Maternal and neonatal 25‐hydroxyvitamin D concentrations and school‐age lung function, asthma and allergy. The Generation R Study

Abstract

SummaryBackgroundVitamin D deficiency in early life might affect the developing lung and immune system, and subsequently influence the risk of asthma and allergy in later life.ObjectiveWe examined the associations of 25‐hydroxyvitamin D concentrations in mid‐gestation and at birth with lung function, asthma, inhalant allergic sensitization and inhalant allergy at school‐age.MethodsThis study among 4951 children and their mothers was embedded in a population‐based prospective cohort in Rotterdam, the Netherlands. Maternal venous blood samples in mid‐gestation and umbilical cord blood samples at birth were used to determine 25‐hydroxyvitamin D concentrations. At age 10 years, lung function was measured by spirometry, current asthma and physician‐diagnosed inhalant allergy by questionnaire, and inhalant allergic sensitization by skin prick tests. We used multivariable regression models to examine associations.ResultsHigher 25‐hydroxyvitamin D concentrations in mid‐gestation were associated with a higher forced vital capacity (FVC), but a lower forced expiratory volume in 1 second/FVC (FEV1/FVC) and a lower forced expiratory flow after exhaling 75% of FVC (FEF75) (Z‐score differences [95% CI] 0.02 [0.00, 0.03], −0.02 [−0.03, −0.01] and −0.01 [‐0.03, −0.00], respectively, per 10 nmol/L 25‐hydroxyvitamin D), but not with asthma. Furthermore, higher 25‐hydroxyvitamin D concentrations in mid‐gestation were associated with an increased risk of inhalant allergy (Odds Ratio [95% CI] 1.07 [1.02, 1.12]), but not with inhalant allergic sensitization. After additional adjustment for child's 25‐hydroxyvitamin D concentrations at the age of 6 years, only the associations of 25‐hydroxyvitamin D concentrations in mid‐gestation with FEV1/FVC and FEF75 remained. We did not find consistent associations of 25‐hydroxyvitamin D concentrations at birth with respiratory or allergy outcomes.Conclusion and clinical relevanceOur results suggest that maternal 25‐hydroxyvitamin D concentrations in mid‐gestation may influence lung development. The clinical implications of the observed associations remain unclear.

Developments allergy in 2019 through the eyes of Clinical and Experimental Allergy, Part II clinical allergy

“…Other important early life exposures that may have an impact on asthma and allergic disease include exposure to diet and microbiota. In a report from two iFAAM workshops, the role of dietary strategies to prevent childhood food allergy was summarized 12 and Mensink‐Bout reported on the association between maternal and neonatal 25‐hydroxyvitamin D concentrations and school‐age lung function, asthma and allergy from the Generation R Study 13 . Helminth exposure however does not seem to be important for the difference in allergy‐related outcomes between rural and urban communities 14 and the association between season of birth, childhood asthma and allergy to be mediated by lower respiratory infections 15 …”

Association between umbilical cord vitamin D levels and adverse neonatal outcomes

“…Vitamin D cord blood status is directly dependent on maternal levels of 25(OH)D. 9 – 12 Several maternal risk factors contribute to low maternal–fetal 25(OH)D concentrations. 13 Vitamin D insufficiency in the mother results in neonatal insufficiency, which may negatively affect the anthropometric parameters in the neonate, skeletal health, the immune system, and neurological development, and might increase the risk of asthma and type 1 diabetes in later life.…”

“… 2 , 12 , 14 , 15 Based on the potent immunomodulatory effect of vitamin D, several studies have linked maternal vitamin D deficiency to an increased risk of respiratory tract infections in infants, but only a few studies have examined cord blood vitamin D status. 2 , 12 , 16 , 17 …”

Epigenetic methylation in Eosinophilic Esophagitis: Molecular ageing and novel biomarkers for treatment response

“…[26][27][28][29] Maternal and neonatal 25-hydroxyvitamin D concentrations have been associated with atopic illness in children, and supplemental vitamin D, during pregnancy, has been associated with methylation changes in cord blood. 30,31 Although EoE is highly associated with atopic illness, epigenetic markers in EoE have not been extensively studied. Methylation markers have been evaluated as predictors of treatment response in other disease processes, [32][33][34] and thus, we hypothesized that DNA methylation markers could serve as a prognostic tool for identifying patients at risk of poor treatment response in the setting of EoE.…”

“…Advanced molecular age has also been associated with atopic illness 26‐29 . Maternal and neonatal 25‐hydroxyvitamin D concentrations have been associated with atopic illness in children, and supplemental vitamin D, during pregnancy, has been associated with methylation changes in cord blood 30,31 . Although EoE is highly associated with atopic illness, epigenetic markers in EoE have not been extensively studied.…”