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Noninvasive Sampling of Mucosal Lining Fluid for the Quantification of In Vivo Upper Airway Immune-mediator Levels
Published on: August 7, 2017
Vitamin D status at birth and acute respiratory infection hospitalisation during infancy
Rajneeta Saraf1, Berit P Jensen2, Carlos A Camargo3
1Department of Paediatrics, Child and Youth Health, The University of Auckland, Auckland, New Zealand.
Insights
Vitamin D deficiency at birth increases infant hospitalizations for acute respiratory infections (ARIs). Supplementation may reduce ARI hospitalizations in infants, especially where deficiency is common.
Area of Science:
- Pediatrics
- Public Health
- Nutritional Science
Background:
- Acute respiratory infections (ARIs) in early childhood are a significant global health issue.
- Vitamin D deficiency is common in pregnant women and infants.
- Existing evidence suggests vitamin D supplementation can prevent ARIs.
Purpose of the Study:
- To investigate the association between vitamin D deficiency at birth and hospitalization for ARIs during infancy.
Main Methods:
- A nested case-control study involving infants aged 0-12 months.
- Cases were infants with at least one ARI hospitalization; four controls were matched per case.
- Newborn 25-hydroxyvitamin D [25(OH)D] levels were measured from dried blood spots; ARI hospitalizations were identified from healthcare records.
Main Results:
- Infants hospitalized for ARIs had lower median 25(OH)D levels at birth compared to controls (46 nmol/L vs. 61 nmol/L).
- Lower 25(OH)D levels were associated with multiple hospitalizations and longer hospital stays.
- Vitamin D deficiency at birth (25(OH)D < 50 nmol/L) was linked to a 2.20-fold increased odds of ARI hospitalization, even after adjusting for various covariates.
Conclusions:
- Vitamin D deficiency in newborns is associated with a higher risk of ARI hospitalizations in infants.
- These findings are particularly relevant for countries like New Zealand, where routine vitamin D supplementation is not standard practice, yet ARI hospitalizations in young children are frequent.
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.
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