African American infants born prematurely are at higher risk for recurrent wheezing. This condition can cause the baby discomfort and is a risk factor for developing asthma later in life. There are no widely-accepted therapies to prevent prematurity-associated wheezing.
In a first-of-its-kind study published in the Journal of the American Medical Association (JAMA), a Case Western Reserve University School of Medicine and University Hospitals Rainbow Babies & Children’s Hospital (UH Rainbow) physician researcher found African American preterm infants experienced a significant decrease in recurrent wheezing with sustained supplementation of vitamin D. Among infants born at 28-36 weeks gestation, a daily dose of vitamin D through six months of age decreased recurrent wheezing by more than 10 percent.
Prior to conducting the study, it was unclear which vitamin D supplementation strategy would be superior. According to the study’s principal investigator, Anna Maria Hibbs, MD, MSCE, FAAP, associate professor of pediatrics at Case Western Reserve University School of Medicine, continuing vitamin D supplementation with 400IU/day until 6 months of age corrected for prematurity may decrease their chance of recurrent wheezing.
“Parents need to know African American preterm infants are at high risk of wheezing in infancy,” says Hibbs, who is also the Eliza Henry Barnes Chair in Neonatology at UH Rainbow. “I hope this study can highlight the burden of wheezing illness experienced by premature babies and the importance of targeting interventions that can lessen this burden.”
The randomized clinical trial included 300 black infants born preterm between January 2013 and January 2016 at four sites in the United States. Infants were enrolled in the study prior to discharge from the neonatal intensive care unit or newborn nursery, and received open-label multivitamin until they were consuming 200 IU per day of cholecalciferol or vitamin D from formula or fortifiers added to breastmilk. Once they were receiving at least 200 IU/day from their diet, they received either 400 IU of vitamin D per day or placebo until six months of age, adjusted for prematurity. In both groups, exclusively breast-fed infants were provided with a multivitamin containing 400 IU/day. One-hundred fifty three infants received the daily dose of vitamin D, and 147 were randomized in the placebo group.
Among the 300 study participants, 277 completed the trial. Recurrent wheezing was experienced by 31.1 percent of infants in the sustained vitamin D supplementation group, and 41.8 percent of infants in the diet-limited supplementation group. Both strategies were similar in terms of bone health. The study, funded by the National Heart, Lung and Blood Institute and the Office of Dietary Supplements, enrolled infants at UH Rainbow, MetroHealth, Medical University of South Carolina, and Montefiore Medical Center.
“Vitamin D is an attractive treatment option because it is easy to administer, and is relatively inexpensive. Parents can be in control of this intervention,” says Dr. Hibbs. “Further research is needed to identify and optimize interventions that can reduce the wheezing burden, and help us understand any health benefits that may continue as the infants grow up.”
For more information about Case Western Reserve University School of Medicine, please visit case.edu/medicine.
About University Hospitals Rainbow Babies & Children’s Hospital
Located on the campus of University Hospitals Cleveland Medical Center in Cleveland, Ohio, University Hospitals Rainbow Babies & Children’s Hospital is a 244-bed, full-service children’s hospital and academic medical center dedicated to the health care needs of children. A trusted leader in children’s health care for nearly 130 years, UH Rainbow Babies & Children’s Hospital consistently ranks among the top children’s hospitals in the nation. As the region’s premier resource for pediatric referrals, UH Rainbow Babies & Children’s Hospital’s dedicated team of more than 1,300 pediatric specialists uses the most advanced treatments and latest innovations to deliver the complete range of pediatric specialty services for more than 740,000 patient encounters each year. Learn more at Rainbow.org.
Among the nation’s leading academic medical centers, UH Cleveland Medical Center is an affiliate of Case Western Reserve University School of Medicine, a nationally recognized leader in medical research and education.
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