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

Original Articles - Clinical medicine (Article Number: e۵۳۷۱۱)  Background and Objective: 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. Materials and Methods: Total vitamin D levels in plasma were measured before and ۲۴ hours after the operation in ۴۵ neonates with CHD undergoing heart surgery and in ۷۷ hospitalized neonates without a history of CHD as controls, at Children’s Medical Center between March and September ۲۰۱۸. Results: Preoperative vitamin D levels in patients with CHD were not significantly different from the control group (۴۲.۴ +/- ۱۸.۰ versus ۴۶.۹ +/- ۲۷.۷ nmol/L, P=۰.۶۴۰). Patients’ vitamin D levels decreased postoperatively (۴۲.۴ +/- ۱۸.۰ versus ۳۶.۲ +/- ۱۴.۵ nmol/L, P=۰.۰۱۳). This decline was significant in the cyanotic and open-heart surgery groups, but not in non-cyanotic or closed-heart surgery groups. In ۴۱ (۹۱.۱%) patients, the outcome was successful discharge from the hospital, in ۳ (۶.۷%), 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=۱.۲۶۱, ۹۵% CI=۱.۰۲۶-۱.۵۵۱, P=۰.۰۲۸). Conclusion: 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.

Keywords:

Congenital Heart Defects , Vitamin D , Newborn