الفهرس 
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Abstract
Sepsis is the commonest cause of neonatal mortality and is responsible for 30-50% of total neonatal deaths each year in developing countries. The early onset sepsis (EOS) in the newborn infant is found to be a difficult clinical challenge for neonatologists everywhere in the world because it has multiple routes of transmission, many causative agents, and potentially antibiotic resistant.
Vitamin D is a fat-soluble steroid hormone that has many diverse biological actions in a number of target tissues. Its biological action found to be with a wide range effects on different cell and tissue types especially immunomodulatory effects on immune function.
The developing science around vitamin D has begun to reveal potential links between its deficiency and sepsis (immune modulatory effects). As recent evidence suggests that vitamin D enhance the
innate immune response by induction of cathelicidin (LL-37), an
endogenous antimicrobial peptide produced by macrophages and
neutrophils. The connections between these conditions are still in the early phases of discovery.
The aim of this study was to evaluate the effect of vitamin D levels on early-onset sepsis (EOS) in term infants and the association between the severity of vitamin D deficiency and EOS was also investigated.
Our patients were classified into two groups as follow:
• group I: includes 20 cases (10 full term infants suffering from early onset sepsis and their mothers).
• group II: Includes 20 control (10 full term healthy infants and their mothers).
The data were collected by Full history taking about the mother and the neonate, clinical examination and laboratory septic screen of cases of sepsis as (CBC, CRP, blood culture and radiological investigations) amd maternal and neonatal blood samples obtained for measuring of vitamin D level.
The result of our study revealed the following:
• there was highly statistically significant difference in vitamin D serum level and status between the neonates of both groups and their mothers with significant positive correlation between maternal and neonatal vitamin D levels in both groups
• There was significant difference in vitamin D supplementation during pregnancy between the two studied mothers groups with strong relation between vitamin D status of mothers of case group and their vitamin D supplementation during pregnancy.
• there was strong relation between their vitamin D status and the results of blood culture of the neonates in case group and apgar score of 1st minute and –ve correlation with CRP results at 1st day
• the commonest Clinical findings among the cases neonatal group in NICU were need for oxygen (100%), feeding intolerance (90%) and respiratory distress (70%) and also the results of the radiological investigations as chest X-ray of half of the cases reveals congenital pneumonia .
• The blood cultures results in our study revealed that (50%) of the cases in NICU were positive and most of them were Gram –ve cocci (60%) and most sensitive antibiotics were levofloxacin (60%), imipenem (60%) and gatifloxacin (40%).
Conclusion:
The vitamin D stores of the newborn depend entirely on the vitamin D stores of the mother. If the mother is vitamin D deficient, the infant will be deficient because of decreased maternofetal transfer of vitamin D.
And there is a significant association between vitamin D deficiency and sepsis suggesting that vitamin D status is an important contributor to sepsis incidence and outcome and also the neonates with vitamin D deficiency had higher risk of exposure to elevated inflammatory markers at birth.