Pediatrics. 2012 (Nov); 130 (5): e1128–1135
Anderson P. Jones, PG Dip, Debra Palmer, PhD,
Guicheng Zhang, PhD, and Susan L. Prescott, MBBS, PhD
MBBS, School of Pediatrics and Child Health Research,
University of Western Australia,
PO Box D184, Princess Margaret Hospital,
Perth WA 6001, Australia.
This study investigated vitamin D exposure in umbilical cord blood (CB) and allergy risk in the first year of life. Maternal intake of vitamin D from supplements was significantly linked to CB vitamin D levels whereas dietary vitamin D had
no influence. Low CB vitamin D status was observed in infants that developed eczema. Low vitamin D status in pregnancy may be a risk factor for the development of eczema in the first year of life.
OBJECTIVE: There has been growing interest in vitamin D insufficiency as a predisposing factor for allergy development based on immunoregulatory properties and epidemiological studies. The aim of this study was to investigate the association between vitamin D exposure in utero and allergic outcomes in the first year of life.
METHODS: Cord blood (CB) vitamin D was measured in 231 high-risk infants from an Australian prospective birth cohort. CB 25-hydroxyvitamin D(3) (25[OH]D(3)) concentration was analyzed in relation to maternal vitamin D intake and the development of infant eczema, allergen sensitization, and immunoglobulin E-mediated food allergy.
RESULTS: Maternal intake of supplemental vitamin D was significantly correlated with CB 25(OH)D(3) concentration (p = 0.244, P = .003), whereas dietary vitamin D did not influence CB levels. There was significant seasonal variation in CB 25(OH)D(3) concentration suggesting that sunlight exposure was an important determinant. Lower CB vitamin D status was observed in infants that developed eczema (P = .018), and eczema was significantly more likely in those with concentrations <50 nmol/L in comparison with those with concentrations =75 nmol/L (odds ratio 2.66; 95% confidence interval 1.24-5.72; P = .012). This association remained significant after adjustment for multiple confounding factors. The associations between CB 25(OH)D(3) concentration and allergen sensitization, immunoglobulin E-mediated food allergy, and eczema severity (SCORing Atopic Dermatitis) were not significant.
CONCLUSIONS: Reduced vitamin D status in pregnancy may be a risk factor for the development of eczema in the first year of life, reinforcing the need to explore the role of vitamin D exposure during development for disease prevention.