Correlation between neonatal hyperbilirubinemia and vitamin D levels: A meta-analysis

Abstract

Objective Hyperbilirubinemia is a common disease in the neonatal period, and hyperbilirubinemia may cause brain damage. Therefore, prevention and diagnosis and management of hyperbilirubinemia is very important, and vitamin D may affect bilirubin levels. To evaluate the relationship between neonatal hyperbilirubinemia and vitamin D levels. Method The China National Knowledge Infrastructure, VIP, Wanfang, Chinese Biology Medicine Disc, PubMed, Web of Science, Cochrane Library, and Embase databases as well as clinical trial registries in China and the United States were searched for relevant studies from inception to September 2020 without restrictions on language, population, or year. The studies was screened by two reviewers independently, the data were extracted, and the risk of bias of the included studies was evaluated using the NOS. A meta-analysis was conducted on the included studies using Stata11 software. Results Six case-control studies were included, and the methodological quality of the studies was high (grade A). The studies included 690 newborns; more than 409 were diagnosed with hyperbilirubinemia. The means and standard deviations were calculated. Meta-analysis results showed that neonatal vitamin D levels were 7.1 ng/ml lower among infants with hyperbilirubinemia than among healthy newborn levels (z = 6.95, 95% CI 9.10 ~ 5.09, P < 0.05). Subgroup analysis was conducted based on whether the bilirubin levels were concentrated in the 15 to 20 mg/dl range. Vitamin D level of infants with hyperbilirubinemia (the bilirubin levels were concentrated in the 15 to 20 mg/dl range) was 9.52 ng/ml (Z = 15.55, 95% CI-10.72~-8.32, P<0.05) lower than that of healthy infants. The bilirubin levels in four cases were not concentrated in the 15–20 mg/dl range. The results showed that the vitamin D level of hyperbilirubinemia (The bilirubin levels were not concentrated in the 15–20 mg/dl range) neonates were 5.35 ng/ml lower than that of healthy neonates (Z = 6.43, 95% CI-6.98~-3.72, P<0.05). Conclusion Vitamin D levels were observed to be lower in neonates with hyperbilirubinemia as compared to term neonates without hyperbilirubinemia in this study. This can possibly suggest that neonates with lower vitamin D levels are at higher risk for developing hyperbilirubinemia.

Factors associated with the incidence of neonatal hyperbilirubinemia in Perinatology Ward of Wangaya General Hospital, Denpasar

“…This was consistent with the findings of Wijaya et al (2018), which found breastfeeding to be associated with the incidence of hyperbilirubinemia with a p-value of 0.001. 8 The similar results were found by Huang et al (2021) with a p-value of 0.033. 15 Neonates with inadequate breastmilk intake during breastfeeding had not enough milk reach their intestines to process bilirubin elimination from the body.…”

“…8 The similar results were found by Huang et al (2021) with a p-value of 0.033. 15 Neonates with inadequate breastmilk intake during breastfeeding had not enough milk reach their intestines to process bilirubin elimination from the body. This occurs in preterm babies whose mothers do not produce enough breastmilk.…”

Bilirubin Down-Regulates Oxidative Stress and Fibroblast Growth Factor 23 Expression in UMR106 Osteoblast-Like Cells

“…Further studies are also needed to address whether bilirubin-dependent FGF23 suppression affects mineral metabolism. In fact, serum vitamin D levels are lower in neonates with hyperbilirubinemia [66]. Additionally, dietary calcium phosphate ameliorates hyperbilirubinemia in rats [67].…”

Vitamin D metabolic pathway genes polymorphisms and vitamin D levels in association with neonatal hyperbilirubinemia in China: a single-center retrospective cohort study

“…Furthermore, neonates with NH had a higher rate of vitamin D deficiency compared with the controls, but there was no significant difference after adjusting for potential confounding variables. The relationship between vitamin D and NH is not well studied so far, the mechanism remains to be discovered, and the possible explanations for their relationship are as follows [ 10 , 26 ]. Firstly, vitamin D can reduce erythropoietin levels in the blood, which can decrease the lysis of red blood cells and bilirubin production; Secondly, vitamin D can slow down oxidative stress, cell and tissue damage [ 27 ], which may help prevent the accumulation of bilirubin levels induced by red blood cell oxidative damage; Thirdly, the liver is the important organ for the metabolism of both bilirubin and vitamin D, so, their metabolic processes may have potential interaction.…”

“…However, a study from Iran revealed a lack of a correlation between vitamin D levels and NH[ 8 ]. A recent meta-analysis showed that vitamin D level of the NH group was significantly lower than that in the healthy control group, and its subgroup analysis based on the bilirubin level of the study indicated that vitamin D levels might cause differences in the degree of NH[ 10 ]. Therefore, we speculated that low vitamin D level is a risk factor for NH and may also be linked to severe NH.…”