美国戈利萨诺儿童医院Augusto A. Litonjua研究小组近日取得一项新成果。他们对产前补充维生素D是否能降低儿童哮喘的发生率进行了后续试验。 2020年2月6日，国际知名学术期刊《新英格兰医学杂志》发表了这一成果。
Title: Six-Year Follow-up of a Trial of Antenatal Vitamin D for Asthma Reduction
Author: Augusto A. Litonjua, M.D., M.P.H.,, Vincent J. Carey, Ph.D.,, Nancy Laranjo, B.A.,, Benjamin J. Stubbs, B.A.,, Hooman Mirzakhani, M.D., Ph.D.,, George T. O’Connor, M.D.,, Megan Sandel, M.D., M.P.H.,, Avraham Beigelman, M.D.,, Leonard B. Bacharier, M.D.,, Robert S. Zeiger, M.D., Ph.D.,, Michael Schatz, M.D.,, Bruce W. Hollis, Ph.D.,, and Scott T. Weiss, M.D.
We previously reported the results of a trial of prenatal vitamin D supplementation to prevent asthma and recurrent wheeze in young children, which suggested that supplementation provided a protective effect at the age of 3 years. We followed the children through the age of 6 years to determine the course of asthma and recurrent wheeze.
In this follow-up study, investigators and participants remained unaware of the treatment assignments through the children’s sixth birthday. We aimed to determine whether, when maternal levels of 25-hydroxyvitamin D were taken into account, children born to mothers who had received 4400 IU of vitamin D3 per day during pregnancy (vitamin D group) would have a lower incidence of asthma and recurrent wheeze at the age of 6 years than would those born to mothers who had received 400 IU of vitamin D3 per day (control group). Time-to-event methods were used to compare the treatment groups with respect to time to the onset of asthma or recurrent wheeze. Multivariate methods were used to compare longitudinal measures of lung function between the treatment groups.
There was no effect of maternal vitamin D supplementation on asthma and recurrent wheeze in either an intention-to-treat analysis or an analysis with stratification according to the maternal 25-hydroxyvitamin D level during pregnancy. There was no effect of prenatal vitamin D supplementation on most of the prespecified secondary outcomes. We found no effects of prenatal supplementation on spirometric indexes. Although there was a very small effect on airway resistance as measured by impulse oscillometry, this finding was of uncertain significance.
Vitamin D supplementation during the prenatal period alone did not influence the 6-year incidence of asthma and recurrent wheeze among children who were at risk for asthma. (Funded by the National Heart, Lung, and Blood Institute; VDAART ClinicalTrials.gov number, NCT00920621.)