Prenatal vitamin D supplementation reduces risk of asthma/recurrent wheeze in early childhood: A combined analysis of two randomized controlled trials

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Prenatal vitamin D supplementation reduces risk of asthma/recurrent wheeze in early childhood : A combined analysis of two randomized controlled trials. / Wolsk, Helene M; Chawes, Bo L; Litonjua, Augusto A; Hollis, Bruce W; Waage, Johannes; Stokholm, Jakob; Bønnelykke, Klaus; Bisgaard, Hans; Weiss, Scott T.

In: PLOS ONE, Vol. 12, No. 10, e0186657, 2017.

Research output: Contribution to journalJournal articleResearchpeer-review

Harvard

Wolsk, HM, Chawes, BL, Litonjua, AA, Hollis, BW, Waage, J, Stokholm, J, Bønnelykke, K, Bisgaard, H & Weiss, ST 2017, 'Prenatal vitamin D supplementation reduces risk of asthma/recurrent wheeze in early childhood: A combined analysis of two randomized controlled trials', PLOS ONE, vol. 12, no. 10, e0186657. https://doi.org/10.1371/journal.pone.0186657

APA

Wolsk, H. M., Chawes, B. L., Litonjua, A. A., Hollis, B. W., Waage, J., Stokholm, J., ... Weiss, S. T. (2017). Prenatal vitamin D supplementation reduces risk of asthma/recurrent wheeze in early childhood: A combined analysis of two randomized controlled trials. PLOS ONE, 12(10), [e0186657]. https://doi.org/10.1371/journal.pone.0186657

Vancouver

Wolsk HM, Chawes BL, Litonjua AA, Hollis BW, Waage J, Stokholm J et al. Prenatal vitamin D supplementation reduces risk of asthma/recurrent wheeze in early childhood: A combined analysis of two randomized controlled trials. PLOS ONE. 2017;12(10). e0186657. https://doi.org/10.1371/journal.pone.0186657

Author

Wolsk, Helene M ; Chawes, Bo L ; Litonjua, Augusto A ; Hollis, Bruce W ; Waage, Johannes ; Stokholm, Jakob ; Bønnelykke, Klaus ; Bisgaard, Hans ; Weiss, Scott T. / Prenatal vitamin D supplementation reduces risk of asthma/recurrent wheeze in early childhood : A combined analysis of two randomized controlled trials. In: PLOS ONE. 2017 ; Vol. 12, No. 10.

Bibtex

@article{72d3a0859777495fb5a04c5edde9feb7,
title = "Prenatal vitamin D supplementation reduces risk of asthma/recurrent wheeze in early childhood: A combined analysis of two randomized controlled trials",
abstract = "BACKGROUND: We recently published two independent randomized controlled trials of vitamin D supplementation during pregnancy, both indicating a >20{\%} reduced risk of asthma/recurrent wheeze in the offspring by 3 years of age. However, neither reached statistical significance.OBJECTIVE: To perform a combined analysis of the two trials and investigate whether maternal 25-hydroxy-vitamin D (25(OH)D) level at trial entry modified the intervention effect.METHODS: VDAART (N = 806) and COPSAC2010. (N = 581) randomized pregnant women to daily high-dose vitamin D3 (4,000 IU/d and 2,400 IU/d, respectively) or placebo. All women also received a prenatal vitamin containing 400 IU/d vitamin D3. The primary outcome was asthma/recurrent wheeze from 0-3yrs. Secondary end-points were specific IgE, total IgE, eczema and lower respiratory tract infections (LRTI). We conducted random effects combined analyses of the treatment effect, individual patient data (IPD) meta-analyses, and analyses stratified by 25(OH)D level at study entry.RESULTS: The analysis showed a 25{\%} reduced risk of asthma/recurrent wheeze at 0-3yrs: adjusted odds ratio (aOR) = 0.74 (95{\%} CI, 0.57-0.96), p = 0.02. The effect was strongest among women with 25(OH)D level ≥30ng/ml at study entry: aOR = 0.54 (0.33-0.88), p = 0.01, whereas no significant effect was observed among women with 25(OH)D level <30ng/ml at study entry: aOR = 0.84 (0.62-1.15), p = 0.25. The IPD meta-analyses showed similar results. There was no effect on the secondary end-points.CONCLUSIONS: This combined analysis shows that vitamin D supplementation during pregnancy results in a significant reduced risk of asthma/recurrent wheeze in the offspring, especially among women with 25(OH)D level ≥ 30 ng/ml at randomization, where the risk was almost halved. Future studies should examine the possibility of raising 25(OH)D levels to at least 30 ng/ml early in pregnancy or using higher doses than used in our studies.TRIAL REGISTRATION: COPSAC2010: ClinicalTrials.gov NCT00856947; VDAART: ClinicalTrials.gov NCT00920621.",
keywords = "Asthma/prevention & control, Child, Preschool, Female, Humans, Placebos, Pregnancy, Prenatal Care, Randomized Controlled Trials as Topic, Recurrence, Respiratory Sounds, Vitamin D/administration & dosage",
author = "Wolsk, {Helene M} and Chawes, {Bo L} and Litonjua, {Augusto A} and Hollis, {Bruce W} and Johannes Waage and Jakob Stokholm and Klaus B{\o}nnelykke and Hans Bisgaard and Weiss, {Scott T}",
year = "2017",
doi = "10.1371/journal.pone.0186657",
language = "English",
volume = "12",
journal = "P L o S One",
issn = "1932-6203",
publisher = "Public Library of Science",
number = "10",

}

RIS

TY - JOUR

T1 - Prenatal vitamin D supplementation reduces risk of asthma/recurrent wheeze in early childhood

T2 - A combined analysis of two randomized controlled trials

AU - Wolsk, Helene M

AU - Chawes, Bo L

AU - Litonjua, Augusto A

AU - Hollis, Bruce W

AU - Waage, Johannes

AU - Stokholm, Jakob

AU - Bønnelykke, Klaus

AU - Bisgaard, Hans

AU - Weiss, Scott T

PY - 2017

Y1 - 2017

N2 - BACKGROUND: We recently published two independent randomized controlled trials of vitamin D supplementation during pregnancy, both indicating a >20% reduced risk of asthma/recurrent wheeze in the offspring by 3 years of age. However, neither reached statistical significance.OBJECTIVE: To perform a combined analysis of the two trials and investigate whether maternal 25-hydroxy-vitamin D (25(OH)D) level at trial entry modified the intervention effect.METHODS: VDAART (N = 806) and COPSAC2010. (N = 581) randomized pregnant women to daily high-dose vitamin D3 (4,000 IU/d and 2,400 IU/d, respectively) or placebo. All women also received a prenatal vitamin containing 400 IU/d vitamin D3. The primary outcome was asthma/recurrent wheeze from 0-3yrs. Secondary end-points were specific IgE, total IgE, eczema and lower respiratory tract infections (LRTI). We conducted random effects combined analyses of the treatment effect, individual patient data (IPD) meta-analyses, and analyses stratified by 25(OH)D level at study entry.RESULTS: The analysis showed a 25% reduced risk of asthma/recurrent wheeze at 0-3yrs: adjusted odds ratio (aOR) = 0.74 (95% CI, 0.57-0.96), p = 0.02. The effect was strongest among women with 25(OH)D level ≥30ng/ml at study entry: aOR = 0.54 (0.33-0.88), p = 0.01, whereas no significant effect was observed among women with 25(OH)D level <30ng/ml at study entry: aOR = 0.84 (0.62-1.15), p = 0.25. The IPD meta-analyses showed similar results. There was no effect on the secondary end-points.CONCLUSIONS: This combined analysis shows that vitamin D supplementation during pregnancy results in a significant reduced risk of asthma/recurrent wheeze in the offspring, especially among women with 25(OH)D level ≥ 30 ng/ml at randomization, where the risk was almost halved. Future studies should examine the possibility of raising 25(OH)D levels to at least 30 ng/ml early in pregnancy or using higher doses than used in our studies.TRIAL REGISTRATION: COPSAC2010: ClinicalTrials.gov NCT00856947; VDAART: ClinicalTrials.gov NCT00920621.

AB - BACKGROUND: We recently published two independent randomized controlled trials of vitamin D supplementation during pregnancy, both indicating a >20% reduced risk of asthma/recurrent wheeze in the offspring by 3 years of age. However, neither reached statistical significance.OBJECTIVE: To perform a combined analysis of the two trials and investigate whether maternal 25-hydroxy-vitamin D (25(OH)D) level at trial entry modified the intervention effect.METHODS: VDAART (N = 806) and COPSAC2010. (N = 581) randomized pregnant women to daily high-dose vitamin D3 (4,000 IU/d and 2,400 IU/d, respectively) or placebo. All women also received a prenatal vitamin containing 400 IU/d vitamin D3. The primary outcome was asthma/recurrent wheeze from 0-3yrs. Secondary end-points were specific IgE, total IgE, eczema and lower respiratory tract infections (LRTI). We conducted random effects combined analyses of the treatment effect, individual patient data (IPD) meta-analyses, and analyses stratified by 25(OH)D level at study entry.RESULTS: The analysis showed a 25% reduced risk of asthma/recurrent wheeze at 0-3yrs: adjusted odds ratio (aOR) = 0.74 (95% CI, 0.57-0.96), p = 0.02. The effect was strongest among women with 25(OH)D level ≥30ng/ml at study entry: aOR = 0.54 (0.33-0.88), p = 0.01, whereas no significant effect was observed among women with 25(OH)D level <30ng/ml at study entry: aOR = 0.84 (0.62-1.15), p = 0.25. The IPD meta-analyses showed similar results. There was no effect on the secondary end-points.CONCLUSIONS: This combined analysis shows that vitamin D supplementation during pregnancy results in a significant reduced risk of asthma/recurrent wheeze in the offspring, especially among women with 25(OH)D level ≥ 30 ng/ml at randomization, where the risk was almost halved. Future studies should examine the possibility of raising 25(OH)D levels to at least 30 ng/ml early in pregnancy or using higher doses than used in our studies.TRIAL REGISTRATION: COPSAC2010: ClinicalTrials.gov NCT00856947; VDAART: ClinicalTrials.gov NCT00920621.

KW - Asthma/prevention & control

KW - Child, Preschool

KW - Female

KW - Humans

KW - Placebos

KW - Pregnancy

KW - Prenatal Care

KW - Randomized Controlled Trials as Topic

KW - Recurrence

KW - Respiratory Sounds

KW - Vitamin D/administration & dosage

U2 - 10.1371/journal.pone.0186657

DO - 10.1371/journal.pone.0186657

M3 - Journal article

C2 - 29077711

VL - 12

JO - P L o S One

JF - P L o S One

SN - 1932-6203

IS - 10

M1 - e0186657

ER -

ID: 194772409