Most Viewed Views of 2018

At the end of each year, I love to revisit some of the most read pediatric views of the previous 12 months. These five topics – determined by you, our readers – and the comments they have generated underline how important they are in pediatric practice. Continue reading!

Vitamin D and wheezing in infants

A study published in JAMA in the fall looked to determine if Vitamin Dsupplementation in preterm neonates may decrease the risk of recurrent wheezing.[[[[1]The main result was parental reporting of recurrent wheezing before the children reached the adjusted 12-month age. A total of 300 babies were randomly assigned and an equal number of people participated in the trial (approximately 135 per group). About 37% of infants had a family history of food allergy. More than two-thirds came from families with a history of eczema and, in both groups, over 60% of infants had a family history of eczema. asthma. The group receiving sustained supplementation received 400 IU of cholecalciferol per day up to the adjusted age of 6 months, in addition to dietary vitamin D that it could consume. The comparison group initially received 400 IU / day, but stopped the supplement when its food intake reached at least 200 IU / day of vitamin D.

The frequency of recurrent wheezing was less common in children (31.1%) compared to the group receiving limited supplementation (41.8%, relative risk 0.66, 95% confidence interval). [CI]0.47 to 0.94; P = 0.02).

Other findings were also less common in the extended-supplementation group, including a diagnosis of asthma or eczema, but these differences were not statistically significant. Other secondary outcomes, such as emergency visits for respiratory disorders, pediatric visits, or pediatric visits while in a state of illness, were virtually identical between the two groups.

The authors concluded that in black infants born premature, sustained supplementation with at least 400 IU / day of adjusted 6-month vitamin D reduced the risk of recurrent wheeze at 12 months.

Point of view

I do not think I anticipated it would be the most read of 2018, but I guess it reflects the fact that asthma is such a common pediatric condition, and any possibility of reducing it would be welcome! There was an excellent accompanying editorial that reviewed some of the potential mechanisms by which vitamin D could improve lung health, including potential anti-inflammatory and pro-immunogenic effects.[[[[2]The editorialist also reviewed some of the other recent randomized trials examining the effect of maternal vitamin D supplementation on the incidence of atopic diseases in children. A Cochrane 2016: Examining the Link Between Vitamin D and Asthma provides more detailed information.[[[[3]