In black infants born preterm, maintained vitamin D supplementation may facilitate a reduced risk for recurrent wheeze by 12 months old (adjusted age), according to a study published in JAMA.
Anna Maria Hibbs, MD, MSCE, of Case Western Reserve University in Cleveland, Ohio, and associates conducted a randomized clinical trial to determine whether a pair of vitamin D dosing strategies would prevent recurrent wheezing in black preterm infants.
The investigation included 300 black infants born between 28 and 36 weeks’ gestational age who were given open-label multivitamin until consumption of 200 IU/d of cholecalciferol from formula was reached, after which time 400 IU/d of cholecalciferol was administered until 6 months of age (n=153). Infants in the control group were administered a placebo diet-limited supplement (n=147).
The primary outcome was recurrent wheezing prior to 12 months’ adjusted age.
Of the 300 enrolled participants (average gestational age 33 weeks, average birth weight 1.9 kg), 277 (92.3%) reached trial completion. Recurrent wheezing occurred in 42 (31.1%) of infants in the case cohort, while 56 (41.8%) of infants in the control group experienced wheezing (relative risk, 0.66).
The investigators reported upper and lower respiratory tract infections as the most frequently observed adverse events. Upper respiratory infections were reported in 54.9% of case-group infants and 56.5% of control-group infants; lower respiratory infections were reported in 21.6% and 25.2%, respectively.
“Among black infants born preterm, sustained supplementation with vitamin D, compared with diet-limited supplementation, resulted in a reduced risk of recurrent wheezing by 12 months’ adjusted age,” the authors reported. “Future research is needed to better understand the mechanism and longer-term effects of vitamin D supplementation on wheezing in children born preterm.”
Hibbs AM, Ross K, Kerns LA, et al. Effect of vitamin D supplementation on recurrent wheezing in black infants who were born preterm: the D-Wheeze randomized clinical trial [published online May 22, 2018]. JAMA. doi:10.1001/jama.2018.5729