A study on vitamin D levels in preterm and term neonates and their mothers

Background: Vitamin D is a fat-soluble vitamin which has immunomodulatory and anti-inflammatory effects. Vitamin D deficiency is a worldwide problem and yet is one of the most under diagnosed and under treated nutritional deficiency. Despite India being in the tropical zone with plentiful sunlight, there is a wide prevalence of vitamin D deficiency.Methods: Cross sectional descriptive study done in a tertiary care hospital involving 30 mother baby dyads equally divided into term and preterm babies. Maternal vitamin D levels (before delivery) and cord blood vitamin D levels (after delivery) were estimated.Results: All the mothers had low vitamin D levels, 93% having deficiency and 7% having insufficiency. The maternal vitamin D levels correlated with cord blood vitamin D levels. There was significant correlation between maternal vitamin D levels and cord blood vitamin D levels with maternal age and parity. There was no correlation between maternal vitamin D levels with gestational age, sociodemographic profile or neonatal anthropometry.Conclusions: Vitamin D deficiency is widely prevalent even in well-nourished mothers. Vitamin D supplementation may be helpful in antenatal mothers. Larger studies are needed to study the prevalence of vitamin D deficiency in mothers and babies and look for effectiveness of supplementation.

SNAPPE II score: predictor of mortality in NICU

Background: Advances in the NICU (neonatal intensive care unit) have significantly decreased mortality and morbidity and increased survival rate in neonates. SNAPPE II (Score for Neonatal Acute Physiology-Perinatal Extension II) score, which is a modified version of the SNAP score (Score for Neonatal Acute Physiology) helps in predicting the neonatal mortality. The aim of the study was to assess the risk of mortality using SNAPPE II score in neonates admitted to NICU.Methods: It was a prospective validation study done in a tertiary care hospital. Data was collected from 116 new borns admitted to NICU within 48 hours of birth who required respiratory support between December 2017 to June 2018.Results: A total of 116 newborns admitted to the NICU was included in present study. Out of 116 babies, 56 (48%) had mild SNAPPE-II score, 44 (38%) had moderate score and 16 (14%) had severe score. Among the 44 babies with moderate score, 12 (27%) died, which was statistically significant (P<0.001). Among 16 babies with severe score, 13 (81%) babies died, which was highly statistically significant (P<0.0001). Urine output, seizures, serum pH in the first 24 hours of life are independent predictors of mortality with significant p value (0.001).Conclusions: The SNAPPE-II score recorded in the first 48 hours of life could be a good predictor of mortality in babies admitted to NICU.