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Off topic: Large dose of Vitamin A increased allergic reaction in girls by 1.8X – RCT May 2015

Neonatal vitamin A supplementation associated with increased atopy in girls

Allergy, DOI: 10.1111/all.12641
Sofie Aage1,2,*, Nicholas Kiraly3, Kassarai Da Costa1, Stine Byberg1,2,4, Morten Bjerregaard-Andersen1,2, Ane B. Fisker1,2, Peter Aaby1,2 andChristine S. Benn1,2,4

VitaminDWiki Summary

(50,000 IU retinyl palmitate) to new infants
A decade later the girls had increased risk of reaction to skin prick test
VitaminDWiki wonders if this is due to Vitamin A blocking Vitamin D receptors


Background
Neonatal vitamin A supplementation (NVAS) is currently being considered as policy in countries at risk of deficiency. A previous study suggested that NVAS may be associated with increased atopy. We examined the effect of NVAS on atopy by conducting long-term follow-up of a previous randomised controlled trial in Guinea-Bissau.

Methods
In 2002-2004, we randomised 4345 normal birth weight neonates to NVAS (50,000 IU retinyl palmitate) or placebo together with their Bacillus Calmette-Guérin vaccination. In 2013, we visited the 1692 (39%) children now aged 8-10 years who were still living in the study area, and 1478 (87%) were found at home. Provided consent, a skin prick test was performed, and history of allergic symptoms was recorded. Associations of NVAS and atopy (defined as skin prick test reaction of ≥3mm) were analysed using binomial regression.

Results
Of the 1430 children with a valid skin prick test, 228 (16%) were positive (more boys (20%) than girls (12%), p-value<0.0001). NVAS did not increase the overall risk of atopy (RR 1.10 [95% CI 0.87-1.40]). However, NVAS was associated with significantly increased risk among females (RR 1.78 [1.17-2.72]) but not among males (0.86 [0.64-1.15], p-value for interaction between NVAS and gender=0.005). Furthermore, NVAS was associated with increased risk of wheezing among females (RR 1.80 [1.03-3.17], but not among males, p-value for interaction=0.05).

Conclusion
The study corroborated previous observations; NVAS was associated with increased risk of atopy and wheezing, in this study only among females. Further studies on NVAS and atopy are warranted.

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