Camargo Carlos A, Rifas-Shiman Sheryl L, Litonjua Augusto A, Rich-Edwards Janet W, Weiss Scott T, Gold Diane R, Kleinman Ken, Gillman Matthew W
Center for D-receptor Activation Research, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA.
Am J Clin Nutr. 2007 Mar;85(3):788-95. doi: 10.1093/ajcn/85.3.788.
Vitamin D deficiency and asthma are common at higher latitudes. Although vitamin D has important immunologic effects, its relation with asthma is unknown.
We hypothesized that a higher maternal intake of vitamin D during pregnancy is associated with a lower risk of recurrent wheeze in children at 3 y of age.
The participants were 1194 mother-child pairs in Project Viva-a prospective prebirth cohort study in Massachusetts. We assessed the maternal intake of vitamin D during pregnancy from a validated food-frequency questionnaire. The primary outcome was recurrent wheeze, ie, a positive asthma predictive index (>or=2 wheezing attacks among children with a personal diagnosis of eczema or a parental history of asthma).
The mean (+/-SD) total vitamin D intake during pregnancy was 548 +/- 167 IU/d. By age 3 y, 186 children (16%) had recurrent wheeze. Compared with mothers in the lowest quartile of daily intake (median: 356 IU), those in the highest quartile (724 IU) had a lower risk of having a child with recurrent wheeze [odds ratio (OR): 0.39; 95% CI: 0.25, 0.62; P for trend < 0.001]. A 100-IU increase in vitamin D intake was associated with lower risk (OR: 0.81; 95% CI: 0.74, 0.89), regardless of whether vitamin D was from the diet (OR: 0.81; 95% CI: 0.69, 0.96) or supplements (OR: 0.82; 95% CI: 0.73, 0.92). Adjustment for 12 potential confounders, including maternal intake of other dietary factors, did not change the results.
In the northeastern United States, a higher maternal intake of vitamin D during pregnancy may decrease the risk of recurrent wheeze in early childhood.
维生素D缺乏症和哮喘在高纬度地区较为常见。尽管维生素D具有重要的免疫作用，但其与哮喘的关系尚不清楚。
我们假设孕期母亲摄入较高剂量的维生素D与3岁儿童复发性喘息风险较低有关。
研究对象为参与“活力计划”的1194对母婴，该计划是在马萨诸塞州开展的一项前瞻性产前队列研究。我们通过一份经过验证的食物频率问卷评估孕期母亲维生素D的摄入量。主要结局是复发性喘息，即哮喘预测指数为阳性（个人诊断为湿疹或父母有哮喘病史的儿童中出现≥2次喘息发作）。
孕期维生素D的平均（±标准差）总摄入量为548±167IU/天。到3岁时，186名儿童（16%）出现复发性喘息。与每日摄入量处于最低四分位数（中位数：356IU）的母亲相比，处于最高四分位数（724IU）的母亲所生孩子出现复发性喘息的风险较低[比值比（OR）：0.39；95%置信区间（CI）：0.25，0.62；趋势P值<0.001]。无论维生素D是来自饮食（OR：0.81；95%CI：0.69，0.96）还是补充剂（OR：0.82；95%CI：0.73，0.92），维生素D摄入量每增加100IU，风险都会降低（OR：0.81；95%CI：0.74，0.89）。对12个潜在混杂因素进行调整，包括母亲对其他饮食因素的摄入量，结果并未改变。
在美国东北部，孕期母亲摄入较高剂量的维生素D可能会降低幼儿期复发性喘息的风险。
