A Case Control Study to Assess the Serum Vitamin D Levels in Neonates with and without Seizures
European Journal of Molecular & Clinical Medicine,
2021, Volume 8, Issue 3, Pages 4868-4872
AbstractAim: To evaluate the Vitamin D Levels in Neonates With and Without Seizures.
Methods: A case control study was conducted in the Department of Pediatrics, Shri Krishna Medical College and Hospital, Muzaffarpur, Bihar, India from May 2019 to April 2021. Term and late preterm (35-40 weeks) neonates admitted to the neonatal intensive care unit (NICU) of our institute with seizures were enrolled as cases. Controls were healthy term and late preterm neonates admitted in the postnatal ward along with their mothers. Blood samples of all neonates with seizures included in the study were sent for vitamin D levels, calcium, and magnesium along with other investigations like sepsis screen (to rule out septicemia), ammonia, lactate, pyruvate, ABG, TMS/GCMS (to rule out IEM), blood glucose, ionized calcium and total calcium, and serum albumin. Blood samples were taken immediately after seizures and before administration of any specific treatment. Second-line investigations were done in cases, as and when indicated. These included electro- encephalography (EEG), cerebrospinal fluid analysis, and neurosonogram/magnetic resonance imaging. Serum vitamin D estimation was done by electro-chemiluminescence immunoassay.
Results: total of 100 babies with seizures were admitted to the NICU during the study period, of which 50 were excluded. 50 neonates were enrolled as controls. Baseline characteristics of cases and controls were not significantly different . Based on the semiology, the most common seizures were multifocal clonic type (n=15), followed by focal clonic (n=13). Mixed type and subtle seizures were seen in six neonates each, and tonic and myoclonic types in one each. Based on the etiology, idiopathic seizures were the most common (n=40) followed by hypocalcemic seizures (n=8). The serum vitamin D levels were higher in cases than the controls (P=0.22); although, both groups had levels in the insufficient range (15-20 ng/mL) . There were 30 neonates with seizures with low vitamin D levels (<20 ng/mL). Out of which, 10 mothers’ samples could not be done as they were not willing and/or were not admitted to the same Institute as the babies were outborn. The mean (SD) serum vitamin D levels of remaining mothers (n=20) was 14.25 (5.17) ng/mL and the mean serum vitamin D levels of their babies (n=20) was 14.04 (3.55) ng/mL. There was no significant association (P=0.71) between maternal and neonatal vitamin D levels. There was no significant association (P=0.22) between onset of seizures (within and beyond 72 hours) and vitamin D levels. Levels of vitamin D were low among neonates with hypocalcemic seizures but it was not statistically significant [16.02 (7.79) vs 21.02 (5.88); P=0.17]. Among the cases, EEG was done in 40 babies. Out of the 40 EEGs, only three were abnormal.
Conclusion: Hypovitaminosis D in mothers is also associated with hypovitaminosis D in neonates.
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