Vitamin A and D intake in pregnancy, infant supplementation, and asthma development: the Norwegian Mother and Child Cohort

Christine L. Parr*, Maria C. Magnus, Karlstad Øystein, Kristin Holvik, Nicolai A. Lund-Blix, Margareta Haugen, Christian M. Page, Per Nafstad, Per M. Ueland, Stephanie J. London, Siri E. Håberg, Wenche Nystad

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)peer-review

7 Citations (Scopus)
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Background: Western diets may provide excess Vitamin A, which is potentially toxic and could adversely affect respiratory health and counteract benefits from vitamin D. Objective The aim of this study was to examine child asthma at age 7 y in relation to maternal intake of vitamins A and D during pregnancy, infant supplementation with these vitamins, and their potential interaction. Design We studied 61,676 school-Age children (born during 2002-2007) from the Norwegian Mother and Child Cohort with data on maternal total (food and supplement) nutrient intake in pregnancy (food-frequency questionnaire validated against biomarkers) and infant supplement use at age 6 mo (n = 54,142 children). Linkage with the Norwegian Prescription Database enabled near-complete follow-up (end of second quarter in 2015) for dispensed medications to classify asthma. We used log-binomial regression to calculate adjusted RRs (aRRs) for asthma with 95% CIs. Results Asthma increased according to maternal intake of total Vitamin A [retinol activity equivalents (RAEs)] in the highest (≥2031 RAEs/d) compared with the lowest (≤779 RAEs/d) quintile (aRR: 1.21; 95% CI: 1.05, 1.40) and decreased for total vitamin D in the highest (≥13.6 μg/d) compared with the lowest (≤3.5 μg/d) quintile (aRR: 0.81; 95% CI: 0.67, 0.97) during pregnancy. No association was observed for maternal intake in the highest quintiles of both nutrients (aRR: 0.99; 95% CI: 0.83, 1.18) and infant supplementation with vitamin D or cod liver oil. Conclusions Excess Vitamin A (≥2.5 times the recommended intake) during pregnancy was associated with increased risk, whereas vitamin D intake close to recommendations was associated with a reduced risk of asthma in school-Age children. No association for high intakes of both nutrients suggests antagonistic effects of vitamins A and D. This trial was registered at as NCT03197233.

Original languageEnglish
Pages (from-to)789-798
Number of pages10
JournalAmerican Journal of Clinical Nutrition
Issue number5
Early online date20 Apr 2018
Publication statusPublished - May 2018


  • dietary supplements
  • food-frequency questionnaire
  • infants
  • Norwegian Mother and Child Cohort
  • Norwegian Prescription Database
  • pediatric asthma
  • pregnant women
  • prescriptions
  • Vitamin A
  • Vitamin D

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