Center for D-receptor Activation Research, Massachusetts General Hospital, 326 Cambridge St, Suite 410, Boston, MA 02114, USA.
Pediatrics. 2011 Jan;127(1):e180-7. doi: 10.1542/peds.2010-0442. Epub 2010 Dec 27.
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.
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.
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.
Cord-blood levels of 25(OH)D had inverse associations with risk of respiratory infection and childhood wheezing but no association with incident asthma.
孕期母体维生素 D 摄入量较高与后代喘息风险降低有关。脐带血 25-羟维生素 D（25[OH]D）水平与儿童喘息之间的关系尚不清楚。我们假设脐带血水平与呼吸道感染、喘息和哮喘的风险呈负相关。
对 922 名新生儿的脐带血进行 25（OH）D 检测。父母被问及他们的孩子在 3 个月大时是否有呼吸道感染史，或在 15 个月大时是否有喘息史，然后每年随访一次。确诊哮喘的定义为在孩子 5 岁时由医生诊断为哮喘，并报告 4 岁后使用吸入器或出现喘息。
脐带血 25（OH）D 的中位数水平为 44nmol/L（四分位间距：29-78）。随访至 5 岁时的比例为 89%。调整出生季节后，25（OH）D 与 3 个月大时呼吸道感染风险呈负相关（比值比：≥75nmol/L 为 1.00[参考值]，25-74nmol/L 为 1.39，<25nmol/L 为 2.16[95%置信区间：1.35-3.46]）。同样，脐带血 25（OH）D 水平也与 15 个月、3 岁和 5 岁时的喘息风险呈负相关（均 P<.05）。进一步调整 12 个以上的潜在混杂因素并没有改变这些结果。相比之下，我们发现脐带血 25（OH）D 水平与 5 岁时的哮喘发生率之间没有关联。
脐带血 25（OH）D 水平与呼吸道感染和儿童喘息的风险呈负相关，但与哮喘发生率无关。
