희|장세원
한국병원약사회 (The Korean Society of Health-System Pharmacists)|2021.11|병원약사회지 (Journal of Korean Society of Health-System Pharmacists)|제38권 제4호|pp. 473-487|DOI 10.32429/jkshp.2021.38.4.005

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Meta-analysisVitamin DNeonatesHypoxic-ischemic encephalopathy

초록

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.

Abstract

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.

참고문헌 (34)

  1. Stoll BJ, "Neonatal outcomes of extremely preterm infants from the NICHD Neonatal Research Network", Pediatrics, 126(3), pp.443~456 (2010)
  2. Domínguez-Dieppa F, "Hypoxic Ischemic Encephalopathy in Units Reporting to the Ibero-American Society of Neonatology Network : Prevalence and Mortality", ME DICC Rev, 23(1), pp.30~34 (2021)
  3. Policy Issues on Neonatal Intensive Care for Low Birth Weight Infants, "Choi JS BC", Korea Institute for Health and Social Affairs, ~ (2012)
  4. Yıldız EP, "Neonatal hypoxic ischemic encephalopathy : an update on disease pathogenesis and treatment", Expert Rev Neurother, 17(5), pp.449~459 (2017)
  5. Dusso AS, "Vitamin D", Am J Physiol Renal Physiol, 289(1), pp.F8~28 (2005)
  6. McCarty MF, "Secondary hyperparathyroidism promotes the acute phase response-a rationale for supplemental vitamin D in prevention of vascular events in the elderly", Med Hypotheses, 64(5), pp.1022~1026 (2005)
  7. Sharma S, "Neuroprotective Role of Oral Vitamin D Supplementation on Consciousness and Inflammatory Biomarkers in Determining Severity Outcome in Acute Traumatic Brain Injury Patients : A Double-Blind Randomized Clinical Trial", Clin Drug Investig, 40(4), pp.327~334 (2020)
  8. Zhou R, "Lower Vitamin D Status Is Associated with an Increased Risk of Ischemic Stroke: A Systematic Review and Meta-Analysis", Nutrients, 10(3), pp.277~ (2018)
  9. Page MJ, "The PRISMA 2020 statement : An updated guideline for reporting systematic reviews", J Clin Epidemiol, 134, pp.178~189 (2021)
  10. Higgins JP, "The Cochrane Collaboration’s tool for assessing risk of bias in randomised trials", Bmj, 343, pp.d5928~ (2011)
  11. Kim SY, "Testing a tool for assessing the risk of bias for nonrandomized studies showed moderate reliability and promising validity", J Clin Epidemiol, 66(4), pp.408~414 (2013)
  12. Friedrich JO, "Ratio of means for analyzing continuous outcomes in meta-analysis performed as well as mean difference methods", J Clin Epidemiol, 64(5), pp.556~564 (2011)
  13. Friedrich JO, "The ratio of means method as an alternative to mean differences for analyzing continuous outcome variables in meta-analysis : a simulation study", BMC Med Res Methodol, 8, pp.32~ (2008)
  14. Hagag AA, "Vitamin D as an Adjuvant Therapy in Neonatal Hypoxia : Is it Beneficial", Endocr Metab Immune Disord Drug Targets, 19(3), pp.341~348 (2019)
  15. Lowe DW, "Vitamin D insufficiency in neonatal hypoxic-ischemic encephalopathy", Pediatr Res, 82(1), pp.55~62 (2017)
  16. McGinn EA, "Neonatal Vitamin D Status Is Associated with the Severity of Brain Injury in Neonatal Hypoxic-Ischemic Encephalopathy : A Pilot Study", Neuropediatrics, 51(4), pp.251~258 (2020)
  17. Mutlu M, "Status of vitamin D, antioxidant enzymes, and antioxidant substances in neonates with neonatal hypoxic-ischemic encephalopathy", J Matern Fetal Neonatal Med, 29(14), pp.2259~2263 (2016)
  18. Saad A, "Study of Lactate, Vitamin D and Nucleated Red Blood Cells for Early Prediction of Hypoxic–Ischemic Encephalopathy:A Cross-Sectional Case-Control Study" (2021)
  19. Saleh SM, "The status of vitamin D in neonates with hypoxic ischemic encephalopathy", Ann Neo J, 2(1), pp.14~19 (2020)
  20. Holick MF, "Evaluation, treatment, and prevention of vitamin D deficiency : an Endocrine Society clinical practice guideline", J Clin Endocrinol Metab, 96(7), pp.1911~1930 (2011)
  21. Sarnat HB, "Neonatal encephalopathy following fetal distress. A clinical and electroencephalographic study", Arch Neurol, 33(10), pp.696~705 (1976)
  22. Wion D, "1, 25-Dihydroxyvitamin D3 is a potent inducer of nerve growth factor synthesis", J Neurosci Res, 28(1), pp.110~114 (1991)
  23. Eyles D, "Vitamin D3 and brain development", Neuroscience, 118(3), pp.641~653 (2003)
  24. Stessman LE, "Vitamin D and Its Role in Neonatal Hypoxic-Ischemic Brain Injury", Neonatology, 113(4), pp.305~312 (2018)
  25. Zeng YY, "Low vitamin D levels and the long-term functional outcome of stroke up to 5years", Brain Behav, pp.e2244~ (2021)
  26. Alfieri DF, "Vitamin D deficiency is associated with acute ischemic stroke, C-reactive protein, and short-term outcome", Metab Brain Dis, 32(2), pp.493~502 (2017)
  27. Esmeraldo CUP, "Vitamin D in Term Newborns : Relation with Maternal Concentrations and Birth Weight", Ann Nutr Metab, 75(1), pp.39~46 (2019)
  28. Voltas N, "Effect of Vitamin D Status during Pregnancy on Infant Neurodevelopment:The ECLIPSES Study", Nutrients, 12(10) (2020)
  29. Janbek J, "Associations between vitamin D status in pregnancy and offspring neurodevelopment : a systematic literature review", Nutrition Reviews, 77(5), pp.330~349 (2019)
  30. Eyles D, "Vitamin D in fetal brain development", Semin Cell Dev Biol, 22(6), pp.629~636 (2011)
  31. Whitehouse AJ, "Maternal serum vitamin D levels during pregnancy and offspring neurocognitive development", Pediatrics, 129(3), pp.485~493 (2012)
  32. Sass L, "High-Dose Vitamin D Supplementation in Pregnancy and Neurodevelopment in Childhood : A Prespecified Secondary Analysis of a Randomized Clinical Trial", JAMA Netw Open, 3(12), pp.e2026018~ (2020)
  33. Wagner CL, "Prevention of rickets and vitamin D deficiency in infants, children, and adolescents", Pediatrics, 122(5), pp.1142~1152 (2008)
  34. Braegger C, "Vitamin D in the healthy European paediatric population", J Pediatr Gastroenterol Nutr, 56(6), pp.692~701 (2013)

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