Prenatal vitamin D supplementation to prevent childhood asthma: 15-year results from the Vitamin D Antenatal Asthma Reduction Trial (VDAART)

Weiss S, Mirzakhani H, Carey V, O'Connor G, Zeiger R, Bacharier L, Stokes J, Litonjua A (2023) The Journal of Allergy and Clinical Immunology Oct 16:S0091-6749(23)01254-X doi: 10.1016/j.jaci.2023.10.003.

Web URL: Read this article on PubMed

Abstract:

This article provides an overview of the findings obtained from the Vitamin D Antenatal Asthma Reduction Trial (VDAART) spanning a period of 15 years.

The review covers various aspects, including the trial's rationale, study design, and initial intent-to-treat analyses, as well as an explanation of why those analyses did not achieve statistical significance.

Additionally, the article delves into the post hoc results obtained from stratified intent-to-treat analyses based on maternal vitamin D baseline levels and genotype-stratified analyses.

These results demonstrate a statistically significant reduction in asthma among offspring aged 3 and 6 years when comparing vitamin D supplementation (4400 IU/d) to the standard prenatal multivitamin with vitamin D (400 IU/d).

Furthermore, these post hoc analyses found that vitamin D supplementation led to a decrease in total serum IgE levels and improved lung function in children compared to those whose mothers received a placebo alongside the standard prenatal multivitamin with vitamin D.

Last, the article concludes with recommendations regarding the optimal dosing of vitamin D for pregnant women to prevent childhood asthma as well as suggestions for future trials in this field.

FAB RESEARCH COMMENT:

The risk of asthma in children could be signficantly reduced by maternal Vitamin D supplementation in pregnancy, according to this important new review of the findings from a large randomised controlled trial.

While the findings from this trial were initially reported as 'negative' - i.e. not showing significant treatment effects - those analyses failed to take into account either

the mother's Vitamin D status at baseline, or
genetic factors known to influence Vitamin D status and metabolism

When these important confounds are taken into account, statistically significant reductions in asthma in the children at age 3 and 6 years of age were found to result from high-dose Vitamin D supplementation during pregnancy (4400 IU/d), when compared with the much lower dose (400 IU/d) provided by a standard prenatal multivitamin supplement with vitamin D.

See the related news article and FAB comment here:

Clinical trial data suggests prenatal vitamin D reduces a child's risk of asthma

And for more information on the complications of randomised controlled clinical trials of Vitamin D (which also apply to most other essential nutrients) see:

Gorham & Garland 2011 - Vitamin D and the limits of randomized controlled trials

< Bhattacharyya P et al 2024 - Serum vitamin C status of people in New South Wales: retrospective analysis of findings at a public referral hospital

Kovatcheva M et al 2023 - Vitamin B12 is a limiting factor for induced cellular plasticity and tissue repair >

UK Nutrient Gaps and Impacts on Early Development with Dr Emma Derbyshire and TC Callis - BOOK HERE

Prenatal vitamin D supplementation to prevent childhood asthma: 15-year results from the Vitamin D Antenatal Asthma Reduction Trial (VDAART)

Abstract:

FAB RESEARCH COMMENT:

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