Early and late prenatal vitamin D sufficiency reduces childhood asthma risk

Published: August 18, 2020

Childhood asthma is the most common chronic disease of childhood in the United States and globally. Maternal asthma is a major risk factor in the development of childhood asthma and wheezing. The vitamin D (VD) status in pregnancy has emerged as a modifiable factor influencing these outcomes. The combined effects of maternal asthma status and prenatal VD status across pregnancy have not been assessed to date.

In an article recently published in The Journal of Allergy and Clinical Immunology (JACI), Lu and colleagues examined the combined effects of prenatal VD sufficiency (25-hydroxyvitamin D ≥ 30 ng/mL) and maternal asthma status on the development of childhood asthma or recurrent wheeze by age 3 years. The study included 806 mother-offspring pairs from the Vitamin D Antenatal Asthma Reduction Trial (VDAART), a randomized double-blinded placebo-controlled trial of vitamin D supplementation in pregnant women at high risk of offspring asthma due to a maternal or paternal history of asthma or atopy. Vitamin D sufficiency status was examined in early (10-18 weeks of gestation) and late pregnancy (32-38 weeks of gestation).

Among mothers with asthma, VD sufficiency in either early or late pregnancy was associated with an almost halved risk of childhood asthma or recurrent wheeze by age 3 years compared to VD insufficiency in both early and late pregnancy. VD sufficiency in both early and late pregnancy was associated with a further reduction of the risk to two-thirds. This protective trend was reiterated in the progression of childhood asthma or recurrent wheeze from age 3 years to active asthma at age 6 years, regardless of maternal asthma status.

Based on these findings, the authors suggest a protective role for prenatal VD sufficiency throughout pregnancy on the subsequent development of childhood asthma and recurrent wheeze outcomes, particularly in women with asthma, who are at a higher baseline risk of offspring asthma. Further studies may shed light on the underlying mechanisms of the effects of prenatal VD and its optimal levels in the prevention of offspring asthma.

The Journal of Allergy and Clinical Immunology (JACI) is an official scientific journal of the AAAAI, and is the most-cited journal in the field of allergy and clinical immunology.

Full Article

Graphical Abstract