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Vitamin A has an important role in fetal lung development. This study tested the hypothesis that maternal vitamin A deficiency could have a long-term adverse effect on the lung function of offspring, quantified by reduced forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC).
The participants were a cohort of rural Nepali children, aged between 9 and 13 years, whose mothers had taken part in an original study aimed to determine the effects of vitamin A, β-carotene or placebo supplementation throughout pregnancy on maternal death rates.
Over a 2 year period spirometric data were collected from 1371 children (83% of those eligible for participation after the original study). Results demonstrated normally distributed FEV1 and FVC volumes, with means of 1.54 and 1.74 litres, respectively. Compared with the placebo group, the FEV1 was 46 ml higher in the children whose mothers had received vitamin A supplementation throughout pregnancy, and 14 ml higher in the β-carotene group than the placebo group. Even after adjustment for confounders such as age, height and sex, a similar comparison was made for FVC. Compared with the placebo group the FVC was 46 ml higher in the vitamin A group and 17 ml higher in the β-carotene group.
The study concludes that repletion of vitamin A and, to a lesser degree, β-carotene during pregnancy improves lung function, potentially providing long-term public health benefits.
▶ Checkley W, West KP, Wise RA, et al. Maternal vitamin A supplementation and lung function in offspring. N Engl J Med 2010;362:1784–94.