Vitamin D Status in Neonates with Congenital Heart Disease: Its Changes after Heart Surgery and Relationship to the Outcome

 Vitamin D deficiency has been implicated in a wide range of conditions such as infectious and autoimmune diseases, cardiovascular and cerebrovascular events, and various malignancies to unfavorable birth outcomes. We studied vitamin D status in a group of neonates with congenital heart disease (CHD) and its relationship with the outcome of heart surgery.

 Total vitamin D levels in plasma were measured before and 24 hours after the operation in 45 neonates with CHD undergoing heart surgery and in 77 hospitalized neonates without a history of CHD as controls, at Children’s Medical Center between March and September 2018.

Preoperative vitamin D levels in patients with CHD were not significantly different from the control group (42.4 +/- 18.0 versus 46.9 +/- 27.7 nmol/L, P=0.640). Patients’ vitamin D levels decreased postoperatively (42.4 +/- 18.0 versus 36.2 +/- 14.5 nmol/L, P=0.013). This decline was significant in the cyanotic and open-heart surgery groups, but not in non-cyanotic or closed-heart surgery groups. In 41 (91.1%) patients, the outcome was successful discharge from the hospital, in 3 (6.7%), the outcome was demise, and in one, it was not determined due to early discharge. Preoperative and postoperative vitamin D levels did not show any relationship with the outcome. However, logistic regression analysis revealed a significant relationship between the amount of postoperative decline in vitamin D levels and the outcome of death (OR=1.261, 95% CI=1.026-1.551, P=0.028).

 Results corroborates previous findings and suggests the amount of postoperative decline in vitamin D levels as a predictor of the outcome of heart surgery in CHD.