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Prenatal and child vitamin D levels and allergy and asthma in childhood
Pediatr Res. 2022 Sep 3 doi: 10.1038/s41390-022-02256-9 Behind $35 paywall
Júlia Sangüesa 1 2 3 , Jordi Sunyer 1 2 3 , Raquel Garcia-Esteban 1 2 3 , Alicia Abellan 1 2 3 4 , Ana Esplugues 2 5 6 , Judith Garcia-Aymerich 1 2 3 , Mònica Guxens 1 2 3 7 , Amaia Irizar 2 8 9 , Jordi Júlvez 1 2 3 10 , Leire Luque-García 11 , Ana Cristina Rodríguez-Dehli 2 12 , Adonina Tardón 2 13 , Maties Torrent 2 14 , Jesús Vioque 2 15 16 , Martine Vrijheid 1 2 3 , Maribel Casas 17 18 19
Background: Early-life vitamin D deficiency may impair immune system development contributing to allergy and asthma onset. Findings from prospective studies are inconsistent.
Objective: To examine whether maternal and child vitamin D levels are associated with allergic and asthma-related symptoms throughout childhood in a Spanish birth cohort.
Methods: 25-Hydroxyvitamin D3 (25(OH)D3) levels were measured in the serum of pregnant women (N = 2525) and children (N = 803). Information on allergic and asthma-related symptoms was obtained from repeated questionnaires from 1 to 9 years.
Results: A total of 19% of mothers and 24% of children had deficient 25(OH)D3 levels (<20 ng/ml). Higher child 25(OH)D3 levels at 4 years were associated with lower odds of atopic eczema from 4 to 9 years (adjusted odds ratio = 0.90; 95% CI = 0.84-0.97 per 5 ng/ml).
Higher maternal and child 25(OH)D3 levels were associated with a lower prevalence of late-onset wheezing at the limit of statistical significance (adjusted relative risk ratio (RRRadj) = 0.86; 95% CI = 0.74-1.00 and RRRadj = 0.76; 95% CI = 0.58-1.02 per 5 ng/ml, respectively). All the remaining associations were null.
Conclusion: Child 25(OH)D3 levels at pre-school age are associated with a reduced odds of atopic eczema in later childhood and both maternal and child levels may reduce the prevalence of late-onset wheezing.
Impact: In this Spanish birth cohort, with a total of 19% of mothers and 24% of children with deficient levels of vitamin D, higher child vitamin D at 4 years of age was associated with reduced odds of atopic eczema up to 9 years. There was also some evidence that higher maternal and child vitamin D levels reduced the prevalence of late-onset wheezing. Although these findings need replication, they may imply optimal vitamin D levels at pre-school age to prevent atopic eczema.
The Role of Vitamin D Deficiency in Children With Recurrent Wheezing—Clinical Significance - June 2020
Front Pediatr. 2020; 8: 344.doi: 10.3389/fped.2020.00344
Gavriela Feketea,1,2,*† Corina I. Bocsan,3,† Luminita Aurelia Stanciu,4 Anca Dana Buzoianu,3 and Mihnea Tudor Zdrenghea1,5
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Recurrent wheezing (RW) in infancy is one of the most frequent reasons for parents to consult health care providers and creates a significant global burden. Clinical course of RW is difficult to predict, also which infants will progress to asthma, since no valid biomarkers have been established. Identification of those infants with RW who are at risk of further recurrences and/or severe acute respiratory tract infection (ARTI) could help pediatricians to improve their therapeutic decisions. Increasing research interest is focused on the extra-skeletal actions of vitamin D (VD) and the clinical impact of VD insufficiency/deficiency. As VD deficiency could be a risk factor for causing RW in children, measurement of their serum level of 25-hydroxycholecalciferol [25(OH)D] is recommended. In the case of deficiency, VD administration is recommended in age-appropriate doses for at least 6 weeks, until achievement of normal blood 25(OH)D level, followed by supplementation as long as exposure to sun is inadequate. Higher doses of VD given in an attempt to prevent asthma development appear to be of no additional benefit. In children with severe ARTI, VD level is recommended to be assess.
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