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Vitamin D deficiency increases odds of sepsis and mechanical ventilation in neonatesVitamin D Deficiency Linked to Higher Sepsis Risk in Neonates

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Key Takeaway
Note that Vitamin D deficiency is associated with higher sepsis risk and longer hospital stays in neonates.

This meta-analysis evaluated the impact of Vitamin D status on clinical outcomes in 1981 neonates across 18 studies. The analysis compared Vitamin D deficient (VDD) neonates to those with sufficient levels (>30 ng/mL).

The synthesis indicates that VDD is associated with a significantly increased risk of sepsis, with an OR of 2.31 (95%CI 1.50–3.57). This risk was even more pronounced in the term subgroup (OR 3.96; 95%CI 1.68–9.35) and the preterm subgroup (OR 2.05; 95%CI 1.04–4.04). Additionally, VDD neonates required mechanical ventilation more frequently (OR 1.67; 95%CI 1.09–2.55) and experienced longer hospital stays with a mean difference of 4.52 days (95% CI 1.66–7.37).

A primary limitation noted by the authors is significant heterogeneity across the included studies. While the association between Vitamin D deficiency and sepsis or mechanical ventilation needs is clear, the results should be interpreted with caution due to this variability. The findings suggest that Vitamin D status may serve as a relevant clinical indicator for risk in critically ill neonates.

How this fits prior evidence

This meta-analysis addresses a gap in understanding neonatal outcomes related to nutritional status and sepsis. While previous coverage noted that gut microbiota dysbiosis and microbial metabolites impair renal function in sepsis-associated acute kidney injury, this study specifically links Vitamin D deficiency to increased odds of sepsis (OR 2.31) and mechanical ventilation needs in neonates.

A large review of 18 studies involving nearly 2,000 infants in neonatal intensive care units (NICU) looked at the link between vitamin D status and health outcomes. The researchers compared babies with sufficient vitamin D to those with low levels. They found that infants with a deficiency were more likely to develop sepsis, especially among full-term babies.

In addition to infection risks, the study found that babies with low vitamin D levels often required mechanical ventilation and stayed in the hospital for longer periods. These findings suggest that vitamin D status is an important factor for babies in critical care. However, because the studies included were very different from one another, these results show a link rather than a direct cause.

It is important to note that while the data shows a strong connection between low vitamin D and complications like sepsis, it does not prove that vitamin D alone causes these issues. Because this was a broad review of many different studies, the results may vary. Parents and doctors should discuss these findings regarding specific care plans for infants.

What this means for you:
Low vitamin D levels are linked to higher sepsis risk and longer hospital stays in babies in intensive care.

Common questions

Is it safe for babies to receive vitamin D?

The study did not report any specific safety concerns or adverse events regarding vitamin D administration. It focused on the link between low vitamin D levels and complications like sepsis in infants in neonatal intensive care units.

Who is most affected by low vitamin D in the NICU?

The study found that both preterm and term babies with low vitamin D were more likely to develop sepsis. However, the link was particularly strong in full-term infants, who showed a much higher risk of infection when vitamin D was low.

How does this affect hospital stay length?

The data shows that babies with vitamin D levels below 30 ng/mL were more likely to have longer stays in the hospital. Specifically, these infants were also more likely to need mechanical ventilation compared to those with sufficient levels.

Study Details

Study typeMeta analysis
EvidenceLevel 1
PublishedJun 2026
View Original Abstract ↓
Vitamin D is key in immunoregulation and impacts critical care outcomes. With a high prevalence of neonatal Vitamin D deficiency (VDD), we aim to evaluate its association with clinical outcomes in the neonatal intensive care unit (NICU). Systematic search of PubMed, EMBASE, Web of Science and Scopus was conducted. Primary outcomes included mortality and incidence of sepsis, while secondary outcomes were length of stay (LOS), incidence of bronchopulmonary dysplasia (BPD), and need for mechanical ventilation (MV). Eligible studies included preterm and term NICU neonates with 25-hydroxyvitamin D levels reported on admission. Definition of VDD was based on individual studies due to significant inter-study heterogeneity, however further sub-analyses with VDD definitions of ≤ 30 ng/mL and Vitamin D sufficient (VDS) > 30 ng/mL were performed to evaluate possible dose–response relationships. Pooled estimates were calculated with random-effects model due to study heterogeneity. Among 2,735 articles, 18 studies met predefined inclusion criteria (n = 1981 patients). VDD was associated with increased incidence of sepsis [odds ratio (OR) 2.31, 95%CI 1.50–3.57], length of hospital stay (mean difference 4.52 days, 95% CI 1.66–7.37) and need for MV (OR 1.67, 95%CI 1.09–2.55), in comparison to VDS neonates. Further subgroup analyses for preterm (OR 2.05, 95%CI 1.04–4.04) and term neonates (OR 3.96, 95%CI 1.68–9.35) continued to show significant association between VDD and sepsis. No differences were observed between both groups for mortality and incidence of BPD. Further subgroup analyses based on Vitamin D levels found that those ≤ 30 ng/mL had no significant difference (mean difference 0 days, 95%CI -1.89 - 1.89) in terms of length of hospital stay. VDD in critically ill neonates is significantly associated with increased odds of sepsis, need for MV, and longer LOS. However, these findings are limited by significant heterogeneity across studies. This warrants further interventional studies, involving both term and preterm neonates, to examine the potential of optimization of Vitamin D levels to improve critical care outcomes in NICU.
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