Vitamin D supplementation in pregnancy may decrease offspring’s eczema risk
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Daily administration of vitamin D during pregnancy decreased the risk for atopic eczema in children, according to data published in the British Journal of Dermatology.
“The prevalence of infantile atopic eczema is increasing worldwide, and there is strengthening evidence that it may partly originate during intrauterine development,” Sarah El-Heis, MBBS, MRCP (London), DM, an academic clinical lecturer in dermatology at the University of Southampton in England, told Healio. “Observational studies have led to speculation that antenatal vitamin D supplementation may be beneficial, but to date there have been no population-based randomized trials.”
El-Heis and colleagues evaluated the development of atopic eczema in children born to 703 mothers in the Maternal Vitamin D Osteoporosis Study (MAVIDOS), a multicenter, double-blind, randomized, placebo-controlled trial. Pregnant women in the MAVIDOS were randomly assigned to either 1,000 international units (IU) of vitamin D per day (n = 351) or placebo (n = 352), which was self-administered from 14 weeks’ gestation until delivery. The researchers assessed the incidence of eczema at age 12 months for 635 children, age 24 months for 610 children and age 48 months for 449 children.
At 12 months, the children whose mothers who took 1,000 IU of vitamin D had a significantly lower risk for atopic eczema compared with those born to mothers taking a placebo (7.2% vs. 12%; adjusted OR = 0.55; 95% CI, 0.32-0.97).
Compared with children born to mothers in the placebo group, those born to mothers in the intervention group were also less likely to have atopic eczema at 24 months (14.6% vs. 11.4%) and at 48 months (8.4% vs. 6.7%), although the differences were not statistically significant.
Of note, the benefits of vitamin D supplementation were only observed in infants who were breastfed for more than 1 month, despite supplementation ending at delivery.
“This may reflect gestational supplementation raising vitamin D levels in breast milk, having normalized the mother’s vitamin D stores during pregnancy,” El-Heis told Healio.
El-Heis said the findings provide support for guidelines recommending routine vitamin D supplementation in pregnancy and urged health care professionals to discuss the benefits with their patients.
“To guide recommendations on the optimal amount to be taken, we would like to examine the vitamin D content in breast milk of mothers who took different amounts of [vitamin D] as a supplement during pregnancy,” El-Heis said. “Additionally, there is evidence that taking vitamin D can influence the gut microbiome, and we would like to conduct studies characterizing the mechanisms through which perinatal supplementation might influence eczema development.”