الفهرس 
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Abstract
Neonatal sepsis: Abacterial infection of the blood in a neonate,
an infant younger than 4 weeks of age. Babies with sepsis may be
listless, ovely sleepy, floppy, week and very pale. Neonatal sepsis is
life-threatening.
Neonatal septicemia remains one of the main causes of
mortality and morbidity despite the progress in hygiene, introduction
of new and potent antimicrobial agents for treatment and advanced
measures for diagnosis. It is responsible for 30‐50% of total neonatal
deaths in developing countries.
Neonatal sepsis can be classified to early, late and very lateonset
sepsis. Early onset sepsis in general is the sepsis occurs in the
first 72 of life. Early-onset sepsis (EOS) often presents as a fulminant,
multi-system illness within 72 hours of delivery and is mainly due to
bacteria acquired before and during delivery whereas late onset sepsis
(LOS) is due to bacteria acquired after delivery (Nosocomial or
community sources) and can present as either a fulminant or a
smoldering infection.
Vitamin D is a fat-soluble steroid hormone that contributes to
the maintenance of normal calcium homeostasis and skeletal
mineralization. Vitamin D also has immunomodulatory effects on
immune function. It was suggested that it might have a role in the
optimal functioning of the innate immune system by inducing
antimicrobial peptides in epithelial cells, neutrophils and
macrophages.
Newborns are more susceptible to infections as both innate and
adaptive immune systems are not entirely developed. The relationship
between vitamin D deficiency and infections, especially lower
respiratory tract infections (RTIs), has been demonstrated in children
and newborns. Low cord blood 25-hydroxyvitamin D (25-OHD)
levels in healthy newborns were found to be associated with an
increased risk of developing respiratory syncytial virus infections
during infancy.
So the aim of this work was to correlate the levels of maternal
and neonatal plasma vitamin D with development of early onset sepsis
in full term infants.
This study was conducted on 60 full term neonates and their mothers
divided into two groups:
1-Patients group: 30 full term neonates and their mothers diagnosed
as having sepsis.
2-Controls group: 20 full term neonates and their mothers with no
clinical or laboratory evidence of sepsis (healthy neonate).
Full history taking, full clinical examination for all neonates included
in this study and the following investigations were done to all cases:
•Complete blood count (CBC).
•C-reactive protein (CRP).
•Serum 25-hydroxyvitamin D (25OHD) levels in both
neonates and mother.
The patient group compromised 30 newborns: 18 males (60%)
and 12 females (40%), with mean gestational age of (38.3± 0, 53wks).
mean birth weight of (2.8± 0.36 kg).
The control group compromised 30 healthy full term newborns:
10 males (50%) and 10 females (50%), with mean gestational age of
(38.5±0.67wks), mean birth weight of (3.05± 0.28 kg).
In the patient group, 13 (43.3%) neonates were delivered
vaginally, and 17 (56.7%) neonates were delivered by caesarian
section. In the control group, 13(65%) neonates were delivered
vaginally, and 7 (35%) neonates were delivered by caesarian section.
The results of our study were:
•There were no significant differences regarding infants sex,
GA and weight between the sepsis and control groups
(P>0.05).
•There were significant differences between the sepsis and
control groups regarding mode of delivery, season of birth.
•There were highly significant differences between the
sepsis and control groups regarding Apgar score at 1 min
and Apgar score 5 min.
•As regard maternal history, there was a highly significant
difference between the sepsis and control groups regarding
maternal education and history of vit D intake by the
mothers.
•Regarding the most frequent clinical presentation of sepsis
poor suckling was found in about (96.7%) followed by
tachypnea (83.3%) then feeding intolerance (80%).
•There were a significant difference between patient and
control as regard Hb%, TLC, and show a highly significant
difference between them as regard PLT.
•There were a highly significant difference between patient
and control as regard infant and maternal vit D level.
•There were a highly significant difference between patient
and control as regard CRP.
•There were a significant negative colleration between infant
vitD level in patient and CRP.
•A highly significant positive colleration between infant vit
D level and maternal vit D in patient group and a
significant positive colleration between infant vit D level
and maternal vit D in control group.
•There were a highly significant relation between infant,
maternal vit D level and season.
•ROC analysis of the data showed that the best cutoff
neonatal vit D value for the risk of sepsis was 8.74 ng
(sensitivity =95.3%, specificity = 95.5%, area under the
curve = 0.95 NPV=95.5 and PPV=95.5while the cutoff
maternal vit D was 22.02ng (sensitivity = 91.5%,
specificity =94.7%, area under the curve = 0.91,
NPV=93.5and PPV=95.3)