Cord-Blood 25-Hydroxyvitamin D Levels and Risk of Respiratory Infection, Wheezing, and Asthma

被引:418
作者
Camargo, Carlos A., Jr. [1 ,2 ]
Ingham, Tristram [3 ]
Wickens, Kristin [3 ]
Thadhani, Ravi [1 ]
Silvers, Karen M. [4 ]
Epton, Michael J. [4 ]
Town, G. Ian [5 ]
Pattemore, Philip K. [4 ]
Espinola, Janice A. [2 ]
Crane, Julian [3 ]
机构
[1] Harvard Univ, Massachusetts Gen Hosp, Sch Med, Ctr D Receptor Activat Res, Boston, MA 02114 USA
[2] Harvard Univ, Massachusetts Gen Hosp, Sch Med, Dept Emergency Med, Boston, MA 02114 USA
[3] Univ Otago, Wellington Sch Med & Hlth Sci, Dept Med, Wellington Asthma Res Grp, Wellington, New Zealand
[4] Univ Otago, Christchurch Sch Med & Hlth Sci, Dept Paediat, Canterbury Resp Res Grp, Christchurch, New Zealand
[5] Univ Canterbury, Christchurch 1, New Zealand
关键词
vitamin D; 25-hydroxyvitamin D; cord blood; respiratory infection; wheezing; asthma; New Zealand; VITAMIN-D DEFICIENCY; PREGNANCY; CHILDREN; CATHELICIDIN; INFLUENZA; EXPOSURE; INNATE;
D O I
10.1542/peds.2010-0442
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
OBJECTIVE: Higher maternal intake of vitamin D during pregnancy is associated with a lower risk of wheezing in offspring. The relationship between cord-blood levels of 25-hydroxyvitamin D (25[OH]D) and childhood wheezing is unknown. We hypothesized that cord-blood levels would be inversely associated with risk of respiratory infection, wheezing, and asthma. PATIENTS AND METHODS: Cord blood from 922 newborns was tested for 25(OH)D. Parents were asked if their child had a history of respiratory infection at 3 months of age or a history of wheezing at 15 months of age and then annually thereafter. Incident asthma was defined as doctor-diagnosed asthma by the time the child was 5 years old and reported inhaler use or wheezing since the age of 4 years. RESULTS: The median cord-blood level of 25(OH)D was 44 nmol/L (interquartile range: 29-78). Follow-up was 89% at the age of 5 years. Adjusting for the season of birth, 25(OH)D had an inverse association with risk of respiratory infection by 3 months of age (odds ratio: 1.00 [reference] for >= 75 nmol/L, 1.39 for 25-74 nmol/L, and 2.16 [95% confidence interval: 1.35-3.46] for <25 nmol/L). Likewise, cord-blood 25(OH) D levels were inversely associated with risk of wheezing by 15 months, 3 years, and 5 years of age (all P < .05). Additional adjustment for more than 12 potential confounders did not materially change these results. In contrast, we found no association between 25(OH)D levels and incident asthma by the age of 5 years. CONCLUSIONS: Cord-blood levels of 25(OH)D had inverse associations with risk of respiratory infection and childhood wheezing but no association with incident asthma. Pediatrics 2011;127:e180-e187
引用
收藏
页码:E180 / E187
页数:8
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