Abstract
Maternal vitamin D status during pregnancy may modulate fetal immune system development and infant susceptibility to infections. Vitamin D deficiency is common during pregnancy, particularly among African American (AA) women. Our objective was to compare maternal vitamin D status (plasma 25(OH)D concentration) during pregnancy and first-year infections in the offspring of African American (AA) and non-AA women. We used medical records to record frequency and type of infections during the first year of life of 220 term infants (69 AA, 151 non-AA) whose mothers participated in the Kansas University DHA Outcomes Study. AA and non-AA groups were compared for maternal 25(OH)D by Mann–Whitney U-test. Compared to non-AA women, AA women were more likely to be vitamin D deficient (<50 nmol/L; 84 vs. 37%, p < 0.001), and more of their infants had at least one infection in the first 6 months (78.3% and 59.6% of infants, respectively, p = 0.022). We next explored the relationship between maternal plasma 25(OH)D concentration and infant infections using Spearman correlations. Maternal 25(OH)D concentration was inversely correlated with the number of all infections (p = 0.033), eye, ear, nose, and throat (EENT) infections (p = 0.043), and skin infection (p = 0.021) in the first 6 months. A model that included maternal education, income, and 25(OH)D identified maternal education as the only significant predictor of infection risk in the first 6 months (p = 0.045); however, maternal education, income, and 25(OH)D were all significantly lower in AA women compared to non-AA women . The high degree of correlation between these variables does not allow determination of which factor is driving the risk of infection; however, the one that is most easily remediated is vitamin D status. It would be of value to learn if vitamin D supplementation in this at-risk group could ameliorate at least part of the increased infection risk.
Highlights
Maternal vitamin D status during pregnancy may modulate fetal immune system development, which in turn may alter susceptibility to immune-mediated diseases and infections during infancy [1,2,3,4].Nutrients 2018, 10, 111; doi:10.3390/nu10020111 www.mdpi.com/journal/nutrientsPlasma 25-hydroxycholecalciferol (25(OH)D) is the most widely-accepted biomarker for vitamin D status in humans, the active form of vitamin D is 1,25-di(OH)D [5]
Diagnoses were made by parent report rather than by a medical practitioner. None of these studies were conducted in the US, and none included a large number of African-American (AA) participants, who are more likely to be vitamin D deficient compared to women of other races, at least in part because increased skin pigmentation lowers the amount of vitamin D synthesis that occurs with ultraviolet light exposure [5,13,14,15,16,17]
Maternal education may well be linked to efforts to consume more vitamin D during pregnancy, and could be related to other maternal actions that reduce the likelihood of skin and EENT infections
Summary
Maternal vitamin D status during pregnancy may modulate fetal immune system development, which in turn may alter susceptibility to immune-mediated diseases and infections during infancy [1,2,3,4].Nutrients 2018, 10, 111; doi:10.3390/nu10020111 www.mdpi.com/journal/nutrientsPlasma 25-hydroxycholecalciferol (25(OH)D) is the most widely-accepted biomarker for vitamin D status in humans, the active form of vitamin D is 1,25-di(OH)D [5]. Several cohort studies to date have implicated low plasma 25(OH)D concentration during pregnancy or at birth with increased risk of respiratory infections in infancy or early childhood [6,7,8,9,10,11,12]. None of these studies were conducted in the US, and none included a large number of African-American (AA) participants, who are more likely to be vitamin D deficient compared to women of other races, at least in part because increased skin pigmentation lowers the amount of vitamin D synthesis that occurs with ultraviolet light exposure [5,13,14,15,16,17]. Several studies conducted in countries other than the US have included women who had darker skin or were not Caucasian, but these studies did not look at infection in children of women with darker skin
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