Hostname: page-component-78c5997874-t5tsf Total loading time: 0 Render date: 2024-11-10T08:08:40.621Z Has data issue: false hasContentIssue false
  • English
  • Français

Vitamin D exposure during pregnancy, but not early childhood, is associated with risk of childhood wheezing

Published online by Cambridge University Press:  17 April 2015

L. N. Anderson Open the ORCID record for L. N. Anderson [Opens in a new window] ,
Y. Chen ,
J. A. Omand ,
C. S. Birken ,
P. C. Parkin ,
T. To ,
J. L. Maguire  and
the TARGet Kids Collaboration
L. N. Anderson*
Affiliation:
Division of Pediatric Medicine and the Pediatric Outcomes Research Team, The Hospital for Sick Children, Toronto, Ontario, Canada Department of Pediatrics, St. Michael’s Hospital, Toronto, Ontario, Canada
Y. Chen
Affiliation:
The Applied Health Research Centre of the Li Ka Shing Knowledge Institute of St. Michael’s Hospital, Toronto, Ontario, Canada
J. A. Omand
Affiliation:
Department of Pediatrics, St. Michael’s Hospital, Toronto, Ontario, Canada Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada
C. S. Birken
Affiliation:
Division of Pediatric Medicine and the Pediatric Outcomes Research Team, The Hospital for Sick Children, Toronto, Ontario, Canada Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Canada Institute for Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
P. C. Parkin
Affiliation:
Division of Pediatric Medicine and the Pediatric Outcomes Research Team, The Hospital for Sick Children, Toronto, Ontario, Canada Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Canada Institute for Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
T. To
Affiliation:
Division of Pediatric Medicine and the Pediatric Outcomes Research Team, The Hospital for Sick Children, Toronto, Ontario, Canada Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Canada Institute for Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
J. L. Maguire
Affiliation:
Department of Pediatrics, St. Michael’s Hospital, Toronto, Ontario, Canada The Applied Health Research Centre of the Li Ka Shing Knowledge Institute of St. Michael’s Hospital, Toronto, Ontario, Canada Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada Institute for Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
*
*Address for correspondence: L. N. Anderson, The Hospital for Sick Children, Division of Paediatric Medicine, 686 Bay Street, Rm. 109832, Peter Gilgan Centre for Research and Learning, Toronto, Ontario, Canada M5G 0A4.(Email: LN.Anderson@utoronto.ca)
Get access Rights & Permissions [Opens in a new window]

Abstract

The association between vitamin D and wheezing in early childhood is unclear. The primary objective of this study was to evaluate the association between vitamin D exposure, during both pregnancy and childhood, and early childhood wheezing. Secondary objectives were to evaluate the associations between vitamin D exposures and asthma and wheezing severity. We conducted a cohort study of children (0–5 years) recruited from 2008 to 2013 through the TARGet Kids! primary-care research network. Vitamin D exposures included maternal vitamin D supplement use during pregnancy, child vitamin D supplementation and children’s 25-hydroxyvitamin D (25(OH)D) concentrations. The outcomes measured were parent-reported childhood wheezing, diagnosed asthma and wheezing severity. Vitamin D supplement and wheezing data were available for 2478 children, and blood samples were available for 1275 children. Adjusted odds ratios (aOR) were estimated using logistic regression adjusted for age, sex, ethnicity, body mass index, birth weight, outdoor play, breastfeeding duration, daycare status, parental smoking and family history of asthma. Vitamin D supplementation during pregnancy was associated with lower odds of childhood wheezing (aOR=0.65; 95% CI: 0.46–0.93). In early childhood, neither 25(OH)D (aOR per 10 nmol/l=1.01; 95% CI: 0.96–1.06) nor vitamin D supplementation (aOR=1.00; 95% CI: 0.81–1.23) was associated with wheezing. No significant associations were observed with diagnosed asthma or wheezing severity. Vitamin D supplementation during pregnancy was associated with reduced odds of wheezing, but child vitamin D supplementation and childhood 25(OH)D were not associated with reduced wheezing. The timing of exposure may be important in understanding the association between vitamin D and childhood wheezing.

Keywords

asthmachildpre-schoolvitamin Dwheezing
Type
Original Article
Information
Journal of Developmental Origins of Health and Disease , Volume 6 , Issue 4 , August 2015 , pp. 308 - 316
Check for updates
Copyright
© Cambridge University Press and the International Society for Developmental Origins of Health and Disease 2015 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

†

TARGet Kids! Collaboration – Scientific Committee: Kawsari Abdullah, Laura N. Anderson, Catherine S. Birken, Cornelia M. Borkhoff, Sarah Carsley, Yang Chen, Matthew D’Ascanio, Mikael Katz-Lavigne, Kanthi Kavikondala, Grace Jieun Lee, Jonathon L. Maguire, Jessica Omand, Patricia C. Parkin, Navindra Persaud, Meta van den Heuvel, Weeda Zabih; Site Investigators: Jillian Baker, Tony Barozzino, Joey Bonifacio, Douglas Campbell, Sohail Cheema, Brian Chisamore, Karoon Danayan, Paul Das, Mary Beth Derocher, Anh Do, Michael Dorey, Sloane Freeman, Keewai Fung, Charlie Guiang, Curtis Handford, Hailey Hatch, Sheila Jacobson, Tara Kiran, Holly Knowles, Bruce Kwok, Sheila Lakhoo, Margarita Lam-Antoniades, Eddy Lau, Fok-Han Leung, Jennifer Loo, Sarah Mahmoud, Rosemary Moodie, Julia Morinis, Sharon Naymark, Patricia Neelands, James Owen, Michael Peer, Marty Perlmutar, Navindra Persaud, Andrew Pinto, Michelle Porepa, Nasreen Ramji, Noor Ramji, Alana Rosenthal, Janet Saunderson, Rahul Saxena, Michael Sgro, Susan Shepherd, Barbara Smiltnieks, Carolyn Taylor, Thea Weisdors, Sheila Wijayasinghe, Peter Wong, Ethel Ying, Elizabeth Young.

References

1. To, T, Dell, S, Dick, P, Cicutto, L. The burden of illness experienced by young children associated with asthma: a population-based cohort study. J Asthma. 2008; 45, 45–49.Google Scholar
2. Krahn, MD, Berka, C, Langlois, P, Detsky, AS. Direct and indirect costs of asthma in Canada, 1990. Can Med Assoc J. 1996; 154, 821–831.Google Scholar
3. Crighton, EJ, Feng, J, Gershon, A, Guan, J, To, T. A spatial analysis of asthma prevalence in Ontario. Can J Public Health. 2012; 103, e384–e389.CrossRefGoogle ScholarPubMed
4. Garner, R, Kohen, D. Changes in the prevalence of asthma among Canadian children. Health Rep. 2008; 19, 45–50.Google Scholar
5. Sears, MR. Epidemiology of childhood asthma. Lancet. 1997; 350, 1015–1020.CrossRefGoogle ScholarPubMed
6. Ginde, AA, Mansbach, JM, Camargo, CA Jr. Vitamin D, respiratory infections, and asthma. Curr Allergy Asthma Rep. 2009; 9, 81–87.CrossRefGoogle ScholarPubMed
7. Litonjua, AA. Vitamin D deficiency as a risk factor for childhood allergic disease and asthma. Curr Opin Allergy Clin Immunol. 2012; 12, 179–185.CrossRefGoogle ScholarPubMed
8. Hollams, EM. Vitamin D and atopy and asthma phenotypes in children. Curr Opin Allergy Clin Immunol. 2012; 12, 228–234.CrossRefGoogle ScholarPubMed
9. Lau, S. What is new in the prevention of atopy and asthma? Curr Opin Allergy Clin Immunol. 2013; 13, 181–186.CrossRefGoogle ScholarPubMed
10. Yong, SB, Wu, CC, Wang, L, Yang, KD. Influence and mechanisms of maternal and infant diets on the development of childhood asthma. Pediatr Neonatol. 2013; 54, 5–11.Google Scholar
11. De Luca, G, Olivieri, F, Melotti, G, et al. Fetal and early postnatal life roots of asthma. J Matern Fetal Neonatal Med. 2010; 23(Suppl. 3), 80–83.Google Scholar
12. Devereux, G. Early life events in asthma--diet. Pediatr Pulmonol. 2007; 42, 663–673.CrossRefGoogle ScholarPubMed
13. Devereux, G, Litonjua, AA, Turner, SW, et al. Maternal vitamin D intake during pregnancy and early childhood wheezing. Am J Clin Nutr. 2007; 85, 853–859.Google Scholar
14. Miyake, Y, Sasaki, S, Tanaka, K, Hirota, Y. Dairy food, calcium and vitamin D intake in pregnancy, and wheeze and eczema in infants. Eur Respir J. 2010; 35, 1228–1234.Google Scholar
15. Erkkola, M, Kaila, M, Nwaru, BI, et al. Maternal vitamin D intake during pregnancy is inversely associated with asthma and allergic rhinitis in 5-year-old children. Clin Exp Allergy. 2009; 39, 875–882.Google Scholar
16. Camargo, CA, Rifas-Shiman, SL, Litonjua, AA, et al. Maternal intake of vitamin D during pregnancy and risk of recurrent wheeze in children at 3 years of age. Am J Clin Nutr. 2007; 85, 788–795.CrossRefGoogle Scholar
17. Maslova, E, Hansen, S, Jensen, CB, et al. Vitamin D intake in mid-pregnancy and child allergic disease – a prospective study in 44,825 Danish mother-child pairs. BMC Pregnancy Childbirth. 2013; 13, 199.Google Scholar
18. Zosky, GR, Hart, PH, Whitehouse, AJ, et al. Vitamin D deficiency at 16 to 20 weeks’ gestation is associated with impaired lung function and asthma at 6 years of age. Ann Am Thorac Soc. 2014; 11, 571–577.Google Scholar
19. Gale, CR, Robinson, SM, Harvey, NC, et al. Maternal vitamin D status during pregnancy and child outcomes. Eur J Clin Nutr. 2008; 62, 68–77.CrossRefGoogle ScholarPubMed
20. Pike, KC, Inskip, HM, Robinson, S, et al. Maternal late-pregnancy serum 25-hydroxyvitamin D in relation to childhood wheeze and atopic outcomes. Thorax. 2012; 67, 950–956.Google Scholar
21. Morales, E, Romieu, I, Guerra, S, et al. Maternal vitamin D status in pregnancy and risk of lower respiratory tract infections, wheezing, and asthma in offspring. Epidemiology. 2012; 23, 64–71.Google Scholar
22. Magnus, MC, Stene, LC, Håberg, SE, et al. Prospective study of maternal mid-pregnancy 25-hydroxyvitamin D level and early childhood respiratory disorders. Paediatr Perinat Epidemiol. 2013; 27, 532–541.CrossRefGoogle ScholarPubMed
23. Baïz, N, Dargent-Molina, P, Wark, JD, Souberbielle, JC, Annesi-Maesano, I, Group EM-CCS. Cord serum 25-hydroxyvitamin D and risk of early childhood transient wheezing and atopic dermatitis. J Allergy Clin Immunol. 2014; 133, 147–153.Google Scholar
24. Camargo, CA, Ingham, T, Wickens, K, et al. Cord-blood 25-hydroxyvitamin D levels and risk of respiratory infection, wheezing, and asthma. Pediatrics. 2011; 127, e180–e187.Google Scholar
25. Gergen, PJ, Teach, SJ, Mitchell, HE, et al. Lack of a relation between serum 25-hydroxyvitamin D concentrations and asthma in adolescents. Am J Clin Nutr. 2013; 97, 1228–1234.CrossRefGoogle ScholarPubMed
26. Tolppanen, AM, Sayers, A, Granell, R, et al. Prospective association of 25-hydroxyvitamin d3 and d2 with childhood lung function, asthma, wheezing, and flexural dermatitis. Epidemiology. 2013; 24, 310–319.Google Scholar
27. Hollams, EM, Hart, PH, Holt, BJ, et al. Vitamin D and atopy and asthma phenotypes in children: a longitudinal cohort study. Eur Respir J. 2011; 38, 1320–1327.CrossRefGoogle ScholarPubMed
28. Brehm, JM, Acosta-Pérez, E, Klei, L, et al. Vitamin D insufficiency and severe asthma exacerbations in Puerto Rican children. Am J Respir Crit Care Med. 2012; 186, 140–146.CrossRefGoogle ScholarPubMed
29. Brehm, JM, Schuemann, B, Fuhlbrigge, AL, et al. Serum vitamin D levels and severe asthma exacerbations in the Childhood Asthma Management Program study. J Allergy Clin Immunol. 2010; 126, 52–58, e55.Google Scholar
30. Carsley, S, Borkhoff, CM, Maguire, JL, et al. Cohort profile: The Applied Research Group for Kids (TARGet Kids!). Int J Epidemiol. 2014; doi:10.1093/ije/dyu123 [epub ahead of print].Google Scholar
31. Godel, JC, Canadian Paediatric Society FN, Inuit and Metis Health Committee. Vitamin D supplementation: recommendations for Canadian mothers and infants. Paediatr Child Health. 2007; 12, 583–589.Google Scholar
32. Carter, GD, Carter, R, Jones, J, Berry, J. How accurate are assays for 25-hydroxyvitamin D? Data from the international vitamin D external quality assessment scheme. Clin Chem. 2004; 50, 2195–2197.Google Scholar
33. Maunsell, Z, Wright, DJ, Rainbow, SJ. Routine isotope-dilution liquid chromatography-tandem mass spectrometry assay for simultaneous measurement of the 25-hydroxy metabolites of vitamins D2 and D3. Clin Chem. 2005; 51, 1683–1690.CrossRefGoogle ScholarPubMed
34. Singh, RJ, Taylor, RL, Reddy, GS, Grebe, SK. C-3 epimers can account for a significant proportion of total circulating 25-hydroxyvitamin D in infants, complicating accurate measurement and interpretation of vitamin D status. J Clin Endocrinol Metab. 2006; 91, 3055–3061.CrossRefGoogle ScholarPubMed
35. Institutes of Medicine (US) Committee to Review Dietary Reference Intakes for Vitamin D and Calcium. In Dietary Reference Intakes for Calcium and Vitamin D (eds. Ross AC, Taylor CL, Yaktine AL, et al.), 2011. Washington, DC: The National Academies Press.Google Scholar
36. Asher, MI, Keil, U, Anderson, HR, et al. International Study of Asthma and Allergies in Childhood (ISAAC): rationale and methods. Eur Respir J. 1995; 8, 483–491.CrossRefGoogle Scholar
37. Wilkins, R. PCCF+ Version 5E User’s Guide. Automated Geographic Coding Based on the Statistics Canada Postal Code Conversion Files, Including Postal Codes through March 2009. Ottawa: 2009.Google Scholar
38. Mei, Z, Grummer-Strawn, LM, Pietrobelli, A, et al. Validity of body mass index compared with other body-composition screening indexes for the assessment of body fatness in children and adolescents. Am J Clin Nutr. 2002; 75, 978–985.CrossRefGoogle ScholarPubMed
39. Group WMGRS. WHO Child Growth Standards based on length/height, weight and age. Acta Paediatr Suppl. 2006; 450, 76–85.Google Scholar
40. Little, RJA, Rubin, DB. Statistical Analysis with Missing Data, 2nd edn, 2002. Wiley: Hoboken, NJ.CrossRefGoogle Scholar
41. Goldring, ST, Griffiths, CJ, Martineau, AR, et al. Prenatal vitamin D supplementation and child respiratory health: a randomised controlled trial. PLoS One. 2013; 8, e66627.Google Scholar
42. Demirel, S, Guner, SN, Celiksoy, MH, Sancak, R. Is vitamin D insufficiency to blame for recurrent wheezing? Int Forum Allergy Rhinol. 2014; 4, 980–985.Google Scholar
43. Ozaydin, E, Butun, MF, Cakir, BC, Kose, G. The association between vitamin d status and recurrent wheezing. Indian J Pediatr. 2013; 80, 907–910.Google Scholar
44. Stenberg Hammar, K, Hedlin, G, Konradsen, JR, et al. Subnormal levels of vitamin D are associated with acute wheeze in young children. Acta Paediatr Suppl. 2014; 103, 856–861.Google Scholar
45. Niruban, SJ, Alagiakrishnan, K, Beach, J, Senthilselvan, A. Association of vitamin D with respiratory outcomes in Canadian children. Eur J Clin Nutr. 2014; 68, 1334–1340.Google Scholar
46. Bener, A, Ehlayel, MS, Bener, HZ, Hamid, Q. The impact of Vitamin D deficiency on asthma, allergic rhinitis and wheezing in children: an emerging public health problem. J Family Community Med. 2014; 21, 154–161.CrossRefGoogle ScholarPubMed
47. Uysalol, M, Uysalol, EP, Yilmaz, Y, et al. Serum level of vitamin D and trace elements in children with recurrent wheezing: a cross-sectional study. BMC Pediatr. 2014; 14, 270.Google Scholar
48. Zosky, GR, Berry, LJ, Elliot, JG, et al. Vitamin D deficiency causes deficits in lung function and alters lung structure. Am J Respir Crit Care Med. 2011; 183, 1336–1343.Google Scholar
49. Nguyen, M, Trubert, CL, Rizk-Rabin, M, et al. 1,25-Dihydroxyvitamin D3 and fetal lung maturation: immunogold detection of VDR expression in pneumocytes type II cells and effect on fructose 1,6 bisphosphatase. J Steroid Biochem Mol Biol. 2004; 89–90, 93–97.Google Scholar
50. Nguyen, TM, Guillozo, H, Marin, L, et al. Evidence for a vitamin D paracrine system regulating maturation of developing rat lung epithelium. Am J Physiol. 1996; 271(3 Pt 1), L392–L399.Google Scholar
51. Becker, A, Berube, D, Chad, Z, et al. Diagnosis of asthma. Can Med Assoc J. 2005; 173(6 Suppl), S15–S19.Google Scholar