Antenatal vitamin D is not linked to reduced childhood asthma risk

  • Litonjua AA & al.
  • N Engl J Med
  • 6 Feb 2020

  • curated by Miriam Davis, PhD
  • Clinical Essentials
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Takeaway

  • Prenatal vitamin D supplementation (4400 vs 400 IU per day) is not linked to reduced risk for asthma and recurrent wheeze in children by age 6 years.
  • The findings contrast with results suggestive of benefit at age 3 years.

Why this matters

  • Findings suggest that vitamin D supplementation should not be given for child asthma prevention during the prenatal period.

Study design

  • A randomized controlled trial of 881 women enrolled in the VDAART trial who were given either 4400 IU per day (the vitamin D group) or 400 IU per day (the control group).
  • Primary outcomes were asthma or recurrent wheeze in children.
  • Funding: NIH.

Key results

  • Groups did not differ in the percentage of children at age 6 years with asthma or recurrent wheeze (interval-censored control vs vitamin D group: HR, 1.12; P=.25).
  • They also did not differ in these secondary outcomes:
    • Active asthma.
    • Recurrent wheeze without asthma diagnosis.
    • Late-onset wheeze.
    • Eczema with typical rash.
    • Allergic rhinitis.
    • Lower respiratory tract infection.
    • Total log IgE level.
    • Any allergic sensitization.
    • Percentage of 13 specific IgE tests with positive results.
  • Vitamin D was linked to a minimal benefit for airway resistance as measured by impulse oscillometry, but no benefit for spirometry values.

Limitations

  • No postnatal supplementation.