Vitamin D and T- regulator cells are not independent factors for RDS  in premature neonates

Putri Maharani Tristanita Marsubrin; Agus Firmansyah; Rinawati Rohsiswatmo; Yuditiya Purwosunu; Zakiudin Munasir; Tetty Yuniati

doi:10.14238/pi61.4.2021.192-7

Putri Maharani Tristanita Marsubrin Doctoral Program in Medical Science Universitas Indonesia Medical School, Jakarta
Agus Firmansyah Department of Child Health, Universitas Indonesia Medical School/Dr. Cipto Mangunkusumo Hospital, Jakarta
Rinawati Rohsiswatmo Department of Child Health, Universitas Indonesia Medical School/Dr. Cipto Mangunkusumo Hospital, Jakarta
Yuditiya Purwosunu Department of Obstetrics and Gynecology, Universitas Indonesia Medical School/Dr. Cipto Mangunkusumo Hospital, Jakarta
Zakiudin Munasir Department of Child Health, Universitas Indonesia Medical School/Dr. Cipto Mangunkusumo Hospital, Jakarta
Tetty Yuniati Department of Child Health, Universitas Padjadjaran Medical School/Dr. Hasan Sadikin Central General Hospital, Bandung, West Java

DOI: https://doi.org/10.14238/pi61.4.2021.192-7

Keywords: vitamin D; respiratory distress syndrome; Treg

Abstract

Background The high morbidity and mortality of premature neonates remain significant problem in Indonesia with respiratory distress syndrome (RDS) as one of the most common problem. Vitamin D plays an important role in lung maturity. Vitamin D deficiency causes epithelial cell inflammation, leading to a higher risk of RDS. Previous studies suggest that T regulatory cells (Treg) in inflammatory diseases, such as RDS in neonates, are possibly linked to vitamin D deficiency.

Objective To determine the role of vitamin D on RDS and Treg cells in very premature or very low birth weight neonates.

Methods A prospective cohort study conducted on premature neonates in Neonatology Division, Department of Child Health, Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia. Umbilical cord blood samples were collected to evaluate total vitamin D 25-OH levels and Treg cells. Subjects with RDS were evaluated until the end of the observation period.

Results The mean umbilical cord vitamin D level was 15.79 (SD 6.9) ng/mL, and 53% of the subjects were found to be deficient. As much as 65.1% of neonates had RDS. The mean Treg level was 11.38 (SD 2.45)%. No significant correlation was observed between vitamin D level and the occurrence of RDS (RR 0.87; 95%CI 0.56 to 1.34; P=0.53); vitamin D level and the dysregulation of Treg cells (RR 1.30; 95%CI 0.76 to 2.21; P=0.31) as well as between Treg dysregulation and RDS (RR 1.11; 95%CI 0.70 to 1.75; P=0.64). However, we found that RDS group had a lower gestational age and higher presentation of dysregulation Treg.

Conclusion In very premature or very low birth weight neonates, no association between occurence of RDS and vitamin D deficiency as well as Treg cell dysregulation.

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