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KMID : 1130320130560100439
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Korean Journal of Pediatrics
2013 Volume.56 No. 10 p.439 ~ p.445
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Association between cord blood 25-hydroxyvitamin D concentrations and respiratory tract infections in the first 6 months of age in a Korean population: A birth cohort study (COCOA)
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Shin Youn-Ho
Yu Jin-Ho
Kim Kyung-Won
Ahn Kang-Mo
Hong Seo-Ah
Lee Eun
Yang Song-I
Jung Young-Ho
Kim Hyung-Young
Seo Ju-Hee
Kwon Ji-Won
Kim Byoung-Ju
Kim Hyo-Bin
Shim Jung-Yeon
Kim Woo-Kyung
Song Dae-Jin
Lee So-Yeon
Lee Soo-Young
Jang Gwang-Cheon
Suh Dong-In
Yang Hyeon-Jong
Kim Bong-Sung
Choi Suk-Joo
Oh Soo-Young
Kwon Ja-Young
Lee Kyung-Ju
Park Hee-Jin
Lee Pil-Ryang
Won Hye-Sung
Hong Soo-Jong
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Abstract
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Purpose: Previous studies suggest that the concentration of 25-hydroxyvitamin D [25(OH)D] in cord blood may show an inverse association with respiratory tract infections (RTI) during childhood. The aim of the present study was to examine the influence of 25(OH)D concentrations in cord blood on infant RTI in a Korean birth cohort.
Methods: The levels of 25(OH)D in cord blood obtained from 525 Korean newborns in the prospective COhort for Childhood Origin of Asthma and allergic diseases were examined. The primary outcome variable of interest was the prevalence of RTI at 6-month follow-up, as diagnosed by pediatricians and pediatric allergy and pulmonology specialists. RTI included acute nasopharyngitis, rhinosinusitis, otitis media, croup, tracheobronchitis, bronchiolitis, and pneumonia.
Results: The median concentration of 25(OH)D in cord blood was 32.0 nmol/L (interquartile range, 21.4 to 53.2). One hundred and eighty neonates (34.3%) showed 25(OH)D concentrations less than 25.0 nmol/L, 292 (55.6%) showed 25(OH)D concentrations of 25.0?74.9 nmol/L, and 53 (10.1%) showed concentrations of ≥75.0 nmol/L. Adjusting for the season of birth, multivitamin intake during pregnancy, and exposure to passive smoking during pregnancy, 25(OH)D concentrations showed an inverse association with the risk of acquiring acute nasopharyngitis by 6 months of age (P for trend= 0.0004).
Conclusion: The results show that 89.9% of healthy newborns in Korea are born with vitamin D insufficiency or deficiency (55.6% and 34.3%, respectively). Cord blood vitamin D insufficiency or deficiency in healthy neonates is associated with an increased risk of acute nasopharyngitis by 6 months of age. More time spent outdoors and more intensified vitamin D supplementation for pregnant women may be needed to prevent the onset of acute nasopharyngitis in infants.
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KEYWORD
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Cohort studies, Infant, Respiratory tract infections, Umbilical cord blood, Vitamin D
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