#Grand Rounds

VDAART RCT Results: Does Vitamin D Supplementation During Pregnancy Reduce Asthma Incidence in Children at 6 Years of Age?

BACKGROUND AND PURPOSE:

Higher maternal vitamin D levels might be linked to a lower risk of asthma in children
- The Vitamin D Antenatal Asthma Reduction Trial (VDAART) found that vitamin D supplementation is associated with a reduction in asthma and recurrent wheeze in 3-year-old children
Litonjua et al. (N Engl J Med, 2020) performed a 6-year follow-up on VDAART participants

Randomized, double-blind, placebo-controlled trial
- VDAART Follow-up
Participants
- Mothers, and offspring
- Follow-up through offspring’s 6th birthday
Interventions
- Vitamin D group: Mothers received 4000 IU plus multivitamin with 400 IU of vitamin D3 daily during pregnancy
- Control group: Mothers received multivitamin with 400 IU of vitamin D3 daily during pregnancy
Primary outcome
- Extension of original trial (at 6 years): Asthma | Recurrent wheeze | Both outcomes
Study design and data analysis
- Investigators remained unaware of the treatment assignments
- Time-to-event methods were used to compare the treatment groups with respect to time to the onset of asthma or recurrent wheeze
- Multivariate methods were used to compare longitudinal measures of lung function between the treatment groups

806 children included
Maternal vitamin D supplementation level had no effect on
- Primary outcome: Asthma and recurrent wheeze at 6 years
- Prespecified secondary outcomes
- Spirometric indexes

While the original 3-year RCT demonstrated benefit in offspring, the 6-year follow-up failed to show that vitamin D supplementation during pregnancy could prevent asthma and recurrent wheeze

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