Is antenatal or early-life vitamin D associated with eczema or food allergy in childhood? A systematic review
Rong Zeng
Allergy and Lung Health Unit, Melbourne School of Population and Global Health, University of Melbourne, Carlton, Victoria, Australia
Search for more papers by this authorYusi Li
Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
Search for more papers by this authorSongying Shen
Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
Guangdong Provincial Key Laboratory of Research in Structural Birth Defect Disease, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
Guangdong Provincial Clinical Research Center for Child Health, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
Search for more papers by this authorXiu Qiu
Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
Guangdong Provincial Key Laboratory of Research in Structural Birth Defect Disease, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
Guangdong Provincial Clinical Research Center for Child Health, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
Department of Women's Health, Guangdong Provincial Key Clinical Specialty of Woman and Child Health, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
Search for more papers by this authorChia-Lun Chang
Allergy and Lung Health Unit, Melbourne School of Population and Global Health, University of Melbourne, Carlton, Victoria, Australia
Search for more papers by this authorJennifer J. Koplin
Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
Murdoch Children's Research Institute, Parkville, Victoria, Australia
Centre for Food and Allergy Research, Murdoch Children's Research Institute, Parkville, Victoria, Australia
Search for more papers by this authorKirsten P. Perrett
Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
Murdoch Children's Research Institute, Parkville, Victoria, Australia
Centre for Food and Allergy Research, Murdoch Children's Research Institute, Parkville, Victoria, Australia
Department of Allergy & Immunology, Royal Children's Hospital, Parkville, Victoria, Australia
Search for more papers by this authorShyamali C. Dharmage
Allergy and Lung Health Unit, Melbourne School of Population and Global Health, University of Melbourne, Carlton, Victoria, Australia
Murdoch Children's Research Institute, Parkville, Victoria, Australia
Centre for Food and Allergy Research, Murdoch Children's Research Institute, Parkville, Victoria, Australia
Search for more papers by this authorCaroline J. Lodge
Allergy and Lung Health Unit, Melbourne School of Population and Global Health, University of Melbourne, Carlton, Victoria, Australia
Murdoch Children's Research Institute, Parkville, Victoria, Australia
Centre for Food and Allergy Research, Murdoch Children's Research Institute, Parkville, Victoria, Australia
Search for more papers by this authorCorresponding Author
Adrian J. Lowe
Allergy and Lung Health Unit, Melbourne School of Population and Global Health, University of Melbourne, Carlton, Victoria, Australia
Murdoch Children's Research Institute, Parkville, Victoria, Australia
Centre for Food and Allergy Research, Murdoch Children's Research Institute, Parkville, Victoria, Australia
Correspondence
Adrian J. Lowe, Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, 207 Bouverie Street, Carlton, Vic. 3052, Australia.
Email: [email protected]
Search for more papers by this authorRong Zeng
Allergy and Lung Health Unit, Melbourne School of Population and Global Health, University of Melbourne, Carlton, Victoria, Australia
Search for more papers by this authorYusi Li
Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
Search for more papers by this authorSongying Shen
Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
Guangdong Provincial Key Laboratory of Research in Structural Birth Defect Disease, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
Guangdong Provincial Clinical Research Center for Child Health, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
Search for more papers by this authorXiu Qiu
Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
Guangdong Provincial Key Laboratory of Research in Structural Birth Defect Disease, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
Guangdong Provincial Clinical Research Center for Child Health, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
Department of Women's Health, Guangdong Provincial Key Clinical Specialty of Woman and Child Health, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
Search for more papers by this authorChia-Lun Chang
Allergy and Lung Health Unit, Melbourne School of Population and Global Health, University of Melbourne, Carlton, Victoria, Australia
Search for more papers by this authorJennifer J. Koplin
Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
Murdoch Children's Research Institute, Parkville, Victoria, Australia
Centre for Food and Allergy Research, Murdoch Children's Research Institute, Parkville, Victoria, Australia
Search for more papers by this authorKirsten P. Perrett
Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
Murdoch Children's Research Institute, Parkville, Victoria, Australia
Centre for Food and Allergy Research, Murdoch Children's Research Institute, Parkville, Victoria, Australia
Department of Allergy & Immunology, Royal Children's Hospital, Parkville, Victoria, Australia
Search for more papers by this authorShyamali C. Dharmage
Allergy and Lung Health Unit, Melbourne School of Population and Global Health, University of Melbourne, Carlton, Victoria, Australia
Murdoch Children's Research Institute, Parkville, Victoria, Australia
Centre for Food and Allergy Research, Murdoch Children's Research Institute, Parkville, Victoria, Australia
Search for more papers by this authorCaroline J. Lodge
Allergy and Lung Health Unit, Melbourne School of Population and Global Health, University of Melbourne, Carlton, Victoria, Australia
Murdoch Children's Research Institute, Parkville, Victoria, Australia
Centre for Food and Allergy Research, Murdoch Children's Research Institute, Parkville, Victoria, Australia
Search for more papers by this authorCorresponding Author
Adrian J. Lowe
Allergy and Lung Health Unit, Melbourne School of Population and Global Health, University of Melbourne, Carlton, Victoria, Australia
Murdoch Children's Research Institute, Parkville, Victoria, Australia
Centre for Food and Allergy Research, Murdoch Children's Research Institute, Parkville, Victoria, Australia
Correspondence
Adrian J. Lowe, Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, 207 Bouverie Street, Carlton, Vic. 3052, Australia.
Email: [email protected]
Search for more papers by this authorCaroline J. Lodge and Adrian J. Lowe: equal senior author.
Abstract
Objective
To summarise the associations between antenatal or early-life blood vitamin D and the development of eczema/food allergy in childhood.
Design
A systematic review and meta-analyses were conducted to synthesize the published literature. Two reviewers independently performed the study selection and data extraction on Covidence. We assessed the risk of bias for observational studies by using the Newcastle-Ottawa Scale and the Cochrane Risk of Bias tool for clinical trials. The certainty of the evidence was assessed using Grading of Recommendations, Assessment, Development and Evaluations (GRADE).
Data sources
We systematically searched PubMed and Embase from inception and April 2022.
Eligibility criteria
Human studies that investigated prospective associations between antenatal or early-life blood vitamin D levels, dietary intake or supplementation and childhood eczema/food allergy.
Results
Forty-three articles including six randomised controlled trials (RCTs) were included. Four RCTs of vitamin D supplementation during pregnancy showed no evidence of an effect on the incidence of eczema (pooled odds ratio [OR] = 0.85; 0.67–1.08, I2 = 6.7%, n = 2074). Three RCTs reported null associations between supplementation in pregnancy/infancy and food allergy. From six cohort studies, increasing cord blood vitamin D levels were associated with reduced prevalence of eczema at/close to age one (OR per 10 nmol/L increase = 0.89; 0.84–0.94, I2 = 0%, 2025 participants). We found no evidence of an association between maternal antenatal or infant vitamin D level or dietary intake and the development of food allergy or eczema in offspring.
Conclusions
We found an association between higher vitamin D levels in cord blood and reduced risk of eczema in cohort studies. Further trials with maternal and infant supplementation are needed to confirm if vitamin D supplementation can effectively prevent eczema or food allergy in childhood.
Systematic review registration
PROSPERO, No. CRD42013005559.
Graphical Abstract
In this systematic review of prospective studies, we observed an 11% reduction in the prevalence of eczema at approximately 1 year of age per 10 nmol/L increase of vitamin D levels in cord blood (OR = 0.89, 95% CI = 0.84–0.94, six cohort studies, 2025 participants). There was no association between maternal or infant vitamin D levels or vitamin D supplementation during pregnancy and the risk of eczema. A lower level of cord blood vitamin D is a risk factor for developing eczema in childhood.
CONFLICT OF INTEREST
AJL, CJL and SCD have received an investigator-initiated grant from GlaxoSmithKline for unrelated research, and SCD holds a similar grant from AstraZeneca. AJL has received investigational product (EpiCeram TM) free of charge from Primus Pharmaceuticals for use in unrelated research. AJL, SCD and JJK have received grant funding from Sanofi Regeneron for unrelated research. KPP has received research grants from DBV Technologies, Novartis and Siolta Therapeutics and consultant fees from Aravax outside the submitted work, paid to her institution. Other authors have nothing to disclose.
Open Research
DATA AVAILABILITY STATEMENT
The data that support the findings of this study are available from the corresponding author upon reasonable request.
Supporting Information
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| cea14281-sup-0001-AppendixS1.docxWord 2007 document , 1.8 MB |
Appendix S1 |
Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
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