- Baseline 25(OH)D, timing of supplementation initiation and prenatal vitamin D supplementation efficacy to prevent offspring asthma or recurrent wheeze
- 5 ways to reduce asthma risk even more:
- Brain development needs vitamin D level to have plateaued by 9th week
- See also VitaminDWiki
- 15+ Intervention pages with ASTHMA in title
Baseline 25(OH)D, timing of supplementation initiation and prenatal vitamin D supplementation efficacy to prevent offspring asthma or recurrent wheeze
Am J Clin Nutr. 2023 Apr 17;S0002-9165(23)46848-7. doi: 10.1016/j.ajcnut.2023.04.019 PDF costs $31
Iskander L C Shadid 1, Nicklas Brustad 2, Mengdi Lu 3, Bo L Chawes 2, Hans Bisgaard 2, Robert S Zeiger 4, George T O'Connor 5, Leonard B Bacharier 6, Henk-Jan Guchelaar 7, Augusto A Litonjua 8, Scott T Weiss 3, Hooman Mirzakhani 9
Background: Prenatal vitamin D deficiency is associated with asthma or recurrent wheeze in offspring. However, evidence from randomized trials on the efficacy of vitamin D supplementation is inconclusive.
Objective: To examine the differential efficacy of prenatal vitamin D supplementation based on maternal baseline vitamin D status and starting time of supplementation to prevent early life asthma or recurrent wheeze.
Method: We conducted a secondary analysis of the Vitamin D Antenatal Asthma Reduction Trial (VDAART), a randomized double-blind trial of prenatal vitamin D supplementation initiated at 10-18 weeks of gestation (intervention 4400IU/daily vs placebo 400IU/daily) to prevent offspring asthma or recurrent wheeze by age of 6 years. We assessed the effect modification of supplementation by maternal baseline vitamin D status at enrollment and timing of initiation of supplementation.
Results: An inverse relationship was observed between maternal 25(OH)D levels at trial entry and 25(OH)D levels during late pregnancy (32-38 weeks of gestation) in both supplementation arms (p<0.001). Overall, supplementation efficacy was not dependent on maternal baseline 25(OH)D status. However, a trend towards the reduction of asthma or recurrent wheeze was observed across baseline groups in the intervention arm (p=0.01) with the greatest reduction in the most severely vitamin D deficient women (25(OH)D<12 ng/ml, aOR=0.48, CI=0.17-1.34). Gestational age at trial enrollment modified supplementation efficacy, showing a greater reduction of offspring asthma or recurrent wheeze with earlier intervention during pregnancy (aOR=0.85, CI=0.76-0.95), particularly in women at 9-12 weeks pregnant (aOR=0.45, CI=0.24-0.82).
Conclusion: Pregnant women with severe vitamin D deficiency show the greatest 25(OH)D improvement due to the supplementation. In these women, a dose of 4400 IU vitamin D might have a protective effect on early life offspring asthma or recurrent wheeze. Gestational age is suggested to modify the efficacy of prenatal vitamin D supplementation, showing the highest beneficial effect if supplementation is started during the first trimester of pregnancy.
5 ways to reduce asthma risk even more:
- Higher dose
- Start before 9th week
- Use a loading dose
- Use weekly dosing in place of daily
- Also use Vitamin D Receptor Activator
Brain development needs vitamin D level to have plateaued by 9th week
See also VitaminDWiki
- Overview Asthma and Vitamin D
- Asthma treated by Vitamin D - 13th Meta-analysis – July 2022
- Vitamin D is cost-effective to give to asthmatic children in Columbia - Feb 2023
- Reduction of infant asthma may require good vitamin D when lung development starts (4 weeks) – March 2017
15+ Intervention pages with ASTHMA in title
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