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Asthma in 3 year olds decreased somewhat with 4,000 IU during pregnancy – RCT Jan 2016

Effect of Prenatal Supplementation With Vitamin D on Asthma or Recurrent Wheezing in Offspring by Age 3 Years, The VDAART Randomized Clinical Trial

JAMA. 2016;315(4):362-370. doi:10.1001/jama.2015.18589. Text Size: A A A
Augusto A. Litonjua, MD, MPH1,2; Vincent J. Carey, PhD1,2; Nancy Laranjo, BA1; Benjamin J. Harshfield, BA1; Thomas F. McElrath, MD, PhD2,3; George T. O’Connor, MD, MS4; Megan Sandel, MD, MPH5; Ronald E. Iverson Jr, MD, MPH6; Aviva Lee-Paritz, MD6; Robert C. Strunk, MD, PhD7,8; Leonard B. Bacharier, MD7,8; George A. Macones, MD, MSCE9; Robert S. Zeiger, MD, PhD10; Michael Schatz, MD, MS10; Bruce W. Hollis, PhD11; Eve Hornsby, PhD12; Catherine Hawrylowicz, PhD12; Ann Chen Wu, MD, MPH2,13; Scott T. Weiss, MD, MS1,2

VitaminDWiki Summary

4,000 IU ==> 6% decline in Asthma (not statistically significant)
6,000 IU would have been much better
Suspect that Vitamin D earlier during pregnancy would have been better as well
Abstract did not seem to say how earlier in pregnancy Vitamin D was supplemented
Suspect that a Vitamin D loading dose would have helped a lot
Suspect that supplementing the infant with vitamin D would have helped a lot as well
Suspect far better results if they had analyzed Asthma reduction for women with levels > 30 nanograms
See also VitaminDWiki

Pages listed in BOTH the categories Pregnancy and Breathing

Review of the study at Vitamin D Council

 Download the PDF from VitaminDWiki

Importance Asthma and wheezing begin early in life, and prenatal vitamin D deficiency has been variably associated with these disorders in offspring.

Objective To determine whether prenatal vitamin D (cholecalciferol) supplementation can prevent asthma or recurrent wheeze in early childhood.

Design, Setting, and Participants The Vitamin D Antenatal Asthma Reduction Trial was a randomized, double-blind, placebo-controlled trial conducted in 3 centers across the United States. Enrollment began in October 2009 and completed follow-up in January 2015. Eight hundred eighty-one pregnant women between the ages of 18 and 39 years at high risk of having children with asthma were randomized at 10 to 18 weeks’ gestation. Five participants were deemed ineligible shortly after randomization and were discontinued.

Interventions Four hundred forty women were randomized to receive daily 4000 IU vitamin D plus a prenatal vitamin containing 400 IU vitamin D, and 436 women were randomized to receive a placebo plus a prenatal vitamin containing 400 IU vitamin D.

Main Outcomes and Measures Coprimary outcomes of (1) parental report of physician-diagnosed asthma or recurrent wheezing through 3 years of age and (2) third trimester maternal 25-hydroxyvitamin D levels.

Results Eight hundred ten infants were born in the study, and 806 were included in the analyses for the 3-year outcomes. Two hundred eighteen children developed asthma or recurrent wheeze: 98 of 405 (24.3%; 95% CI, 18.7%-28.5%) in the 4400-IU group vs 120 of 401 (30.4%, 95% CI, 25.7%-73.1%) in the 400-IU group (hazard ratio, 0.8; 95% CI, 0.6-1.0; P = .051). Of the women in the 4400-IU group whose blood levels were checked, 289 (74.9%) had 25-hydroxyvitamin D levels of 30 ng/mL or higher by the third trimester of pregnancy compared with 133 of 391 (34.0%) in the 400-IU group (difference, 40.9%; 95% CI, 34.2%-47.5%, P < .001).

Conclusions and Relevance In pregnant women at risk of having a child with asthma, supplementation with 4400 IU/d of vitamin D compared with 400 IU/d significantly increased vitamin D levels in the women. The incidence of asthma and recurrent wheezing in their children at age 3 years was lower by 6.1%, but this did not meet statistical significance; however, the study may have been underpowered. Longer follow-up of the children is ongoing to determine whether the difference is clinically important.

Trial Registration clinicaltrials.gov Identifier: NCT00920621

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7430 VDAART Asthma Jan 2016.pdf PDF 2016 admin 02 Dec, 2016 11:53 414.24 Kb 164
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