Taking fish oil and/or high-dose vitamin D supplements during pregnancy has a protective effect on childhood croup, demonstrated a randomised-controlled trial. If this finding is confirmed in other trials, 2 cheap micronutrient supplies could be efficiently used in the prevention of this common childhood respiratory disease.
Croup is a common respiratory disease among children aged 6 months to 3 years . Mostly, the disease is mild, but it can lead to hospitalisations in severe cases [2,3]. Furthermore, it has been suggested in various studies that fish oil and vitamin D play a role in the development of the immune system and lung tissue [4,5]. Dr Nicklas Brustad (University of Copenhagen, Denmark) and co-investigators designed a randomised-controlled trial to examine the influence of fish oil and vitamin D supplements during pregnancy on the incidence of childhood croup . Pregnant Danish women (n=623) were allocated to 1 of the 4 study arms:
- High-dose vitamin D (2800 IU/day) and fish oil;
- Standard-dose vitamin D (400 IU/day) and fish oil;
- High-dose vitamin D and placebo; or
- Standard-dose vitamin D and placebo.
After their birth, children were followed from age 0 to 3 years during planned visits to measure any experienced acute respiratory symptoms.
A significantly beneficial effect was observed for the intake of fish oil versus the intake of placebo on the risk of croup (11% vs 17%; HR 0.62; 95% CI 0.41–0.93; P=0.02). Interestingly, high-dose vitamin D significantly reduced the risk of croup compared with standard-dose vitamin D (11% vs 18%; HR 0.60; 95% CI 0.38–0.93; P=0.02). There was no interaction effect between the supplements on the risk of croup (Pinteraction=0.56). “Observing the Kaplan-Meier curves, we can clearly see that there is no additive effect from 1 intervention to the other, suggesting that there is a ceiling effect of the 2 interventions (see Figure),” clarified Dr Brustad.
Figure: No evidence of interaction between supplements 
n-3 LCPUFA, fish oil supplement.
In summary, this is the first randomised-controlled trial to demonstrate protective effects of both fish oil and high-dose vitamin D supplements during pregnancy on the occurrence of childhood croup.
- Bjornson CL, Johnson DW. Lancet. 2008;371:329–339.
- Bjornson CL, et al. N Engl J Med. 2004;351:1306–1313.
- Baiu I, Melendez E. JAMA. 2019;3219(16);1642.
- Hewison M. Endocrinol Metab Clin North Am. 2010;39:365–379.
- Calder PC. Lipids. 2001;36:1007–1024.
- Brustad N, et al. Fish oil and vitamin D supplementations in pregnancy protect against childhood croup. Chronic and acute lung infections in children. OA2189, ERS International Congress 2022, Barcelona, Spain, 4–6 September.
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Table of Contents: ERS 2022
Letter from the Editor
ERS 2022 Highlights Podcast
COVID-19: What Is New?
Does vilobelimab reduce mortality in severe COVID-19?
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Inhaled agent under investigation for COVID-19
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COPD: Therapies and Innovations
Icenticaftor achieves results on top of triple inhalation therapy in COPD
STARR2: A new approach for treating COPD exacerbations
COPD medication not effective in symptomatic smokers with preserved spirometry
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Hyperpolarised gas MRI ready for clinical use
All About Asthma
Tezepelumab in asthma: mucus plugging down, lung function up
Digital asthma intervention improves health and reduces costs
Digitally enhanced therapy lowers treatment burden and costs in severe asthma
Mepolizumab beneficial for patients with severe eosinophilic asthma
Progress in Paediatrics
Antibiotics cause increased risk of wheezing in severe RSV bronchiolitis
Inhaled corticosteroids useful in preterms with decreased lung function
Fish oil or vitamin D during pregnancy can prevent croup
Encouraging results of nintedanib in children with fibrosing ILD
Focus on Interventional Pulmonology
Head-to-head: lung volume reduction surgery vs endobronchial valves
Durable effect of endobronchial valves in severe emphysema
Cone beam CT-guided ENB improves detection of pulmonary nodules
Confirmatory mediastinoscopy not needed in resectable NSCLC
Sleep and Breathing Disorders
In the spotlight: Cancer trends in obstructive sleep apnoea
Impact of CPAP on cardiac endpoints in OSA
Sustained hypoxaemia predicts unprovoked VTE in OSA
CPAP therapy in the prevention of cardiovascular risk in patients with OSA
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Antifibrotic therapy may slow down FVC decline in RAILD
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New trends in cystic lung diseases
Gastroesophageal reflux, IPF and lessons learned
Interview with Prof. Christian Bergmann