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Doroodgar Moein
Aminian Alireza
Doroodgar Masoud
Abolhassan Choobdar Farhad
Yousefi Zoshk Mojtaba
Kowsari Kourosh
Kazemi Galougahi Mohammad Hassan


Respiratory distress syndrome, Vitamin D deficiency, Neonate, Inflammatory factor


Background and Aim: Neonatal respiratory distress is a common complication among new-borns with fatal consequences if left untreated. Inflammation plays an important role in the pathophysiology of this condition as the neonate’s immune system is not fully developed upon birth. Previously, it has been reported that vitamin D levels are attributed to inflammatory responses in adults and animal models. Hence, we aimed at evaluating the association between the vitamin D deficiency and inflammatory markers among neonates who suffer from respiratory distress after birth.


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1. Ustun, N., et al., Association of vitamin D receptor gene FokI and TaqI polymorphisms and risk of RDS. The Journal of Maternal-Fetal & Neonatal Medicine, 2020. 33(21): p. 3640-3646.
2. Mailhot, G. and J.H. White, Vitamin D and Immunity in Infants and Children. Nutrients, 2020. 12(5).
3. Al‐Beltagi, M., et al., Vitamin D status in preterm neonates and the effects of its supplementation on respiratory distress syndrome. Pediatric pulmonology, 2020. 55(1): p. 108-115.
4. Matejek, T., et al., Severe vitamin D deficiency in preterm infants: possibly no association with clinical outcomes? The Journal of Maternal-Fetal & Neonatal Medicine, 2022. 35(8): p. 1562-1570.
5. Hornsby, E., et al., Vitamin D supplementation during pregnancy: Effect on the neonatal immune system in a randomized controlled trial. J Allergy Clin Immunol, 2018. 141(1): p. 269-278.e1.
6. Rosendahl, J., et al., 25-hydroxyvitamin D correlates with inflammatory markers in cord blood of healthy newborns. Pediatric Research, 2017. 81(5): p. 731-735.
7. Yılmaz, B., C. Aygün, and E. Çetinoğlu, Vitamin D levels in newborns and association with neonatal hypocalcemia. J Matern Fetal Neonatal Med, 2018. 31(14): p. 1889-1893.
8. Sodri, N.I., et al., Rickets Due to Severe Vitamin D and Calcium Deficiency During the COVID-19 Pandemic in Malaysia. Am J Case Rep, 2021. 22: p. e934216.
9. Charoenngam, N., D. Ayoub, and M.F. Holick, Nutritional rickets and vitamin D deficiency: consequences and strategies for treatment and prevention. Expert Rev Endocrinol Metab, 2022: p. 1-14.
10. Zang, R., et al., Association Between Vitamin D Level and Neonatal Respiratory Distress Syndrome: A Systematic Review and Meta-Analysis. Front Pediatr, 2021. 9: p. 803143.
11. Saraf, R., et al., Global summary of maternal and newborn vitamin D status–a systematic review. Maternal & child nutrition, 2016. 12(4): p. 647-668.
12. Liefaard, M.C., et al., Vitamin D and C-reactive protein: a Mendelian randomization study. PloS one, 2015. 10(7): p. e0131740.
13. Tao, R.X., et al., Inverse Correlation between Vitamin D and C-Reactive Protein in Newborns. Nutrients, 2015. 7(11): p. 9218-28.
14. Amer, M. and R. Qayyum, The relationship between 25-hydroxyvitamin D and homocysteine in asymptomatic adults. The Journal of Clinical Endocrinology & Metabolism, 2014. 99(2): p. 633-638.
15. Holmlund-Suila, E., et al., High-dose vitamin D intervention in infants—effects on vitamin D status, calcium homeostasis, and bone strength. The Journal of Clinical Endocrinology & Metabolism, 2012. 97(11): p. 4139-4147.
16. Yu, R.-Q., et al., Relationship between serum 25 (OH) D levels at birth and respiratory distress syndrome in preterm infants. Zhongguo Dang dai er ke za zhi= Chinese Journal of Contemporary Pediatrics, 2017. 19(11): p. 1134-1137.
17. Dogan, P., et al., Vitamin D deficiency and its effect on respiratory distress syndrome in premature infants: results from a prospective study in a tertiary care centre. African Health Sciences, 2020. 20(1): p. 437-443.
18. Firth, M.A., P.E. Shewen, and D.C. Hodgins, Passive and active components of neonatal innate immune defenses. Animal health research reviews, 2005. 6(2): p. 143-158.
19. Baeke, F., et al., Vitamin D: modulator of the immune system. Current opinion in pharmacology, 2010. 10(4): p. 482-496.
20. Adkins, B., C. Leclerc, and S. Marshall-Clarke, Neonatal adaptive immunity comes of age. Nature Reviews Immunology, 2004. 4(7): p. 553-564.
21. Tao, R.-X., et al., Inverse correlation between vitamin D and C-reactive protein in newborns. Nutrients, 2015. 7(11): p. 9218-9228.
22. Ao, T., J. Kikuta, and M. Ishii, The Effects of Vitamin D on Immune System and Inflammatory Diseases. Biomolecules, 2021. 11(11).
23. Aranow, C., Vitamin D and the immune system. J Investig Med, 2011. 59(6): p. 881-6.
24. Association, C.s.H.B.o.C.P.M., Expert consensus on clinical application of vitamin A and vitamin D in Chinese children. Chin J Child Heal Care, 2021. 29: p. 110-6.
25. Sweet, D.G., et al., European consensus guidelines on the management of respiratory distress syndrome–2019 update. Neonatology, 2019. 115(4): p. 432-450.
26. Van Schoor, N., et al., Cross-sectional and longitudinal associations between serum 25-hydroxyvitamin D and cognitive functioning. International psychogeriatrics, 2016. 28(5): p. 759-768.
27. Amer, M. and R. Qayyum, Relation between serum 25-hydroxyvitamin D and C-reactive protein in asymptomatic adults (from the continuous National Health and Nutrition Examination Survey 2001 to 2006). The American journal of cardiology, 2012. 109(2): p. 226-230.
28. Ngo, D.T., et al., Does vitamin D modulate asymmetric dimethylarginine and C-reactive protein concentrations? The American journal of medicine, 2010. 123(4): p. 335-341.
29. Bellia, A., et al., Serum 25-hydroxyvitamin D levels are inversely associated with systemic inflammation in severe obese subjects. Internal and emergency medicine, 2013. 8: p. 33-40.
30. Robinson, A.B., et al., Vitamin D deficiency is common and associated with increased C-reactive protein in children and young adults with lupus: an Atherosclerosis Prevention in Pediatric Lupus Erythematosus substudy. Lupus science & medicine, 2014. 1(1): p. e000011.
31. Jorde, R., et al., No effect of supplementation with cholecalciferol on cytokines and markers of inflammation in overweight and obese subjects. Cytokine, 2010. 50(2): p. 175-180.
32. Schleithoff, S.S., et al., Vitamin D supplementation improves cytokine profiles in patients with congestive heart failure: a double-blind, randomized, placebo-controlled trial. The American journal of clinical nutrition, 2006. 83(4): p. 754-759.
33. Coussens, A., et al., 1α, 25‐dihydroxyvitamin D3 inhibits matrix metalloproteinases induced by Mycobacterium tuberculosis infection. Immunology, 2009. 127(4): p. 539-548.
34. Britt Jr, R.D., et al., Vitamin D attenuates cytokine‐induced remodeling in human fetal airway smooth muscle cells. Journal of cellular physiology, 2015. 230(6): p. 1189-1198.
35. Viljakainen, H.T., et al., Maternal vitamin D status determines bone variables in the newborn. The Journal of Clinical Endocrinology & Metabolism, 2010. 95(4): p. 1749-1757.
36. Hewison, M., Antibacterial effects of vitamin D. Nature Reviews Endocrinology, 2011. 7(6): p. 337-345.
37. White, J.H., Regulation of intracrine production of 1, 25-dihydroxyvitamin D and its role in innate immune defense against infection. Archives of biochemistry and biophysics, 2012. 523(1): p. 58-63.
38. Zhang, Y., et al., Vitamin D inhibits monocyte/macrophage proinflammatory cytokine production by targeting MAPK phosphatase-1. The Journal of Immunology, 2012. 188(5): p. 2127-2135.
39. Kruit, A. and P. Zanen, The association between vitamin D and C-reactive protein levels in patients with inflammatory and non-inflammatory diseases. Clinical biochemistry, 2016. 49(7-8): p. 534-537.
40. Patel, S., et al., Association between serum vitamin D metabolite levels and disease activity in patients with early inflammatory polyarthritis. Arthritis & Rheumatism: Official Journal of the American College of Rheumatology, 2007. 56(7): p. 2143-2149.
41. Mellenthin, L., et al., Association between serum vitamin D concentrations and inflammatory markers in the general adult population. Metabolism, 2014. 63(8): p. 1056-1062.
42. Kozgar, S.A.M., P. Chay, and C.F. Munns, Screening of vitamin D and calcium concentrations in neonates of mothers at high risk of vitamin D deficiency. BMC Pediatrics, 2020. 20(1): p. 332.
43. Elsori, D.H. and M.S. Hammoud, Vitamin D deficiency in mothers, neonates and children. J Steroid Biochem Mol Biol, 2018. 175: p. 195-199.