Is antenatal or early‐life vitamin D associated with eczema or food allergy in childhood? A systematic review

Abstract

Objective To summarise the associations between antenatal or early‐life blood vitamin D and the development of eczema/food allergy in childhood. Design A systematic review and meta‐analyses were conducted to synthesize the published literature. Two reviewers independently performed the study selection and data extraction on Covidence. We assessed the risk of bias for observational studies by using the Newcastle‐Ottawa Scale and the Cochrane Risk of Bias tool for clinical trials. The certainty of the evidence was assessed using Grading of Recommendations, Assessment, Development and Evaluations (GRADE). Data sources We systematically searched PubMed and Embase from inception and April 2022. Eligibility criteria Human studies that investigated prospective associations between antenatal or early‐life blood vitamin D levels, dietary intake or supplementation and childhood eczema/food allergy. Results Forty‐three articles including six randomised controlled trials (RCTs) were included. Four RCTs of vitamin D supplementation during pregnancy showed no evidence of an effect on the incidence of eczema (pooled odds ratio [OR] = 0.85; 0.67–1.08, I2 = 6.7%, n = 2074). Three RCTs reported null associations between supplementation in pregnancy/infancy and food allergy. From six cohort studies, increasing cord blood vitamin D levels were associated with reduced prevalence of eczema at/close to age one (OR per 10 nmol/L increase = 0.89; 0.84–0.94, I2 = 0%, 2025 participants). We found no evidence of an association between maternal antenatal or infant vitamin D level or dietary intake and the development of food allergy or eczema in offspring. Conclusions We found an association between higher vitamin D levels in cord blood and reduced risk of eczema in cohort studies. Further trials with maternal and infant supplementation are needed to confirm if vitamin D supplementation can effectively prevent eczema or food allergy in childhood. Systematic review registration PROSPERO, No. CRD42013005559.

Maternal Dietary Vitamin D Intake during Pregnancy Is Associated with Allergic Disease Symptoms in Children at 3 Years Old: The Japan Environment and Children’s Study

“…Most cohort studies found no association between vitamin D intake during pregnancy and eczema in their offspring in Western countries [22,[29][30][31]. Indeed, a meta-analysis and a systematic review that included Japanese cohort studies found no significant relationship, as in our study [11,12]. Differences in the effect of vitamin D intake on the development of each disease might be due to the diverse biological activities of vitamin D [6].…”

“…For atopic dermatitis, one RCT found a reduction in the OR at 12 months of age with vitamin D supplementation during pregnancy, but no significant difference at 24 or 48 months [37]. Furthermore, a recent meta-analysis of four RCTs, including the above study, found no significant relationship [12].…”

“…A previous meta-analysis reported an inverse association of vitamin D intake during pregnancy with infant wheezing but not with asthma, eczema, or allergic rhinitis [11]. Two more recent meta-analyses that included newer cohort studies found, on the one hand, no association between vitamin D intake during pregnancy and eczema in children [12] but, on the other hand, an inverse association between vitamin D intake during pregnancy and asthma [13].…”

Food anaphylaxis in older people

“…Intervention trials have not supported a benefit for vitamin D interventions during pregnancy or infancy on asthma prevention, but the use of vitamin D for eczema and food allergy prevention is less well‐explored 6 . In this month's issue, Zeng et al explore early life vitamin D status and risk of subsequent eczema or food allergy development 7 . They systematically reviewed all cohort studies evaluating 25‐hydroxy‐vitamin D levels in maternal, cord blood or infant blood, maternal or infant dietary vitamin D intake or randomized controlled trials of vitamin D supplementation during pregnancy or infancy.…”

“…MHS approved the manuscript. Robert J. Boyle 1 Mohamed H. Shamji F I G U R E 2 From Zeng et al 7 In a comprehensive and well-conducted systematic review, authors identified a possible relationship between cord blood vitamin D status and future risk of eczema development.…”