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Published on: August 7, 2017
Low gestational vitamin D level and childhood asthma are related to impaired lung function in high-risk children
Hanna M Knihtilä1, Benjamin J Stubbs1, Vincent J Carey1
1Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Mass.
Insights
Low maternal vitamin D levels and childhood asthma are linked to reduced lung function in children. This highlights the importance of vitamin D during pregnancy for respiratory health.
Area of Science:
- Pediatric Pulmonology
- Nutritional Science
- Epidemiology
Background:
- Childhood lung function impairment can persist into adulthood.
- Identifying early-life risk factors for lung function is critical.
- Vitamin D plays a role in immune function and respiratory health.
Purpose of the Study:
- To investigate the association between maternal and child 25-hydroxyvitamin D (25[OH]D) levels and childhood lung function.
- To examine the impact of childhood asthma phenotypes on lung function.
- To analyze data from the Vitamin D Antenatal Asthma Reduction Trial (VDAART).
Main Methods:
- Maternal and child 25(OH)D levels were measured during pregnancy and early life.
- Children were phenotyped based on wheeze and asthma diagnosis at age 6.
- Lung function was assessed using impulse oscillometry and spirometry from ages 4 to 6 years.
Main Results:
- Higher maternal 25(OH)D levels were associated with improved lung function (lower resistance, higher FEV1 and FVC).
- Children diagnosed with asthma at age 6 exhibited significantly lower lung function.
- Gestational 25(OH)D levels showed a negative association with respiratory resistance (R5).
Conclusions:
- Low gestational 25-hydroxyvitamin D levels are a risk factor for decreased lung function.
- Childhood asthma is associated with impaired lung function in early life.
- Optimizing vitamin D status during pregnancy may support childhood respiratory health.
Background:
Lung function impairment in early life often persists into adulthood. Therefore, identifying risk factors for low childhood lung function is crucial.
Objective:
We examined the effect of 25-hydroxyvitamin D (25[OH]D) level and childhood asthma phenotype on childhood lung function in the Vitamin D Antenatal Asthma Reduction Trial (VDAART).
Methods:
The 25(OH)D level was measured at set time points in mothers during pregnancy and in children during early life. On the basis of parental reports, children were categorized into 3 clinical phenotypes: asymptomatic/infrequent wheeze, early transient wheeze, and asthma at age 6 years. Lung function was assessed with impulse oscillometry at ages 4, 5, and 6 years and with spirometry at ages 5 and 6 years.
Results:
A total of 570 mother-child pairs were included in this post hoc analysis. Mean gestational 25(OH)D-level quartiles were negatively associated with child respiratory resistance at 5 Hz (R5) from age 4 to 6 years (β, -0.021 kPa/L/s; 95% CI, -0.035 to -0.007; P = .003) and positively associated with FEV1 (β, 0.018 L; 95% CI, 0.005-0.031; P = .008) and forced vital capacity (β, 0.022 L; 95% CI, 0.009-0.036; P = .002) from age 5 to 6 years. Children with asthma at age 6 years had lower lung function from age 4 to 6 years than the asymptomatic/infrequent wheeze group (β, 0.065 kPa/L/s; 95% CI, 0.028 to 0.102; P < .001 for R5 and β, -0.063 L; 95% CI, -0.099 to -0.028; P < .001 for FEV1).
Conclusions:
Low gestational 25(OH)D level and childhood asthma are important risk factors for decreased lung function in early childhood.
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