The role of vitamin D and trace elements in premature newborns with congenital pneumonia.

Objectives: The objective of the research is to determine the levels of vitamin D and trace elements in the umbilical cord blood, as well as to evaluate the clinical and laboratory characteristics in premature newborns with congenital pneumonia.

Materials And Methods: This single‑center case-control research included 228 premature newborns who were divided into the main group composed of 76 newborns with congenital pneumonia, and control group composed of 152 newborns without congenital pneumonia, who were born in the period from January 2021 to December 2021. An enzyme immunoassay of vitamin D determination was performed along with an assessment of clinical and laboratory characteristics. The modern mass spectrometry was performed to determine the trace element status of the blood of 46 premature newborns proven to have a severe vitamin D deficiency.

Results: The results of our research demonstrated that premature newborns with congenital pneumonia had a severe vitamin D deficiency, low Apgar scores, and severe respiratory disorder (assessed by means of modified Downes score). The analysis showed that the newborns with congenital pneumonia had a significantly worse pH, lactate, HCO3, and pCO2 as compared with the newborns without pneumonia (p < 0.05). The analysis also revealed early biomarkers of congenital pneumonia in premature newborns, particularly thrombocytopenia, leukocytosis, high c-reactive protein (CRP) (p < 0.05).Stage 2 of the research was performed with the use of modern mass spectrometry to determine the trace element status (in the first stage, vitamin D was determined) in 46 premature newborns proven to have a severe vitamin D deficiency. The examination revealed that the levels of iron, calcium, manganese, sodium, strontium were decreased, whereas the levels of magnesium, copper, zinc, aluminum, and arsenic were increased. Only potassium, chromium, and lead turned out to be in normal range. According to the available data, in contrast to the most of micronutrients in the context of inflammatory response, the plasma concentrations of copper and zinc are reported to be increased as opposed to iron, the concentration of which is shown to be decreased.

Conclusion: Our results demonstrated a high prevalence of 25 (OH) vitamin D deficiency in premature newborns. A significant relationship has been shown between the respiratory status of vitamin D and presence of congenital pneumonia in premature newborns. The analysis also showed that the content of trace elements in premature newborns plays an immunomodulatory role and affects the susceptibility and outcome of the infectious process. Thrombocytopenia in premature newborns may be an early biomarker for monitoring congenital pneumonia (Tab. 2, Ref. 28). Text in PDF www.elis.sk Keywords: congenital pneumonia, premature newborn, vitamin D, trace elements, mass spectrometry.