Global Child Health

Significant Accomplishments

Largest Dose Most Effective for Mothers and Infants in Middle East Vitamin D Study

Adekunle Dawodu, MBBS, has completed the first randomized controlled trial of daily vitamin D supplementation in pregnant Arab women, who are reported to have high prevalence of vitamin D deficiency. His group investigated whether high doses were superior to currently recommended 400 IU/day for optimizing vitamin D status of mothers and their infants at birth. The project measured blood vitamin levels during pregnancy and at delivery in 192 women who were randomly assigned to either 400, 2000 or 4000 IU/day vitamin D3 at approximately 12 weeks of pregnancy and followed monthly until delivery. Vitamin D3 doses of 4000 IU/day were more effective than 2000 IU/day in optimizing vitamin D status in mothers and their newborn infants. There were no safety concerns during the study. The results indicate that the currently recommended vitamin D intake for pregnant women in the US is inadequate to prevent vitamin D deficiency in the majority of pregnant women in this study. The study has provided valuable new information for designing future larger studies to assess the effect of vitamin supplementation in populations with similar high prevalence of vitamin D deficiency.

Vaccine Increases Influenza A Antibody Levels in Human Milk

Colleagues in Bangladesh with Elizabeth Schlaudecker, MD, MPH, and Mark Steinhoff, MD, demonstrated that influenza-specific IgA levels in breast milk were significantly higher for at least 6 months postpartum among mothers receiving influenza vaccines during pregnancy compared to a control group that received pneumococcal vaccines. The team also showed that the influenza virus neutralization effect of breast milk was greater in mothers who received influenza vaccine. Greater exclusivity of breastfeeding in the first 6 months of life also significantly decreased the expected number of respiratory illness with fever episodes in infants of influenza-vaccinated mothers, but not in infants of pneumococcal-vaccinated mothers.

Study in China Evaluates Medical Cost Burden of RSV Infections

Expanding on a previous evaluation of the epidemiology of laboratory-proven influenza in children hospitalized in Suzhou, China, Steven Black, MD, and Mark Steinhoff, MD collaborated with investigators at Fudan University in Shanghai and Suzhou Children’s Hospital to evaluate the epidemiology and medical costs of children hospitalized for respiratory syncytial virus (RSV) infections. RSV was a significant cause of hospitalization in children with rates much higher than for influenza. Medical costs, when put in the context of income levels in Suzhou, represented a significant economic burden to parents. This is one of the first population-based studies of in hospitalized children in the People's Republic of China and the first study to evaluate the economic burden of this disease.