Prenatal vitamin D supplementation to prevent childhood asthma: 15-year results from the Vitamin D Antenatal Asthma Reduction Trial (VDAART)

被引:8
作者
Weiss, Scott T. [1 ,7 ]
Mirzakhani, Hooman [1 ]
Carey, Vincent J. [1 ]
O'Connor, George T. [2 ]
Zeiger, Robert S. [3 ]
Bacharier, Leonard B. [4 ]
Stokes, Jeffrey [5 ]
Litonjua, Augusto A. [6 ]
机构
[1] Harvard Med Sch, Brigham & Womens Hosp, Channing Div Network Med, Dept Med, Boston, MA USA
[2] Boston Univ, Boston Med Ctr, Pulm Ctr, Dept Med, Boston, MA USA
[3] Kaiser Permanente Bernard J Tyson Sch Med, Dept Clin Sci, Pasadena, CA USA
[4] Monroe Carell Jr Childrens Hosp Vanderbilt, Div Pediat Allergy Immunol & Pulm Med, Dept Pediat, Nashville, TN USA
[5] Washington Univ, Dept Pediat, Div Pediat Allergy Immunol & Pulm Med, St Louis, MO USA
[6] Univ Rochester, Med Sch, Golisano Childrens Hosp, Pediat Pulm Div,Dept Pediat, Rochester, NY USA
[7] 181 Longwood Ave, Boston, MA 02115 USA
关键词
Vitamin D; supplementation; pregnancy; randomized tri- als; childhood asthma; D DEFICIENCY; PREGNANCY; RISK; IMPACT; OUTCOMES; DESIGN; WHEEZE; FETAL;
D O I
10.1016/j.jaci.2023.10.003
中图分类号
R392 [医学免疫学];
学科分类号
100102 ;
摘要
This article provides an overview of the findings obtained from spanning a period of 15 years. The review covers various aspects, including the trial's rationale, study design, and initial intent-to-treat analyses, as well as an explanation of why those analyses did not achieve statistical significance. Additionally, the article delves into the post hoc results obtained from stratified intent-to-treat analyses based on maternal vitamin D baseline levels and genotype-stratified analyses. These results demonstrate a statistically significant reduction in asthma among offspring aged 3 and 6 years when comparing vitamin D supplementation (4400 IU/d) to the standard prenatal multivitamin with vitamin D (400 IU/d). Furthermore, these post hoc analyses found that vitamin D supplementation led to a decrease in total serum IgE levels and improved lung function in children compared to those whose mothers received a placebo alongside the standard prenatal multivitamin with vitamin D. Last, the article concludes with recommendations regarding the optimal dosing of vitamin D for pregnant women to prevent childhood asthma as well as suggestions for future trials in this field. (J Allergy Clin Immunol 2024;153:378-88.)
引用
收藏
页码:378 / 388
页数:11
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