Early life Vitamin D supplementation for preventing allergic diseases: A
systematic review and meta-analysis of randomized controlled trials
Abstract
Abstract Background: It is still unclear if and to what extent antenatal
or early postnatal or infants vitamin D supplementation would affect the
development of allergy diseases later in life. Methods: Randomized
controlled trials about vitamin D supplementation in pregnant or healthy
children from birth to five years of age to prevent allergic diseases
were selected. Descriptive and quantitative information was extracted.
Relative risk estimates were synthesized under a fixed or random effects
model. Heterogeneity was assessed by using the I2 metric. Grading of
Recommendations Assessment, Development and Evaluation (GRADE) was used
to asses certainty of findings. MEDLINE(PubMed), EMBASE(OVID), and The
Cochrane Central Register of Controlled Trials were searched up to March
1st 2020.Eligibility criteria for selecting studies: (1) the design was
an randomized controlled trial(RCT); (2) healthy pregnant or lactating
females and/or healthy children from birth to five years of age;(3)
vitamin D protocol was specified in the treatment group; (4) outcomes
were asthma/wheeze, allergic rhinitis, eczema(atopic dermatitis), food
allergy and atopic sensitization; (5) the study contained relevant data
to calculate the effect size. Results: In the present systematic review
and meta-analysis, the available published randomized evidence on
vitamin D supplementation in pregnant or infants for preventing allergic
diseases across 7 RCTs were systematically assessed. Our meta-analysis
showed that non-significant trends between vitamin D supplementation in
pregnant or infants and the primary prevention of allergic diseases in
offspring. The Grade quality assessment for all these conclusions
indicated an evidence confidence level of low. Conclusions: In terms of
practice implications, the data in this review should not make patients,
doctors, and public health authorities confident that vitamin D
supplementation in pregnant or infants or young children can primarily
prevent allergic diseases. Systematic review registration: PROSPERO
(CRD42020167747)