Bandim Health Project, Bissau, Guinea-Bissau.
Research Center for Vitamins and Vaccines (CVIVA), Statens Serum Institut, Copenhagen S, Denmark.
Allergy. 2015 Aug;70(8):985-94. doi: 10.1111/all.12641. Epub 2015 May 18.
Neonatal vitamin A supplementation (NVAS) is currently being considered as policy in countries at risk of deficiency. A previous study suggested that NVAS may be associated with increased atopy. We examined the effect of NVAS on atopy by conducting long-term follow-up of a previous randomized controlled trial in Guinea-Bissau.
In 2002-2004, we randomized 4345 normal birthweight neonates to NVAS (50 000 IU retinyl palmitate) or placebo together with their Bacillus Calmette-Guérin vaccination. In 2013, we visited the 1692 (39%) children now aged 8-10 years who were still living in the study area, and 1478 (87%) were found at home. Provided consent, a skin prick test was performed, and history of allergic symptoms was recorded. Associations of NVAS and atopy (defined as skin prick test reaction of ≥3 mm) were analysed using binomial regression.
Of the 1430 children with a valid skin prick test, 228 (16%) were positive (more boys (20%) than girls (12%), P-value < 0.0001). NVAS did not increase the overall risk of atopy (RR 1.10 [95% CI 0.87-1.40]). However, NVAS was associated with significantly increased risk among females (RR 1.78 [1.17-2.72]) but not among males (0.86 [0.64-1.15], P-value for interaction between NVAS and gender = 0.005). Furthermore, NVAS was associated with increased risk of wheezing among females (RR 1.80 [1.03-3.17], but not among males, P-value for interaction = 0.05).
The study corroborated previous observations; NVAS was associated with increased risk of atopy and wheezing, in this study only among females. Further studies on NVAS and atopy are warranted.
新生儿维生素 A 补充（NVAS）目前正在被考虑作为有缺乏风险的国家的政策。此前的一项研究表明，NVAS 可能与过敏增加有关。我们通过对几内亚比绍之前的一项随机对照试验进行长期随访，研究了 NVAS 对过敏的影响。
2002-2004 年，我们将 4345 名正常出生体重的新生儿随机分为 NVAS（50000IU 视黄醇棕榈酸酯）或安慰剂组，同时接受卡介苗接种。2013 年，我们对居住在研究地区的 1692 名（39%）年龄在 8-10 岁的儿童进行了随访，其中 1478 名（87%）在家中被找到。在获得同意的情况下，进行了皮肤点刺试验，并记录了过敏症状的病史。使用二项回归分析 NVAS 与过敏（定义为皮肤点刺试验反应≥3mm）之间的关联。
在 1430 名有有效皮肤点刺试验的儿童中，228 名（16%）呈阳性（男孩（20%）多于女孩（12%），P 值<0.0001）。NVAS 并未增加过敏的总体风险（RR 1.10[95%CI 0.87-1.40]）。然而，NVAS 与女性过敏风险的显著增加相关（RR 1.78[1.17-2.72]），但与男性无关（0.86[0.64-1.15]，NVAS 和性别之间的交互作用 P 值=0.005）。此外，NVAS 与女性喘息的风险增加相关（RR 1.80[1.03-3.17]），但与男性无关，交互作用 P 值=0.05）。
该研究证实了之前的观察结果；NVAS 与过敏和喘息的风险增加有关，在本研究中仅与女性有关。需要进一步研究 NVAS 和过敏的关系。
