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Health News Archive 401 - Asthma
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Low Vitamin E Intake During Pregnancy Can Lead to Childhood Asthma

Children whose mothers had a low intake of vitamin E during pregnancy are more likely to develop wheezing and asthma by age five.

This research appears in the first issue for September 2006 of the American Journal of Respiratory and Critical Care Medicine, published by the American Thoracic Society.

Graham Devereux, M.D., Ph.D., of the Department of Environmental and Occupational Medicine at the University of Aberdeen in the United Kingdom, and seven associates assessed maternal nutrient and respiratory status in 1,253 mothers and children during a five-year period.

According to the authors, children born to mothers from the lowest quintile of vitamin E intake were over five times more likely to manifest early persistent asthma than children whose mothers were in the highest quintile.

"Our findings suggest that vitamin E has a dual effect on lung function and airway inflammation and that the effects could change at differing periods of prenatal and early life," said Dr. Devereux. "Lung function was associated with early vitamin E exposure independent of atopy, whereas allergic airway inflammation was associated with vitamin E exposure in later pregnancy."  However, the researchers also noted that the airways are fully developed by 16 weeks after conception and, consequently, vitamin E exposure in early pregnancy may be more likely to influence airway function than exposure later in pregnancy.

"The present study suggests that children's own nutrient intake at the age of five does not modify the associations between maternal nutrient intake and respiratory outcomes in the children," said Dr. Devereux.

In a prior report on this group of children, the researchers found that two-year-olds whose mothers' vitamin E intake during pregnancy had been relatively low were more likely to wheeze even when they had no cold.

For the previous study, the investigators recruited 2,000 pregnant women at 12 months gestation who were attending area antenatal clinics between 1997 and 1999. Plasma antioxidant concentrations were measured in 1,856 mothers at 12 weeks gestation. In addition, symptom questionnaire data was later obtained for 1,253 children. From that group, 478 children were able to provide a lung function test measurement.

In light of the new findings, the authors concluded that the relationship shown between mothers' vitamin E intake during pregnancy and the respiratory outcomes of their children were likely "underestimates of the true association."

"The results of the present study suggest that dietary modification or supplementation during pregnancy to reduce the likelihood of childhood asthma warrants further investigation," said Dr. Devereux.

The researchers added that vitamin E supplementation in adults with established asthma has not been shown to be of clinical benefit.

Abstract

Rationale: We have previously reported an association between reduced maternal vitamin E intake during pregnancy and wheezing in 2-yr-old children. Objectives: To assess whether maternal nutrient intake during pregnancy is associated with asthma-related outcomes in children aged 5 yr. Methods: A longitudinal cohort study of 1,861 children born to women recruited during pregnancy and followed up at 5 yr. Measurements: Maternal nutrient status was assessed by a food frequency questionnaire and plasma levels. Respiratory and food frequency questionnaires were completed at 5 yr and children were invited for measurement of spirometry and skin-prick testing. Main Results: Symptom and food frequency questionnaire data were available for 1,253 and 1,120 children, respectively; 700 children were skin prick tested, and FEV(1) was measured in 478 and exhaled nitric oxide in 167 children. In 5-yr-old children, maternal vitamin E intake during pregnancy was negatively associated with wheeze in previous year (odds ratio per intake quintile, 0.82; 95% confidence interval, 0.71-0.95), asthma ever (0.84, 0.72-0.98), asthma and wheeze in previous year (0.79, 0.65-0.95), and persistent wheezing (0.77, 0.63-0.93). Maternal plasma alpha-tocopherol during pregnancy was positively associated with post-bronchodilator FEV(1) at 5 yr, with a 7-ml (95% confidence interval, 0-14; p = 0.04) increase in FEV(1) per mug/ml alpha-tocopherol. Maternal zinc intake during pregnancy was negatively associated with asthma ever (0.83, 0.71-0.78) and active asthma (0.72, 0.59-0.89). There were no associations between children's nutrient intake and respiratory outcomes. Conclusion: Maternal intake of foods containing vitamin E and zinc during pregnancy is associated with differences in the risks of developing childhood wheeze and asthma.

Source: Devereux G, Turner SW, Craig LC, McNeill G, Martindale S, Harbour PJ, Helms PJ, Seaton A.  Low Maternal Vitamin E Intake during Pregnancy Is Associated with Asthma in 5-Year-Old Children. Am J Respir Crit Care Med. 2006 Sep 1;174(5):499-507. Epub 2006 Jun 8.

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