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)

Shin, Youn Ho; Yu, Jinho; Kim, Kyung Won; Ahn, Kangmo; 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; ,

Korean J Pediatr. 2013 Oct;56(10):439-445. 10.3345/kjp.2013.56.10.439.

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)

Affiliations

¹Department of Pediatrics, Gangnam CHA Medical Center, CHA University School of Medicine, Seoul, Korea.
²Department of Pediatrics, Childhood Asthma Atopy Center, Research Center for Standardization of Allergic Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. sjhong@amc.seoul.kr
³Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea.
⁴Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
⁵Department of Pediatrics, Gosin University College of Medicine, Busan, Korea.
⁶Department of Pediatrics, Korean Cancer Hospital, Seoul, Korea.
⁷Department of Pediatrics, Seoul National University Bundang Hospital, Seongnam, Korea.
⁸Department of Pediatrics, Inje University Haeundae Paik Hospital, Pusan, Korea.
⁹Department of Pediatrics, Inje University Sanggye Paik Hospital, Seoul, Korea.
¹⁰Department of Pediatrics, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
¹¹Department of Pediatrics, Inje University Seoul Paik Hospital, Seoul, Korea.
¹²Department of Pediatrics, Korea University College of Medicine, Seoul, Korea.
¹³Department of Pediatrics, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea.
¹⁴Department of Pediatrics, Ajou University School of Medicine, Suwon, Korea.
¹⁵Department of Pediatrics, National Health Insurance Corporation Ilsan Hospital, Ilsan, Korea.
¹⁶Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea.
¹⁷Department of Pediatrics, Soonchunhyang University School of Medicine, Seoul, Korea.
¹⁸Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
¹⁹Department of Obstetrics and Gynecology, Yonsei University College of Medicine, Seoul, Korea.
²⁰Department of Obstetrics and Gynecology, Gangnam CHA Medical Center, CHA University School of Medicine, Seoul, Korea.
²¹Department of Obstetrics and Gynecology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

KMID: 1712451
DOI: http://doi.org/10.3345/kjp.2013.56.10.439

Abstract

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 > or =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.

Keyword

Cohort studies; Infant; Respiratory tract infections; Umbilical cord blood; Vitamin D

MeSH Terms

Asthma
Bronchiolitis
Cohort Studies*
Croup
Fetal Blood*
Follow-Up Studies
Humans
Hypersensitivity
Infant
Infant, Newborn
Korea
Nasopharyngitis
Otitis Media
Parturition
Pregnancy
Pregnant Women
Prevalence
Prospective Studies
Respiratory System Abnormalities*
Respiratory Tract Infections*
Seasons
Specialization
Tobacco Smoke Pollution
Vitamin D
Tobacco Smoke Pollution
Vitamin D

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)

Abstract

Keyword

MeSH Terms

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