Maternal and Neonatal Vitamin D Deficiency Associated with an Increased Risk of Neonatal Hypoxic Ischemic Encephalopathy

Neonatal Hypoxic-Ischemic Encephalopathy (HIE) remains a major cause of neonatal morbidity and mortality. Neonates are at a significantly high risk of vitamin D deficiency. Maternal and neonatal vitamin D deficiency is associated with multiple neonatal diseases including HIE. This study aims to explore the possible association between maternal and neonatal 25-hydroxy vitamin D (25-OHD) levels and HIE in full-term infants and it attempts to find whether there is any relationship between vitamin D level and the clinical severity of HIE. This case-control study included 25 full-term neonates with HIE and their mothers along with 25 healthy neonates and their mothers. The level of serum (25-OHD) of the infants and their mothers was measured in the first 6 postnatal hours of the infants by isotope dilution ultra-performance liquid chromatography-tandem mass spectrometry. The severity of HIE was assessed depending on the clinical scoring system. Neonatal and maternal levels (25-OHD) were significantly lower in the study group compared with those of the control group. Neonatal (25-OHD) levels were significantly lower with increasing severity of HIE (p=0.005), but they did not follow the same order in the maternal (25-OHD) levels (p=0.96); i.e., a negative correlation was detected between neonatal (25-OHD) level and severity of HIE (r = − 0.66, P < 0.001). A positive correlation was found between neonatal and maternal (25-OHD) levels in the study group (r = 0.697, P < 0.001). Lower maternal and neonatal vitamin D levels were associated with HIE in full-term infants and the level of vitamin D was inversely associated with the clinical severity of HIE. Further studies are needed to examine the causal relationship between vitamin D deficiency and HIE in neonates.