Correlation Between Vitamin D Levels on Pregnant Women With Latent Tuberculosis Infection and Vitamin D Levels, Cathelicidin, Interferon γ, and Tlr2 Expression on Neonates in Medan, North Sumatera, Indonesia

Abstract

Abstract Background: Latent Tuberculosis Infection (LTBI) on pregnant women are highly prone to progress into an active TB infection that could infect her newborn. The aforementioned progressivity is dependent on the mother’s immunity system, and said immune system’s mechanism is influenced by the levels of vitamin D. The immune response on pregnant mother during the infection process is thought to affect the child’s immune system since the pregnancy term. The purpose of this research is to find the role of vitamin D levels on LTBI pregnant women on the vitamin D level and immune response of the neonates so that we are able to pinpoint and create an adequate immune system for both the children and mothers with LTBI since fetal period as a TB prevention effort on neonates Patients and Methods: This study utilized the case control design that included 84 pregnant women on their third trimester of pregnancy, as well as their children from three hospitals in Medan, North Sumatera. The subject of this study is 42 LTBI pregnant women (IGRA-positive) and 42 non-LTBI pregnant women (IGRA-negative) and their neonates. This study was conducted from December 2021 until July 2022. The measured parameters were vitamin D levels, cathelicidin, and IFNg on the pregnant women that would be correlated with the newborn’s vitamin D levels, cathelicidin, IFNg, and TLR2. Further analysis for this study utilized the Chi-squared test and the Fisher test, and for Spearman’s correlation was used for correlation testing. Results: The study’s result reported that LTBI pregnant women are at risk for vitamin D insufficiency (OR = 3.667, p = 0.006) and plays a role on their newborn’s vitamin D levels (p = 0.038). The vitamin D levels on LTBI pregnant women and the vitamin D levels on healthy newborns from LTBI pregnant women is significantly correlated with the newborns’ TLR2 levels (p = 0.048; p = 0.005). The higher levels of vitamin D on newborns with non-LTBI pregnant women plays a role on their newborn’s cathelicidin (p = 0.043). The cathelicidin and IFNg levels on pregnant woman with LTBI plays a role on their newborn’s cathelicidin and IFNg levels (p = 0.03; p = 0.001). The vitamin D levels on LTBI pregnant women plays a role on their newborn’s vitamin D levels. Cathelicidin, IFNg, and TLR2 level on newborns are influenced by the mother’s immune response and the newborn’s vitamin D levels itself.