Maternal antenatal vitamin D supplementation and offspring risk of
atopic eczema in the first 4 years of life
Abstract
Background Evidence linking prenatal maternal vitamin D
supplementation and offspring risk of atopic eczema is inconsistent,
with most data coming from observational studies. Methods
Within the UK Maternal Vitamin D Osteoporosis Study (MAVIDOS)
double-blind, randomised, placebo-controlled trial, we examined the
relation of maternal vitamin D supplementation during pregnancy with
offspring atopic eczema at ages 12, 24 and 48 months. In MAVIDOS,
pregnant women were allocated to either cholecalciferol 1000 IU/day or
matched placebo, taken from around 14 weeks’ gestation until delivery,
with the primary outcome of neonatal whole-body bone mineral content.
The prevalence of atopic eczema in the offspring was ascertained at ages
12 (n=636), 24 (n=611) and 48 (n=450) months, based on the UK Working
Party Criteria for the Definition of Atopic Dermatitis. Results
Mothers and offspring characteristics were similar between the
intervention and placebo groups, apart from longer breastfeeding
duration in the intervention group. Adjusting for breastfeeding
duration, offspring of mothers who received 1000 IU cholecalciferol
daily had a lower odds ratio (OR) of atopic eczema at age 12 months: OR
(95%CI) 0.55 (0.32-0.97), p=0.04. The ORs of atopic eczema in the
intervention group at ages 24 and 48 months were 0.77 (0.47-1.24) and
0.71 (0.35-1.43), respectively. Conclusion Our data
demonstrated a clinically important reduction in offspring risk of
atopic eczema in infancy following maternal cholecalciferol
supplementation during pregnancy. The findings support a developmental
influence on infantile atopic eczema and point to gestational
cholecalciferol supplementation as a preventive strategy to reduce the
burden of atopic eczema during infancy.