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Associations of maternal and fetal 25-hydroxyvitamin D levels with childhood lung function and asthma: the Generation
T Gazibara1,2,3,4, H T den Dekker1,2,3, J C de Jongste2
1The Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
Insights
Low vitamin D at birth is linked to higher childhood airway resistance. Maternal vitamin D levels during pregnancy did not show a significant association with childhood respiratory outcomes.
Area of Science:
- Pediatric Respiratory Medicine
- Nutritional Epidemiology
- Maternal-Fetal Health
Background:
- Fetal exposure to low vitamin D may increase childhood asthma risk.
- Understanding vitamin D's role in fetal development is crucial for respiratory health.
- Investigating early-life vitamin D status and its long-term respiratory implications.
Purpose of the Study:
- To assess the association between mid-gestation and birth 25-hydroxyvitamin D levels and childhood airway resistance, inflammation, wheezing, and asthma.
- To determine if low vitamin D in early life predicts adverse respiratory outcomes in school-aged children.
- To explore the relationship between maternal and infant vitamin D status and respiratory health at age 6.
Main Methods:
- Population-based prospective cohort study of 3130 mother-child pairs.
- Measurement of maternal 25-hydroxyvitamin D in mid-gestation and cord blood at birth.
- Assessment of airway resistance (Rint) and fractional exhaled nitric oxide (FENO) at age 6, with annual wheezing/asthma questionnaires.
Main Results:
- Maternal mid-gestation 25-hydroxyvitamin D levels showed no association with respiratory outcomes.
- Children with the lowest tertile of 25-hydroxyvitamin D at birth exhibited higher airway resistance (Rint).
- The association between cord blood vitamin D and Rint diminished after adjusting for the child's current vitamin D level.
Conclusions:
- Low 25-hydroxyvitamin D levels at birth are associated with increased childhood airway resistance.
- The impact of birth vitamin D on airway resistance is partially explained by the child's current vitamin D status.
- Further research is required to confirm these findings and elucidate underlying mechanisms and long-term effects.
Background:
Exposure to low levels of vitamin D in fetal life might be a risk factor for childhood asthma.
Objective:
We examined whether 25-hydroxyvitamin D levels in mid-gestation and at birth were associated with higher airway resistance and inflammation, and increased risks of wheezing and asthma in school-age children.
Methods:
We performed a population-based prospective cohort study among 3130 mothers and their children. Maternal blood samples in mid-gestation and umbilical cord blood samples at birth were used to determine 25-hydroxyvitamin D levels. At age of 6, airway resistance (Rint) was measured by interrupter technique and airway inflammation by fractional exhaled nitric oxide (FENO) using NIOX chemiluminescence analyser. Wheezing and asthma were prospectively assessed by annual questionnaires until age 6.
Results:
Maternal levels of 25-hydroxyvitamin D in mid-gestation were not associated with Rint, FeNO, wheezing patterns, or asthma. Children in the lowest tertile of 25-hydroxyvitamin D levels at birth had a higher Rint (Z-score (95% confidence interval [95% CI]): -0.42 (-0.84, -0.01), P-value for trend< 0.05), compared to those in the highest tertile group. The effect estimate attenuated when child's current 25-hydroxyvitamin D level was taken into account [Z-score (95% CI): -0.55 (-1.08, 0.01)].
Conclusion And Clinical Relevance:
Low levels of 25-hydroxyvitamin D at birth were associated with a higher airway resistance in childhood. Additional adjustment for child's current 25-hydroxyvitamin D level reduced the effect size of the association. Further studies are needed to replicate these findings and to examine mechanisms underlying the observed association and the long-term consequences.
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