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
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
- If > 30 ng of vitamin D during pregnancy the child was 5X less likely to get asthma PDF
- Overview Asthma and Vitamin D
- Preeclampsia risk reduced by higher levels of vitamin D (VDAART 4,400 IU) - RCT Nov 2016
Pages listed in BOTH the categories Pregnancy and Breathing
- Childhood Asthma risk greatly reduced when mothers having high vitamin D were given 4,400 IU daily – RCT 2019
- Asthma 7 percent less likely for every 40 IU increase in (early) maternal diet – Feb 2018
- Pregnant women with low vitamin D (e.g. asthmatics) were more likely to have infants with vitamin D problems (asthmatics) – Jan 2018
- Lots of sugar while pregnant doubles asthma risk – 2017
- Risk of infant Asthma cut in half if mother supplemented Vitamin D to get more than 30 ng – RCT Oct 2017
- Reduction of infant asthma may require good vitamin D when lung development starts (4 weeks) – March 2017
- Birth asphyxia 2.4 times more likely if mother was vitamin D deficient – 2016
- Asthma reduced 31 percent when Omega-3 taken during pregnancy – RCT Dec 2016
- Vitamin D during pregnancy reduces risk of childhood asthma by 13 percent – meta-analysis Dec 2016
- MAGNESIUM IN MAN - IMPLICATIONS FOR HEALTH AND DISEASE – review 2015
- Asthmatic pregnant women had 30 percent more preterm births if air pollution (vitamin D not mentioned) – March 2016
- Asthma in 3 year olds decreased somewhat with 4,000 IU during pregnancy – RCT Jan 2016
- Asthma trial underway - 4,000 IU during pregnancy - March 2014
- Infant wheezing 40 percent less likely if mother supplemented with vitamin D, vitamin E, or Zinc – meta-analysis Aug 2015
- Respiratory distress after preterm birth is more likely if low vitamin D – review April 2015
- Wheezing reduced 35 percent if vitamin D added during pregnancy – April 2015
- Newborn acute lower respiratory tract infection associated with low maternal vitamin D – March 2015
- Low vitamin D during pregnancy associated with four health problems in children – Jan 2015
- Just 700 IU of vitamin D during pregnancy reduced rate of asthma at age 7 by 26 percent – Oct 2013
- Single dose of 200,000 IU of vitamin D during pregnancy did not reduce wheezing 3 years later – June 2013
- Dial D for danger – absurd editorial in Thorax – Oct 2012
- High maternal vitamin D resulted in 30 percent less infant problems with breathing – Nov 2011
- Smoking while pregnant lowers vitamin D and increases child asthma by 3.6 X – Aug 2011
- 800 IU Vitamin D while pregnant decrease child asthma by 2X- Sept 2010
- Vitamin D Newsletter May 2010
- Winter babies are more prone to food allergies
- Asthma trial underway - 4,000 IU during pregnancy - March 2014 design of the study on this page?
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