human
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background Observational studies suggest high prenatal vitamin D intake may be associated with reduced childhood wheezing .  We examined the effect of prenatal vitamin D on childhood wheezing  in an interventional study . Methods We r and omised 180 pregnant women at 27 weeks gestation to either  no vitamin D , 800 IU ergocalciferol daily until delivery or single oral bolus of 200,000 IU cholecalciferol  , in an ethnically stratified , r and omised controlled trial . Supplementation improved but did not optimise vitamin D status . Research ers blind to allocation assessed offspring at 3 years . Primary outcome was any history of wheeze assessed by vali date d question naire . Secondary outcomes included atopy , respiratory infection , impulse oscillometry and exhaled nitric oxide . Primary analyses used logistic and linear regression . Results We evaluated 158 of 180 ( 88 % ) offspring at age 3 years for the primary outcome . Atopy was assessed by skin test for 95 children ( 53 % ) , serum IgE for 86 ( 48 % ) , exhaled nitric oxide for 62 ( 34 % ) and impulse oscillometry of acceptable quality for 51 ( 28 % ) . We found no difference between supplemented and control groups in risk of wheeze  [ no vitamin D : 14/50 ( 28 % ) ; any vitamin D : 26/108 ( 24 % ) ( risk ratio 0.86 ; 95 % confidence interval 0.49 , 1.50 ; P = 0.69 ) ] . There was no significant difference in atopy , eczema risk , lung function or exhaled nitric oxide between supplemented groups and controls . Conclusion Prenatal vitamin D supplementation in late pregnancy that had a modest effect on cord blood vitamin D level , was not associated with decreased wheezing in offspring at age three years . Trial Registration Controlled-Trials.com IS RCT OBJECTIVE : To determine the vitamin D dose necessary to achieve serum 25-hydroxyvitamin D ( 25(OH)D ) concentration ≥20 ng/mL during infancy . METHODS : A r and omized , double-blind , placebo-controlled trial in New Zeal and . Pregnant mothers , from 27 weeks ’ gestation to birth , and then their infants , from birth to age 6 months , were r and omly assigned to 1 of 3 mother/infant groups : placebo/placebo , vitamin D3 1000/400 IU , or vitamin D3 2000/800 IU . Serum 25(OH)D and calcium concentrations were measured at enrollment , 36 weeks ’ gestation , in cord blood , and in infants at 2 , 4 , and 6 months of age . RESULTS : Two-hundred- and -sixty pregnant women were r and omized . At enrollment , the proportions with serum 25(OH)D ≥20 ng/mL for placebo , lower-dose , and higher-dose groups were 54 % , 64 % , and 55 % , respectively . The proportion with 25(OH)D ≥20 ng/mL was larger in both intervention groups at 36 weeks ’ gestation ( 50 % , 91 % , 89 % , P < .001 ) . In comparison with placebo , the proportion of infants with 25(OH)D ≥20 ng/mL was larger in both intervention groups to age 4 months : cord blood ( 22 % , 72 % , 71 % , P < .001 ) , 2 months ( 50 % , 82 % , 92 % , P < .001 ) , and 4 months ( 66 % , 87 % , 87 % , P = .004 ) , but only in the higher-dose group at age 6 months ( 74 % , 82 % , 89 % , P = .07 ; higher dose versus placebo P = .03 , lower dose versus placebo P = .21 ) . CONCLUSIONS : Daily vitamin D supplementation during pregnancy and then infancy with 1000/400 IU or 2000/800 IU increases the proportion of infants with 25(OH)D ≥20 ng/mL , with the higher dose sustaining this increase for longer There is intense interest in the role of vitamin D in the development of asthma and allergies . However , studies differ on whether a higher vitamin D intake or status in pregnancy or at birth is protective against asthma and allergies . To address this uncertainty , the Vitamin D Antenatal Asthma Reduction Trial ( VDAART ) was developed . VDAART is a r and omized , double-blind , placebo-controlled trial of vitamin D supplementation  in pregnant women to determine whether prenatal supplementation can prevent the development of  asthma and allergies in women 's offspring . A secondary aim is to determine whether vitamin D supplementation can prevent the development of pregnancy complications , such as preeclampsia , preterm birth , and gestational diabetes .  Women were r and omized to the treatment arm of 4000IU/day of vitamin D3 plus a daily multivitamin that contained 400IU of vitamin D3 or the placebo arm of placebo plus a multivitamin that contained 400IU daily of vitamin D3 . Women who were between the gestational ages of 10 and 18 weeks were r and omized from three clinical centers across the United States - Boston Medical Center , Washington University in St. Louis , and Kaiser Permanente Southern California Region ( San Diego , CA ) . Supplementation took place throughout pregnancy . Monthly monitoring of urinary calcium to creatinine ratio was performed in addition to medical record review for adverse events . Offspring are being evaluated quarterly through question naires and yearly during in-person visits until the 3rd birthday of the child . Ancillary studies will investigate neonatal T-regulatory cell function , maternal vaginal flora , and maternal and child intestinal flora Aim / Background : Vitamin D supplementation during pregnancy is a well-accepted recommendation worldwide ; however , the debate about the correct dose is ongoing . We aim ed to compare daily doses of 600 , 1,200 , and 2,000 IU in this r and omized , controlled study . Methods : The study group consisted of 91 pregnant women aged 16 - 42 years admitted to Kocaeli Maternity and Children Hospital between April 2011 and April 2012 . The participants were r and omly divided into 3 groups . 600 , 1,200 , and 2,000 IU/day of vitamin D was supplemented to group 1 ( control group , n = 31 ) , group 2 ( n = 31 ) , and group 3 ( n = 32 ) , respectively . Serum calcium , 25-hydroxyvitamin D ( 25OHD ) , and the calcium/creatinine ratio in spot urine sample s were measured in the follow-up period . The serum calcium and 25OHD levels of the mothers ' infants were measured as well . Results : The frequency of vitamin D sufficiency after supplementation was 80 % in group 3 and it was significantly higher than in groups 1 ( 42 % ) and 2 ( 39 % ) ( p = 0.03 ) . The frequency of vitamin D sufficiency in the infants of the participants was 91 % in group 3 and it was significantly higher than in groups 1 ( 36 % ) and 2 ( 52 % ) ( p = 0.006 ) . Conclusions : At least 2,000 IU/day of vitamin D is needed to ensure adequate vitamin D status in pregnancy and early infancy Background : To prevent preeclampsia , the WHO recommends antenatal calcium supplementation in population s with inadequate habitual intake . The WHO recommends 1500 - 2000 mg Ca/d with iron-folic acid ( IFA ) taken separately , a complex pill-taking regimen . Objective : The objective of this study was to test the hypothesis that simpler regimens with lower daily dosages would lead to higher adherence and similar supplement intake . Methods : In the Micronutrient Initiative Calcium Supplementation study , we compared the mean daily supplement intake associated with 2 dosing regimens with the use of a parallel , cluster-r and omized noninferiority trial implemented in 16 primary health care facilities in rural Kenya . The st and ard regimen was 3 × 500 mg Ca/d in 3 pill-taking events , and the low-dose regimen was 2 × 500 mg Ca/d in 2 pill-taking events ; both regimens included a 200 IU cholecalciferol and calcium pill and a separate IFA pill . We enrolled 990 pregnant women between 16 and 30 wk of gestation . The primary outcome was supplemental calcium intake measured by pill counts 4 and 8 wk after recruitment . We carried out intention-to-treat analyses with the use of mixed-effect models , with regimen as the fixed effect and health care facilities as a r and om effect , by using a noninferiority margin of 125 mg Ca/d . Results : Women in facilities assigned to the st and ard regimen consumed a mean of 1198 mg Ca/d , whereas those assigned to the low-dose regimen consumed 810 mg Ca/d . The difference in intake was 388 mg Ca/d ( 95 % CI = 341 , 434 mg Ca/d ) , exceeding the prespecified margin of 125 mg Ca/d . The overall adherence rate was 80 % and did not differ between study arms . Conclusions : Contrary to our expectation , a simpler , lower-dose regimen led to significantly lower supplement intake than the regimen recommended by the WHO . Further studies are needed to precisely characterize the dose-response relation of calcium supplementation and preeclampsia risk and to examine cost effectiveness of lower and simpler regimens in program setting s. This trial was registered at clinical trials.gov as NCT02238704 Objective To identify the combined effect of prenatal and postnatal vitamin D3 supplementation on the vitamin D status of pregnant and lactating women and their exclusively breastfed infants . Design Double‐blind , r and omized controlled trial . Setting Upper Midwestern U.S. , hospital‐based obstetric practice . Participants Pregnant women ( N = 13 ) planning to exclusively breastfeed were r and omized at 24 to 28 weeks gestation to receive vitamin D3 at a dosage of 400 IU ( control group , n = 6 ) or 3,800 IU ( intervention group , n = 7 ) daily through 4 to 6 weeks postpartum . Vitamin D status was determined at enrollment and in mother – infant dyads at 24 to 72 hours after birth and 4 to 6 weeks postpartum . Methods Serum 25‐hydroxyvitamin D levels were measured to determine the effect of vitamin D3 supplementation on the vitamin D status of mothers and infants . Analysis of covariance was used to compare differences in 25‐hydroxyvitamin D levels between the control and intervention groups . Results The mothers ’ vitamin D levels were significantly higher in the intervention group than in the control group at birth ( p = .044 ) and at 4 to 6 weeks postpartum ( p = .002 ) . Infants in the intervention group had significantly higher vitamin D levels at birth ( p = .021 ) and nonsignificant , clinical ly relevant increases at 4 to 6 weeks of age ( p = .256 ) . No differences were found between maternal groups in serum calcium or parathyroid hormone levels . Conclusion Prenatal to postpartum vitamin D3 supplementation is an effective intervention to increase a mother ’s vitamin D status and to promote optimal vitamin D status in newborns and exclusively breastfed infants BACKGROUND Low vitamin D status in pregnancy was proposed as a risk factor of  preeclampsia  . METHODS We assessed the effect of vitamin D supplementation ( 4,400 vs. 400 IU/day ) , initiated early in pregnancy ( 10 - 18 weeks ) , on the development of preeclampsia . The effects of serum vitamin D ( 25-hydroxyvitamin D [ 25OHD ] ) levels on preeclampsia incidence at trial entry and in the third trimester ( 32 - 38 weeks ) were studied . We also conducted a nested case-control study of 157 women to investigate peripheral blood vitamin D-associated gene expression profiles at 10 to 18 weeks in 47 participants who developed preeclampsia . RESULTS Of 881 women r and omized , outcome data were available for 816 , with 67 ( 8.2 % ) developing preeclampsia . There was no significant difference between treatment ( N = 408 ) or control ( N = 408 ) groups in the incidence of preeclampsia ( 8.08 % vs. 8.33 % , respectively ; relative risk : 0.97 ; 95 % CI , 0.61 - 1.53 ) . However , in a cohort analysis and after adjustment for confounders , a significant effect of sufficient vitamin D status ( 25OHD ≥30 ng/ml ) was observed in both early and late pregnancy compared with insufficient levels ( 25OHD < 30 ng/ml ) ( adjusted odds ratio , 0.28 ; 95 % CI , 0.10 - 0.96 ) . Differential 
    Output:
    
agent
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background Observational studies suggest high prenatal vitamin D intake may be associated with reduced childhood wheezing .  We examined the effect of prenatal vitamin D on childhood wheezing  in an interventional study . Methods We r and omised 180 pregnant women at 27 weeks gestation to either  no vitamin D , 800 IU ergocalciferol daily until delivery or single oral bolus of 200,000 IU cholecalciferol  , in an ethnically stratified , r and omised controlled trial . Supplementation improved but did not optimise vitamin D status . Research ers blind to allocation assessed offspring at 3 years . Primary outcome was any history of wheeze assessed by vali date d question naire . Secondary outcomes included atopy , respiratory infection , impulse oscillometry and exhaled nitric oxide . Primary analyses used logistic and linear regression . Results We evaluated 158 of 180 ( 88 % ) offspring at age 3 years for the primary outcome . Atopy was assessed by skin test for 95 children ( 53 % ) , serum IgE for 86 ( 48 % ) , exhaled nitric oxide for 62 ( 34 % ) and impulse oscillometry of acceptable quality for 51 ( 28 % ) . We found no difference between supplemented and control groups in risk of wheeze  [ no vitamin D : 14/50 ( 28 % ) ; any vitamin D : 26/108 ( 24 % ) ( risk ratio 0.86 ; 95 % confidence interval 0.49 , 1.50 ; P = 0.69 ) ] . There was no significant difference in atopy , eczema risk , lung function or exhaled nitric oxide between supplemented groups and controls . Conclusion Prenatal vitamin D supplementation in late pregnancy that had a modest effect on cord blood vitamin D level , was not associated with decreased wheezing in offspring at age three years . Trial Registration Controlled-Trials.com IS RCT OBJECTIVE : To determine the vitamin D dose necessary to achieve serum 25-hydroxyvitamin D ( 25(OH)D ) concentration ≥20 ng/mL during infancy . METHODS : A r and omized , double-blind , placebo-controlled trial in New Zeal and . Pregnant mothers , from 27 weeks ’ gestation to birth , and then their infants , from birth to age 6 months , were r and omly assigned to 1 of 3 mother/infant groups : placebo/placebo , vitamin D3 1000/400 IU , or vitamin D3 2000/800 IU . Serum 25(OH)D and calcium concentrations were measured at enrollment , 36 weeks ’ gestation , in cord blood , and in infants at 2 , 4 , and 6 months of age . RESULTS : Two-hundred- and -sixty pregnant women were r and omized . At enrollment , the proportions with serum 25(OH)D ≥20 ng/mL for placebo , lower-dose , and higher-dose groups were 54 % , 64 % , and 55 % , respectively . The proportion with 25(OH)D ≥20 ng/mL was larger in both intervention groups at 36 weeks ’ gestation ( 50 % , 91 % , 89 % , P < .001 ) . In comparison with placebo , the proportion of infants with 25(OH)D ≥20 ng/mL was larger in both intervention groups to age 4 months : cord blood ( 22 % , 72 % , 71 % , P < .001 ) , 2 months ( 50 % , 82 % , 92 % , P < .001 ) , and 4 months ( 66 % , 87 % , 87 % , P = .004 ) , but only in the higher-dose group at age 6 months ( 74 % , 82 % , 89 % , P = .07 ; higher dose versus placebo P = .03 , lower dose versus placebo P = .21 ) . CONCLUSIONS : Daily vitamin D supplementation during pregnancy and then infancy with 1000/400 IU or 2000/800 IU increases the proportion of infants with 25(OH)D ≥20 ng/mL , with the higher dose sustaining this increase for longer There is intense interest in the role of vitamin D in the development of asthma and allergies . However , studies differ on whether a higher vitamin D intake or status in pregnancy or at birth is protective against asthma and allergies . To address this uncertainty , the Vitamin D Antenatal Asthma Reduction Trial ( VDAART ) was developed . VDAART is a r and omized , double-blind , placebo-controlled trial of vitamin D supplementation  in pregnant women to determine whether prenatal supplementation can prevent the development of  asthma and allergies in women 's offspring . A secondary aim is to determine whether vitamin D supplementation can prevent the development of pregnancy complications , such as preeclampsia , preterm birth , and gestational diabetes .  Women were r and omized to the treatment arm of 4000IU/day of vitamin D3 plus a daily multivitamin that contained 400IU of vitamin D3 or the placebo arm of placebo plus a multivitamin that contained 400IU daily of vitamin D3 . Women who were between the gestational ages of 10 and 18 weeks were r and omized from three clinical centers across the United States - Boston Medical Center , Washington University in St. Louis , and Kaiser Permanente Southern California Region ( San Diego , CA ) . Supplementation took place throughout pregnancy . Monthly monitoring of urinary calcium to creatinine ratio was performed in addition to medical record review for adverse events . Offspring are being evaluated quarterly through question naires and yearly during in-person visits until the 3rd birthday of the child . Ancillary studies will investigate neonatal T-regulatory cell function , maternal vaginal flora , and maternal and child intestinal flora Aim / Background : Vitamin D supplementation during pregnancy is a well-accepted recommendation worldwide ; however , the debate about the correct dose is ongoing . We aim ed to compare daily doses of 600 , 1,200 , and 2,000 IU in this r and omized , controlled study . Methods : The study group consisted of 91 pregnant women aged 16 - 42 years admitted to Kocaeli Maternity and Children Hospital between April 2011 and April 2012 . The participants were r and omly divided into 3 groups . 600 , 1,200 , and 2,000 IU/day of vitamin D was supplemented to group 1 ( control group , n = 31 ) , group 2 ( n = 31 ) , and group 3 ( n = 32 ) , respectively . Serum calcium , 25-hydroxyvitamin D ( 25OHD ) , and the calcium/creatinine ratio in spot urine sample s were measured in the follow-up period . The serum calcium and 25OHD levels of the mothers ' infants were measured as well . Results : The frequency of vitamin D sufficiency after supplementation was 80 % in group 3 and it was significantly higher than in groups 1 ( 42 % ) and 2 ( 39 % ) ( p = 0.03 ) . The frequency of vitamin D sufficiency in the infants of the participants was 91 % in group 3 and it was significantly higher than in groups 1 ( 36 % ) and 2 ( 52 % ) ( p = 0.006 ) . Conclusions : At least 2,000 IU/day of vitamin D is needed to ensure adequate vitamin D status in pregnancy and early infancy Background : To prevent preeclampsia , the WHO recommends antenatal calcium supplementation in population s with inadequate habitual intake . The WHO recommends 1500 - 2000 mg Ca/d with iron-folic acid ( IFA ) taken separately , a complex pill-taking regimen . Objective : The objective of this study was to test the hypothesis that simpler regimens with lower daily dosages would lead to higher adherence and similar supplement intake . Methods : In the Micronutrient Initiative Calcium Supplementation study , we compared the mean daily supplement intake associated with 2 dosing regimens with the use of a parallel , cluster-r and omized noninferiority trial implemented in 16 primary health care facilities in rural Kenya . The st and ard regimen was 3 × 500 mg Ca/d in 3 pill-taking events , and the low-dose regimen was 2 × 500 mg Ca/d in 2 pill-taking events ; both regimens included a 200 IU cholecalciferol and calcium pill and a separate IFA pill . We enrolled 990 pregnant women between 16 and 30 wk of gestation . The primary outcome was supplemental calcium intake measured by pill counts 4 and 8 wk after recruitment . We carried out intention-to-treat analyses with the use of mixed-effect models , with regimen as the fixed effect and health care facilities as a r and om effect , by using a noninferiority margin of 125 mg Ca/d . Results : Women in facilities assigned to the st and ard regimen consumed a mean of 1198 mg Ca/d , whereas those assigned to the low-dose regimen consumed 810 mg Ca/d . The difference in intake was 388 mg Ca/d ( 95 % CI = 341 , 434 mg Ca/d ) , exceeding the prespecified margin of 125 mg Ca/d . The overall adherence rate was 80 % and did not differ between study arms . Conclusions : Contrary to our expectation , a simpler , lower-dose regimen led to significantly lower supplement intake than the regimen recommended by the WHO . Further studies are needed to precisely characterize the dose-response relation of calcium supplementation and preeclampsia risk and to examine cost effectiveness of lower and simpler regimens in program setting s. This trial was registered at clinical trials.gov as NCT02238704 Objective To identify the combined effect of prenatal and postnatal vitamin D3 supplementation on the vitamin D status of pregnant and lactating women and their exclusively breastfed infants . Design Double‐blind , r and omized controlled trial . Setting Upper Midwestern U.S. , hospital‐based obstetric practice . Participants Pregnant women ( N = 13 ) planning to exclusively breastfeed were r and omized at 24 to 28 weeks gestation to receive vitamin D3 at a dosage of 400 IU ( control group , n = 6 ) or 3,800 IU ( intervention group , n = 7 ) daily through 4 to 6 weeks postpartum . Vitamin D status was determined at enrollment and in mother – infant dyads at 24 to 72 hours after birth and 4 to 6 weeks postpartum . Methods Serum 25‐hydroxyvitamin D levels were measured to determine the effect of vitamin D3 supplementation on the vitamin D status of mothers and infants . Analysis of covariance was used to compare differences in 25‐hydroxyvitamin D levels between the control and intervention groups . Results The mothers ’ vitamin D levels were significantly higher in the intervention group than in the control group at birth ( p = .044 ) and at 4 to 6 weeks postpartum ( p = .002 ) . Infants in the intervention group had significantly higher vitamin D levels at birth ( p = .021 ) and nonsignificant , clinical ly relevant increases at 4 to 6 weeks of age ( p = .256 ) . No differences were found between maternal groups in serum calcium or parathyroid hormone levels . Conclusion Prenatal to postpartum vitamin D3 supplementation is an effective intervention to increase a mother ’s vitamin D status and to promote optimal vitamin D status in newborns and exclusively breastfed infants BACKGROUND Low vitamin D status in pregnancy was proposed as a risk factor of  preeclampsia  . METHODS We assessed the effect of vitamin D supplementation ( 4,400 vs. 400 IU/day ) , initiated early in pregnancy ( 10 - 18 weeks ) , on the development of preeclampsia . The effects of serum vitamin D ( 25-hydroxyvitamin D [ 25OHD ] ) levels on preeclampsia incidence at trial entry and in the third trimester ( 32 - 38 weeks ) were studied . We also conducted a nested case-control study of 157 women to investigate peripheral blood vitamin D-associated gene expression profiles at 10 to 18 weeks in 47 participants who developed preeclampsia . RESULTS Of 881 women r and omized , outcome data were available for 816 , with 67 ( 8.2 % ) developing preeclampsia . There was no significant difference between treatment ( N = 408 ) or control ( N = 408 ) groups in the incidence of preeclampsia ( 8.08 % vs. 8.33 % , respectively ; relative risk : 0.97 ; 95 % CI , 0.61 - 1.53 ) . However , in a cohort analysis and after adjustment for confounders , a significant effect of sufficient vitamin D status ( 25OHD ≥30 ng/ml ) was observed in both early and late pregnancy compared with insufficient levels ( 25OHD < 30 ng/ml ) ( adjusted odds ratio , 0.28 ; 95 % CI , 0.10 - 0.96 ) . Differential 
    Output:
    