Vitamin D supplementation in pregnancy and early infancy in relation to gut microbiota composition and C. difficile colonization: implications for viral respiratory infections

doi:10.1080/19490976.2020.1799734

. 2020 Nov 9;12(1):1799734.

doi: 10.1080/19490976.2020.1799734.

Vitamin D supplementation in pregnancy and early infancy in relation to gut microbiota composition and C. difficile colonization: implications for viral respiratory infections

Kelsea M Drall¹, Catherine J Field², Andrea M Haqq^{1

2}, Russell J de Souza^{3

4}, Hein M Tun^{1

5}, Nadia P Morales-Lizcano⁶, Theodore B Konya⁶, David S Guttman^{7

8}, Meghan B Azad⁹, Allan B Becker⁹, Diana L Lefebvre¹⁰, Piush J Mandhane¹, Theo J Moraes¹¹, Malcolm R Sears¹⁰, Stuart E Turvey¹², Padmaja Subbarao^{10

11}, James A Scott⁶, Anita L Kozyrskyj^{1

13}

Affiliations

¹ Departments of Pediatrics, Obstetrics & Gynecology, University of Alberta , Edmonton, AB, Canada.
² Department of Agricultural, Food and Nutritional Science, University of Alberta , Edmonton, AB, Canada.
³ Department of Health Research Methods, Evidence, and Impact, McMaster University , Hamilton, ON, Canada.
⁴ Population Health Research Institute, McMaster University , Hamilton, ON, Canada.
⁵ HKU-Pasteur Research Pole, School of Public Health, Hong Kong University , Hong Kong SAR, China.
⁶ Dalla Lana School of Public Health, University of Toronto , Toronto, ON, Canada.
⁷ Department of Cell & Systems Biology, University of Toronto , Toronto, ON, Canada.
⁸ Centre for the Analysis of Genome Evolution & Function, University of Toronto , Toronto, ON, Canada.
⁹ Department of Pediatrics & Child Health, Children's Hospital Research Institute of Manitoba, University of Manitoba , Winnipeg, MB, Canada.
¹⁰ Department of Medicine, McMaster University , Hamilton, ON, Canada.
¹¹ Department of Pediatrics, Hospital for Sick Children, University of Toronto , Toronto, ON Canada.
¹² Department of Pediatrics, BC Children's Hospital, University of British Columbia , Vancouver, BC, Canada.
¹³ School of Public Health, University of Alberta , Edmonton, Canada.

PMID: 32779963
PMCID: PMC7524344
DOI: 10.1080/19490976.2020.1799734

Vitamin D supplementation in pregnancy and early infancy in relation to gut microbiota composition and C. difficile colonization: implications for viral respiratory infections

Kelsea M Drall et al. Gut Microbes. 2020.

. 2020 Nov 9;12(1):1799734.

doi: 10.1080/19490976.2020.1799734.

Authors

Affiliations

¹ Departments of Pediatrics, Obstetrics & Gynecology, University of Alberta , Edmonton, AB, Canada.
² Department of Agricultural, Food and Nutritional Science, University of Alberta , Edmonton, AB, Canada.
³ Department of Health Research Methods, Evidence, and Impact, McMaster University , Hamilton, ON, Canada.
⁴ Population Health Research Institute, McMaster University , Hamilton, ON, Canada.
⁵ HKU-Pasteur Research Pole, School of Public Health, Hong Kong University , Hong Kong SAR, China.
⁶ Dalla Lana School of Public Health, University of Toronto , Toronto, ON, Canada.
⁷ Department of Cell & Systems Biology, University of Toronto , Toronto, ON, Canada.
⁸ Centre for the Analysis of Genome Evolution & Function, University of Toronto , Toronto, ON, Canada.
⁹ Department of Pediatrics & Child Health, Children's Hospital Research Institute of Manitoba, University of Manitoba , Winnipeg, MB, Canada.
¹⁰ Department of Medicine, McMaster University , Hamilton, ON, Canada.
¹¹ Department of Pediatrics, Hospital for Sick Children, University of Toronto , Toronto, ON Canada.
¹² Department of Pediatrics, BC Children's Hospital, University of British Columbia , Vancouver, BC, Canada.
¹³ School of Public Health, University of Alberta , Edmonton, Canada.

PMID: 32779963
PMCID: PMC7524344
DOI: 10.1080/19490976.2020.1799734

Abstract

In Canada and the US, the infant diet is supplemented with vitamin D via supplement drops or formula. Pregnant and nursing mothers often take vitamin D supplements. Since little is known about the impact of this supplementation on infant gut microbiota, we undertook a study to determine the association between maternal and infant vitamin D supplementation, infant gut microbiota composition and Clostridioides difficile colonization in 1,157 mother-infant pairs of the CHILD (Canadian Healthy Infant Longitudinal Development) Cohort Study over 2009-2012. Logistic and MaAsLin regression were employed to assess associations between vitamin D supplementation, and C. difficile colonization, or other gut microbiota, respectively. Sixty-five percent of infants received a vitamin D supplement. Among all infants, infant vitamin D supplementation was associated with a lower abundance of genus Megamonas (q = 0.01) in gut microbiota. Among those exclusively breastfed, maternal prenatal supplementation was associated with lower abundance of Bilophila (q = 0.01) and of Lachnospiraceae (q = 0.02) but higher abundance of Haemophilus (q = 0.02). There were no differences in microbiota composition with vitamin D supplementation among partially and not breastfed infants. Neither infant nor maternal vitamin D supplementation were associated with C. difficile colonization, after adjusting for breastfeeding status and other factors. However, maternal consumption of vitamin-D fortified milk reduced the likelihood of C. difficile colonization in infants (adjustedOR: 0.40, 95% CI: 0.19-0.82). The impact of this compositional difference on later childhood health, especially defense against viral respiratory infection, may go beyond the expected effects of vitamin D supplements and remains to be ascertained.

Keywords: Bilophila; C. difficile; Megamonas; Vitamin D; gut microbiota; infant; milk; supplements.

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Figures

**Figure 1.**
*C. difficile* colonization according to maternal or infant vitamin D supplementation in the perinatal period.

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References

1. Canadian Pediatric Society . Vitamin D supplementation: recommendations for Canadian mothers and infants [Internet]. 2017. [accessed 2019 May 1]. https://www.cps.ca/en/documents/position/vitamin-d.
1. Centers for Disease Control and Prevention . Vitamin D [Internet]. [accessed 2019 May 1]. https://www.cdc.gov/breastfeeding/breastfeeding-special-circumstances/di...
1. Uday S, Kongjonaj a, Aguiar M, Tulchinsky T, Högler W.. Variations in infant and childhood vitamin D supplementation programmes across Europe and factors influencing adherence. Endocr Connect. 2017;6:667–12. - PMC - PubMed
1. Paxton GA, Teale GR, Nowson CA, Mason RS, McGrath JJ, Thompson MJ, Siafarikas a, Rodda CP, Munns CF. Vitamin D and health in pregnancy, infants, children and adolescents in Australia and New Zealand: a position statement. Med J Aust. 2013;198:142–143. - PubMed
1. Ahrens KA, Rossen LM, Simon AE. Adherence to vitamin D recommendations among US infants aged 0 to 11 Months, NHANES, 2009 to 2012. Clin Pediatr (Phila). 2016;55:555–556. - PMC - PubMed

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[1] Canadian Pediatric Society . Vitamin D supplementation: recommendations for Canadian mothers and infants [Internet]. 2017. [accessed 2019 May 1]. https://www.cps.ca/en/documents/position/vitamin-d.

[2] Canadian Pediatric Society . Vitamin D supplementation: recommendations for Canadian mothers and infants [Internet]. 2017. [accessed 2019 May 1]. https://www.cps.ca/en/documents/position/vitamin-d.

[3] Centers for Disease Control and Prevention . Vitamin D [Internet]. [accessed 2019 May 1]. https://www.cdc.gov/breastfeeding/breastfeeding-special-circumstances/di...

[4] Centers for Disease Control and Prevention . Vitamin D [Internet]. [accessed 2019 May 1]. https://www.cdc.gov/breastfeeding/breastfeeding-special-circumstances/di...

[5] Uday S, Kongjonaj a, Aguiar M, Tulchinsky T, Högler W.. Variations in infant and childhood vitamin D supplementation programmes across Europe and factors influencing adherence. Endocr Connect. 2017;6:667–12. - PMC - PubMed

[6] Uday S, Kongjonaj a, Aguiar M, Tulchinsky T, Högler W.. Variations in infant and childhood vitamin D supplementation programmes across Europe and factors influencing adherence. Endocr Connect. 2017;6:667–12. - PMC - PubMed

[7] Paxton GA, Teale GR, Nowson CA, Mason RS, McGrath JJ, Thompson MJ, Siafarikas a, Rodda CP, Munns CF. Vitamin D and health in pregnancy, infants, children and adolescents in Australia and New Zealand: a position statement. Med J Aust. 2013;198:142–143. - PubMed

[8] Paxton GA, Teale GR, Nowson CA, Mason RS, McGrath JJ, Thompson MJ, Siafarikas a, Rodda CP, Munns CF. Vitamin D and health in pregnancy, infants, children and adolescents in Australia and New Zealand: a position statement. Med J Aust. 2013;198:142–143. - PubMed

[9] Ahrens KA, Rossen LM, Simon AE. Adherence to vitamin D recommendations among US infants aged 0 to 11 Months, NHANES, 2009 to 2012. Clin Pediatr (Phila). 2016;55:555–556. - PMC - PubMed

[10] Ahrens KA, Rossen LM, Simon AE. Adherence to vitamin D recommendations among US infants aged 0 to 11 Months, NHANES, 2009 to 2012. Clin Pediatr (Phila). 2016;55:555–556. - PMC - PubMed

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Vitamin D supplementation in pregnancy and early infancy in relation to gut microbiota composition and C. difficile colonization: implications for viral respiratory infections

Affiliations

Vitamin D supplementation in pregnancy and early infancy in relation to gut microbiota composition and C. difficile colonization: implications for viral respiratory infections

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