Effect of Maternal Vitamin D Supplementation During Pregnancy and Lactation on Early Infant Nasal Pneumococcal Carriage in Bangladesh (P10-125-19)
Bibliographic record
Abstract
To estimate the dose-dependent effects of maternal vitamin D3 (VD) supplementation during pregnancy and lactation on the risk of first nasal pneumococcal colonization (PnC) and the dynamics of nasal pneumococcal (Pn) carriage in infants from birth to 6 months (mos) of age in Dhaka, Bangladesh. Infants born to mothers who received weekly VD doses in one of 4 pre/post-partum dose combinations or placebo as part of the Maternal Vitamin D Supplementation during Pregnancy and Lactation to Prevent Acute Respiratory Illness (MDARI) study, were monitored from 0–6 mos for signs of an acute respiratory infection (ARI). A nasal swab was performed to obtain a sample of nasal epithelial tissue if the infant met pre-set ARI criteria. Nasal PnC was detected by qPCR. The effect of VD on the risk of first observed PnC was estimated by an interval-censored survival model. A multi-state model was used to characterize the dynamics of Pn carriage using transition probabilities of state changes. Of 1060 infants in MDARI, PnC was observed in 90% during the first 6 mos of life with 69% of swabs being positive (n = 3792). There was no significant difference between any VD group and placebo on the risk of initial nasal PnC (Table 1). Overall, the predicted median time to colonization was 7 weeks. Transitioning between positive and negative episodes was common: among 949 infants who were ever positive, 238 (25%) were observed to revert to negative during the first 6 mos of life, of whom 99 (40%) had at least one additional positive swab. Across all groups, an infant was predicted to spend 69 days negative and 120 days positive during the first 6 mos; yet, no Pn dynamics differed significantly across treatment groups (P >0.05). PnC and Pn dynamics were associated with season of birth, parental education and number of siblings, but were not associated with infant characteristics including anthropometric parameters. These results do not provide evidence supporting an effect of VD on infants’ risk of first nasal PnC nor the dynamics of carriage in a setting where early infant PnC is highly probable. In contrast to in vitro data that demonstrated that VD promoted immune responses against pneumococcus, the present study does not support the hypothesis that improvements in VD status in early infancy reduces the risk of Pn colonization. Bill & Melinda Gates Foundation.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".