10 Feb NEJM: Does Antenatal Vitamin D Prevent Childhood Asthma?
MedicalResearch.com Interview with:
Augusto A. Litonjua, M.D., M.P.H.
Professor – Department of Pediatrics, Pulmonology
Interim Chief – Department of Medicine , Pulmonary Diseases and Critical Care
Professor – Department of Medicine , Pulmonary Diseases and Critical Care
University of Rochester
MedicalResearch.com: What is the background for this study?
Response: Vitamin D deficiency and insufficiency is prevalent worldwide. Prior observational studies have shown that low vitamin D levels have been associated with the development of asthma. Animal studies have reported that antenatal vitamin D is important for lung development in utero. Thus, we conducted a randomized, double-blind, controlled trial of vitamin D supplementation in pregnant women to see if we could prevent the development of asthma and wheezing illnesses in young children. The initial report of the trial results showed that children born to mothers in the vitamin D supplementation arm had lower risks for developing either asthma or recurrent wheezing episodes over the first 3 years, but this was not statistically significant (p=0.051)(Litonjua et al. JAMA 2016).
MedicalResearch.com: What are the main findings?
Response: The current study followed the children through their 6th birthday. The early suggestion of a protective effect of antenatal vitamin D supplementation was not found in this follow-up study, and there was no difference in the rates of asthma or recurrent wheezing episodes in children from either study arm. However, there was a small effect of antenatal vitamin D supplementation on some of the lung function tests from 4-6 years of age. Of note, the trial design called for supplementation only during the antenatal period. Supplementation after birth was not part of the study. Thus, while there was a difference in the vitamin D levels at birth, there was no difference in the levels between the groups of children from 1 year through 6 years of age.
MedicalResearch.com: What should readers take away from your report?
Response: Vitamin D supplementation during the antenatal period alone was not sufficient to prevent asthma and recurrent wheeze episodes through the child’s 6th birthday. Vitamin D insufficiency and deficiency remain widespread and pregnant women should discuss whether supplementation is necessary with their physicians.
MedicalResearch.com: What recommendations do you have for future research as a result of this work?
Response: Future studies should investigate whether both prenatal and postnatal supplementation with vitamin D, or postnatal supplementation alone, can prevent the development of asthma in young children.
Disclosures: No disclosures except that the trial was funded by the National Heart, Lung, and Blood Institute.
Augusto A. Litonjua, M.D., M.P.H., Vincent J. Carey, Ph.D., Nancy Laranjo, B.A., Benjamin J. Stubbs, B.A., Hooman Mirzakhani, M.D., Ph.D., George T. O’Connor, M.D., Megan Sandel, M.D., M.P.H., Avraham Beigelman, M.D., Leonard B. Bacharier, M.D., Robert S. Zeiger, M.D., Ph.D., Michael Schatz, M.D., Bruce W. Hollis, Ph.D., et al
February 6, 2020
N Engl J Med 2020; 382:525-533
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