Infecciones Respiratorias Infantiles o Sibilancias y Vitamina D Materna en el Embarazo: Una Revisión Sistemática.

Respiratory tract infections (RTIs) are a common cause of morbidity and mortality in young children and can be associated with wheeze. Vitamin D can have a protective role against RTI.

MATERIALS AND METHODS:

A systematic search of Pubmed, Embase and the Cochrane library was performed. Titles and abstracts were evaluated and selected articles were reviewed by two authors. We included randomized controlled trials (RCTs) investigating the effect of vitamin D supplementation during pregnancy on RTIs or wheeze in children of 5 years of age or younger. Observational studies on the association between serum 25-hydroxyvitamin D (25OHD) during pregnancy, or at birth, and RTIs and/or wheeze were included. The protocol was registered on PROSPERO (Registration No. CRD42015019183).

RESULTS:

Of four RCTs, one showed a protective effect of a high daily dose (2,000IU) of vitamin D during pregnancy on offspring RTI doctor visits (p=0.004; the RCT also included 800IU/day supplement to the infants until six months). Meta-analysis of three RCTs showed a reduced relative risk (RR) for offspring wheeze when mothers were supplemented with vitamin D during pregnancy (RR=0.81 [95% CI 0.68-0.97], p=0.025). In three of four strong quality, and five of ten moderate quality observational studies, an inverse association between pregnancy and cord 25OHD and subsequent wheeze and/or RTI was seen.

CONCLUSION:

Growing evidence support a preventive role of vitamin D during pregnancy on offspring wheeze and/or RTI. Future intervention studies may need to exceed current recommendations of vitamin D supplementation during pregnancy to show benefit against childhood wheeze or infections.