The Exchange

Commentary and Observations from
the Medical Front Lines

Prenatal Vitamin D Supplementation and the Development of Allergic Disease

Prenatal Vitamin D Supplementation and the Development of Allergic Disease

It is suggested that the increasing prevalence of vitamin D insufficiency worldwide could be a factor in the rising rates of allergic rhinitis, atopic disease, and aeroallergen sensitization. Given that maternal vitamin D supplementation and dietary intake freely crosses the placenta, and vitamin D has proven immune-modulating effects, several studies have investigated the relationship between prenatal vitamin D supplementation and the development of these conditions in children. Some studies have shown that prenatal vitamin D supplementation can be protective against developing allergic rhinitis and asthma in children, especially in families with a genetic predisposition. Allergic rhinitis, while not life-threatening, affects more than 25% of all children and 40% of all adults and causes significant reductions in quality of life for patients.

A recent study by Chen et al examined the association between prenatal vitamin D levels and the development of allergic rhinitis by ages 3 and 6 years. This study was conducted in 414 mother-child pairs. They found that in mothers with vitamin D deficiency in the first trimester—who were then given supplementation and were sufficient in vitamin D levels by the third trimester—there was a protective effect against development of allergic rhinitis and aeroallergen sensitization in their children at ages 3 and 6 years. These children had a 66% reduced risk of allergic rhinitis by age 3 and 46% reduced risk by age 6. The prevalence of allergic rhinitis increases throughout childhood, which explains the decrease in risk reduction in 6-year-old subjects compared to 3-year-old subjects. Risk reduction for development of food allergy, asthma, and eczema have also been seen with vitamin D supplementation. Several other baseline features are associated with risk of developing atopy, including male sex, higher body mass index, preterm birth, parental history of atopy or asthma, and lower maternal education level.

While these results appear promising, the role of vitamin D supplementation in mitigating the risk of development of atopic disease remains unclear, and more studies need to be completed with larger sample sizes, optimal dosage, and evaluation of further protective effects of continued vitamin D supplementation throughout childhood.

References
  • Chen YS, et al. The association of prenatal vitamin D sufficiency with aeroallergen sensitization and allergic rhinitis in early childhood. J Allergy Clin Immunol Pract. 2021;9:3788.

Filed under: Allergy/Immunology, Women's Health

Development Widget