Vitamin D in pregnancy could prevent neurodermatitis

/ Valerii Honcharuk, stock.adobe.com

Southampton – A randomized trial demonstrated cholecalciferol replacement in pregnant women with proven vitamin D deficiency British Journal of Dermatology (2022; DOI: 10.1111 / bjd.21721) reduced the frequency of eczema in the first year of life. Subsequently, only a downward trend was detected.

The UK Vitamin D Maternal Osteoporosis Study (MAVIDOS) was originally intended to investigate whether administering vitamin D during pregnancy can improve bone density in babies.

Epidemiological studies have shown that prenatal vitamin D deficiency has an adverse effect on bone development with possible lifelong consequences.

A total of 1,134 women with a serum concentration of 25-hydroxyvitamin D ranging from 25 to 100 nmol / l from the 14th week of pregnancy were randomized to replace 1000 IU / day cholecalciferol or placebo.

The main objective of the study, to increase the bone mineral density of babies at birth, was based on the in Lancet diabetes endocrinology (2016; DOI: 10.1016 / S2213-8587 (16) 00044-9) published the results, although subsequent analysis indicated some increase at age 4 (Moreover 2022; DOI: 10.1002 / jbm4.10651).

A beneficial side effect of vitamin D replacement may be protection against neurodermatitis, which also occurs more frequently in low-sun areas and has been associated with vitamin D deficiency in observational studies.

A team led by Keith Godfrey of the University of Southampton can now show that babies whose mothers received cholecalciferol during pregnancy suffered from neurodermatitis (atopic dermatitis) in the first 12 months of life only about half the time as babies in the arm. placebo of the study. The odds ratio of 0.55 was significant with a 95% confidence interval ranging from 0.32 to 0.97.

However, the protective effect decreased over time and at 24 months the odds ratio of 0.76 (0.47-1.23) was no longer significant. Even after 48 months, a protective effect could no longer be reliably demonstrated (odds ratio 0.75; 0.37-1.52).

There was also an interaction with the duration of breastfeeding. The protective effect of vitamin D supplementation was limited to infants who were breastfed by their mother for at least 1 month (odds ratio 0.48, 0.24-0.94). No reliable effect of vitamin D administration was discernible for a shorter breastfeeding period (odds ratio 0.80; 0.29-2.17). Godfrey suspects that the replacement increased the concentration of vitamin D in breast milk.

© rme / aerzteblatt.de

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