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Cord Blood Vitamin D Deficiency is Associated With Respiratory Syncytial Virus Bronchiolitis
Mirjam E. Belderbos, MDa,
Michiel L. Houben, MDa,
Berry Wilbrink, PhDb,
Eef Lentjes, PhDc,
Eltje M. Bloemena,
Jan L. L. Kimpen, MD, PhDa,
Maroeska Rovers, PhDd,
Louis Bont, MD, PhDa
+ Author Affiliations
aDepartment of Pediatrics,
cDepartment of Endocrinology and Metabolic Diseases, and
dJulius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, Netherlands; and
bLaboratory of Infectious Diseases and Perinatal Screening, National Institute of Public Health and the Environment, Bilthoven, Netherlands
Abstract
Background:Respiratory syncytial virus (RSV) is the most important pathogen causing severe lower respiratory tract infection (LRTI) in infants. Epidemiologic and basic studies suggest that vitamin D may protect against RSV LRTI.
Objective:To determine the association between plasma vitamin D concentrations at birth and the subsequent risk of RSV LRTI.
Design:A prospective birth cohort study was performed in healthy term neonates. Concentrations of 25-hydroxyvitamin D (25-OHD) in cord blood plasma were related to RSV LRTI in the first year of life, defined as parent-reported LRTI symptoms in a daily log and simultaneous presence of RSV RNA in a nose-throat specimen.
Results:The study population included 156 neonates. Eighteen (12%) developed RSV LRTI. The mean plasma 25-OHD concentration was 82 nmol/L. Overall, 27% of neonates had 25-OHD concentrations <50 nmol/L, 27% had 50-74 nmol/L and only 46% had 25-OHD 75 nmol/L. Cord blood 25-OHD concentrations were strongly associated with maternal vitamin D3 supplementation during pregnancy. Concentrations of 25-OHD were lower in neonates who subsequently developed RSV LRTI compared with those who did not (65 nmol/L versus 84 nmol/L, P = .009). Neonates born with 25-OHD concentrations <50 nmol/L had a sixfold (95% confidence interval: 1.6-24.9; P = .01) increased risk of RSV LRTI in the first year of life compared with those with 25-OHD concentrations ≥75 nmol/L.
Conclusions:Vitamin D deficiency in healthy neonates is associated with increased risk of RSV LRTI in the first year of life. Intensified routine vitamin D supplementation during pregnancy may be a useful strategy to prevent RSV LRTI during infancy.
Mirjam E. Belderbos, MDa,
Michiel L. Houben, MDa,
Berry Wilbrink, PhDb,
Eef Lentjes, PhDc,
Eltje M. Bloemena,
Jan L. L. Kimpen, MD, PhDa,
Maroeska Rovers, PhDd,
Louis Bont, MD, PhDa
+ Author Affiliations
aDepartment of Pediatrics,
cDepartment of Endocrinology and Metabolic Diseases, and
dJulius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, Netherlands; and
bLaboratory of Infectious Diseases and Perinatal Screening, National Institute of Public Health and the Environment, Bilthoven, Netherlands
Abstract
Background:Respiratory syncytial virus (RSV) is the most important pathogen causing severe lower respiratory tract infection (LRTI) in infants. Epidemiologic and basic studies suggest that vitamin D may protect against RSV LRTI.
Objective:To determine the association between plasma vitamin D concentrations at birth and the subsequent risk of RSV LRTI.
Design:A prospective birth cohort study was performed in healthy term neonates. Concentrations of 25-hydroxyvitamin D (25-OHD) in cord blood plasma were related to RSV LRTI in the first year of life, defined as parent-reported LRTI symptoms in a daily log and simultaneous presence of RSV RNA in a nose-throat specimen.
Results:The study population included 156 neonates. Eighteen (12%) developed RSV LRTI. The mean plasma 25-OHD concentration was 82 nmol/L. Overall, 27% of neonates had 25-OHD concentrations <50 nmol/L, 27% had 50-74 nmol/L and only 46% had 25-OHD 75 nmol/L. Cord blood 25-OHD concentrations were strongly associated with maternal vitamin D3 supplementation during pregnancy. Concentrations of 25-OHD were lower in neonates who subsequently developed RSV LRTI compared with those who did not (65 nmol/L versus 84 nmol/L, P = .009). Neonates born with 25-OHD concentrations <50 nmol/L had a sixfold (95% confidence interval: 1.6-24.9; P = .01) increased risk of RSV LRTI in the first year of life compared with those with 25-OHD concentrations ≥75 nmol/L.
Conclusions:Vitamin D deficiency in healthy neonates is associated with increased risk of RSV LRTI in the first year of life. Intensified routine vitamin D supplementation during pregnancy may be a useful strategy to prevent RSV LRTI during infancy.
