Paediatr Perinat Epidemiol . 2021 Apr 1. doi: 10.1111/ppe.12755
Rajneeta Saraf 1, Berit P Jensen 2, Carlos A Camargo Jr 3, Susan M B Morton 4, Ma Jing 2, Chris W Sies 2, Cameron C Grant 1 4 5
Background: Hospital admission for acute respiratory infections (ARIs) during early childhood is a global public health concern. Vitamin D deficiency is prevalent during pregnancy and infancy. Evidence indicates that vitamin D supplementation prevents ARIs.
Objectives: To determine whether vitamin D deficiency at birth is associated with ARI hospitalisations during infancy.
Methods: We performed a nested case-control study in children aged 0-12 months. Cases had ≥1 ARI hospitalisation and 4 controls were individually matched to each case. Newborn 25(OH)D concentration was measured on dried blood spots using two-dimensional liquid chromatography-tandem mass spectrometry. Hospital admissions were measured using health care records. Median serum 25(OH)D concentration in cases and controls was compared, and covariates of ARI hospitalisation during infancy were assessed using conditional logistic regression analysis.
Results: Six per cent of the cohort (n = 384) had an ARI hospitalisation during infancy, and 1536 controls were matched to cases. Median DBS [25(OH)D] was lower among ARI cases than controls (46 nmol/l vs. 61 nmol/L). Median 25(OH)D levels were lower for those hospitalised ≥2 times (47, IQR 36, 58) vs. those hospitalised once (52, IQR 42, 62) vs. the controls and also lower for those who stayed in the hospital for ≥3 days (45, IQR 36, 54) vs 1-2 days (48, IQR 38, 59) compared to the controls. After adjustment for season of birth and covariates describing demographic, antenatal, perinatal, and infant characteristics, DBS 25(OH)D concentration (<50 nmol/L) at birth was associated with increased odds of ARI hospitalisation during infancy (odds ratio 2.20, 95% confidence interval 1.48, 2.91).
Conclusions: Vitamin D deficiency at birth is associated with increased odds of ARI hospitalisations in infants. The findings have implications for a developed country like New Zealand where vitamin D supplementation is not routinely recommended and the burden of ARI hospitalisation in young children is high.
Studies in categories Infant-Child + Breathing + Intervention are listed here:
- Infant Respiratory Infections not reduced by mothers taking small amount of vitamin D (28,000 weekly)– RCT July 2021
- Lower Respiratory Tract Infection in Infants reduced 5.9 X by daily 600 IU of vitamin D (China) - March 2020
- Allergic Rhinitis in infants treated by 1,000 IU vitamin D daily – June 2019
- Childhood Respiratory Health hardly improved with 600 IU of vitamin D (need much more) – May 2018
- Allergic rhinitis in children reduced somewhat during pollen season by just 1,000 IU of vitamin D – RCT Jan 2018
- Half the risk of Influenza -A in infants taking 1200 IU of vitamin D for 4 months – RCT Jan 2018
- Risk of infant Asthma cut in half if mother supplemented Vitamin D to get more than 30 ng – RCT Oct 2017
- Childhood asthma problems eliminated for months by 600,000 IU of Vitamin D injection – June 2017
- Five times less mite allergy when vitamin D added in mid pregnancy and to infant – RCT April 2016
- Respiratory Tract visits 2.5 less likely with vitamin D: Pregnancy 2000 IU, Infant 800 IU – RCT Oct 2014
- 2000 IU of vitamin D should improve toddlers health in winter – RCT almost completed Feb 2014
- Recurrence of child pneumonia delayed by 100000 IU of vitamin D – RCT Oct 2010
- Black RE, Cousens S, Johnson HL, et al. Global, regional, and national causes of child mortality in 2008: a systematic analysis. Lancet. 2008;2010(375):1969-1987.
- Nair H, Simoes EA, Rudan I, et al. Global and regional burden of hospital admissions for severe acute lower respiratory infections in young children in 2010: a systematic analysis. Lancet. 2013;381:1380-1390.
- Saraf R, Morton SMB, Camargo CA Jr, Grant CC. Global summary of maternal and newborn vitamin D status-a systematic review. Maternal Child Nutr J. 2016;12:647-648.
- Martineau AR, Jolliffe DA, Hooper RL, et al. Vitamin D supplementation to prevent acute respiratory tract infections: systematic review and meta-analysis of individual participant data. BMJ. 2017;356:i6583.
- Belderbos ME, Houben ML, Wilbrink B, et al. Cord blood vitamin D deficiency is associated with respiratory syncytial virus bronchiolitis. Pediatrics. 2011;127(6):1513-1520.
- Mohamed WA, Al-Shehri MA. Cord blood 25-hydroxyvitamin D levels and the risk of acute lower respiratory tract infection in early childhood. J Trop Pediatr. 2012;1(1):2-7.
- Wayse V, Yousafzai A, Mogale K, Filteau S. Association of subclinical vitamin D deficiency with severe acute lower respiratory infection in Indian children under 5 years. Eur J Clin Nutr. 2004;58:563-567.
- Roth DE, Shah R, Black RE, Baqui AH. Vitamin D status and acute lower respiratory infection in early childhood in Sylhet, Bangladesh. Acta Paediatrica. 2010;99:389-393.
- Garg D, Sharma VK, Karnawat BS. Association of serum vitamin D with acute lower respiratory infection in Indian children under 5 years: a case control study. Int J Contemp Pediatr. 2016;3:1164-1169.
- McNally JD, Leis K, Matheson LA, Karuananyake C, Sankaran K, Rosenberg AM. Vitamin D deficiency in young children with severe acute lower respiratory infection. Pediatr Pulmonol. 2009;44:981-988.
- Inamo Y, Hasegawa M, Saito K. Serum vitamin D concentrations and associated severity of acute lower respiratory tract infections in Japanese hospitalized children. Pediatr Int. 2011;53:199-201.
- Karatekin G, Kaya A, Salihoglu O, Balci H, Nuhoglu A. Association of subclinical vitamin D deficiency in newborns with acute lower respiratory infection and their mothers. Eur J Clin Nutr. 2009;63:473-477.
- Camargo CA Jr, Ingham T, Wicken K, et al. Cord-blood 25-hydroxyvitamin D levels and risk of respiratory infection, wheezing, and asthma. Pediatrics. 2011;127(1):e180-e187.
- Binks MJ, Smith-Vaughan HC, Marsh R, Chang AB, Andrews RM. Cord blood vitamin D and the risk of acute lower respiratory infection in Indigenous infants in the Northern Territory. Med J Australia. 2016;204(6):238.e1-e7.
- Vo P, Koppel C, Espinola JA, et al. Vitamin D status at the time of hospitalization for bronchiolitis and Its association with disease severity. J Pediatr. 2018;203:416-422.
- Morton SM, Atatoa Carr PE, Grant CC, et al. Cohort profile: growing up in New Zealand. Int J Epidemiol. 2013;42:65-75.
- Morton SM, Atatoa Carr PE, Grant CC, et al. Growing up in New Zealand cohort alignment with all New Zealand births. Aust N Z J Public Health. 2015;39:82-87.
- Ministry of Health NSU. Newborn Metabolic Screening Programme-heel prick test. https://www.nsu.govt.nz/pregnancy-newborn-screening/newborn-metabolic-sc.... Accessed November 30, 2020.
- Jensen BP, Saraf R, Ma J, et al. Quantitation of 25-hydroxyvitamin D in dried blood spots by 2D LC-MS/MS without derivatization and correlation with serum in adult and pediatric studies. Clin Chim Acta. 2018;481:61-68.
- Ministry of Health. National Immunisation Register; 2012. https://www.health.govt.nz/our-work/preventative-health-wellness/immunis.... Accessed November 30, 2020.
- Morton SMB, Atatoa Carr P, Grant CC, et al. A longitudinal study of New Zealand children and their families. Report 2: Now We Are Born. Auckland: University of Auckland; 2012.
- Salmond C, Crampton P, Atkinson J. NZDep2006 Index of Deprivation. Wellington, NZ: Department of Public Health, University of Otago; 2007.
- Dietz VJ, Zell ER, Stevenson J. Defining delayed immunization letter; comment. Pediatr Infect Dis J. 1992;11(10):897.
- Hull BP, McIntyre BP. Timeliness of childhood immunisation in Australia. Vaccine. 2006;24(20):4403-4408.
- Ministry of Health. National Minimum Dataset (Hospital Inpatient events): Data Mart - Data Dictionary V7.5. 2012.
- Simonsen L, Conn LA, Pinner RW, Teutsch S. Trends in infectious disease hospitalizations in the United States, 1980-1994. Arch Intern Med. 1998;158:1923-1928.
- Baker MG, Barnard LT, Kvalsvig A, et al. Increasing incidence of serious infectious diseases and inequalities in New Zealand: a national epidemiological study. Lancet. 2012;379:1112-1119.
- Langley J, Stephenson S, Thorpe C, Davie G. Accuracy of injury coding under ICD-9 for New Zealand public hospital discharges. Injury Prev. 2006;12:58-61.
- Davie G, Langley J, Samaranayaka A, Wetherspoon ME. Accuracy of injury coding under ICD-10-AM for New Zealand public hospital discharges. Injury Prev. 2008;14:319-323.
- Pearl J. Causal diagrams for empirical research. Biometrika. 1995;82:669-688.
- Weng HY, Hsueh YH, Messam LL, Hertz-Picciotto I. Methods of covariate selection: directed acyclic graphs and the change-in-estimate procedure. Am J Epidemiol. 2009;169(10):1182-1190.
- Ginde AA, Mansbach JM, Camargo CAJ. Association between serum 25-hydroxyvitamin D level and upper respiratory tract infection in the Third National Health and Nutrition Examination Survey. Arch Intern Med. 2009;169(4):384-390.
- Royston P. Multiple imputation of missing values: Further update of ice, with an emphasis on categorical variables. Stata J. 2009;9(3):466-477.
- Sterne JA, White IR, Carlin JB, et al. Multiple imputation for missing data in epidemiological and clinical research: potential and pitfalls. BMJ. 2009;338:2393.
- Greenland S. Response and follow-up bias in cohort studies. Am J Epidemiol. 1977;106:184-187.
- van de Montel TF. Societal desirability response bias in self-reported research. Aust J Adv Nurs. 2008;25:40-48.
- Ekeroma AJ, Camargo CA Jr, Scragg R, et al. Predictors of vitamin D status in pregnant women in New Zealand. N Z Med J. 2015;128:24-34.
- Hobbs MR, Morton SM, Atatoa-Carr P, et al. Ethnic disparities in infectious disease hospitalisations in the first year of life in New Zealand. J Paediatr Child Health. 2017;53(3):223-231.
- Morton SMB, Atatoa Carr PE, Berry SD, et al. Growing Up in New Zealand: A longitudinal study of New Zealand children and their families. Residential Mobility Report 1: Moving house in the first 1000 days. Auckland: Growing Up in New Zealand; 2014.
- White E, Hunt JR, Casso D. Exposure measurement in cohort studies: the challenges of prospective data collection. Epidermiology Revision. 1998;20:43-56.
- Grant CC, Stewart A, Scragg R, et al. Vitamin D during pregnancy and infancy and infant serum 25-hydroxyvitamin D concentration. Pediatrics. 2014;133:e143-e153.
- Grant CC, Kaur S, Waymouth E, et al. Reduced primary care respiratory infection visits following pregnancy and infancy vitamin D supplementation: a randomised controlled trial. Acta Paediatr. 2015;104:396-404.
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