These variables are: acetaminophen exposure, antibiotic exposure, incidence of ear infection, decreased duration of breastfeeding, and decreased consumption of oral vitamin D drops. Objective: To determine whether a set of five postnatal variables are associated with ASD. Yet, the postnatal environment may affect the risk of ASD as well. One study was funded by the New Zealand Aid Corporation one study was funded by an institutional grant and five studies were unfunded.Seth Scott Bittker, 1 Kathleen Roberta Bell 2ġInterdisciplinary Center for Innovative Theory and Empirics (INCITE), Columbia University, New York, NY, USA 2Independent Contractor, Waterloo, ON, Canadaīackground: While many studies have examined environmental risk factors for autism spectrum disorder (ASD), much of the research focus has been on prenatal or perinatal factors. The GRADE assessment found very low-quality evidence (due to serious study limitations, inconsistencies, indirectness, and imprecision) for all outcomes except time to resolution of acute illness. The effects of vitamin D on outcomes were inconclusive when compared with control: time to resolution of acute illness (hours) (mean difference (MD) -0.95, 95% confidence interval (CI) -6.14 to 4.24 3 studies 935 children low-quality evidence) mortality rate (risk ratio (RR) 0.97, 95% CI 0.06 to 15.28 1 study 193 children very low-quality evidence) duration of hospitalisation (MD 0.49, 95% CI -8.41 to 9.4 4 studies 835 children very low-quality evidence) and time to resolution of fever (MD 1.66, 95% CI -2.44 to 5.76 4 studies 584 children very low-quality evidence). One study reported microbiological and radiological diagnosis of pneumonia. Four studies used a single 100,000 IU dose of vitamin D₃ at the onset of illness or within 24 hours of hospital admission two used a daily dose of oral vitamin D₃ (1000 IU for children aged up to one year and 2000 IU for children aged over one year) for five days and one used a daily dose of oral vitamin D₃ (50,000 IU) for two days. We included seven RCTs conducted in low-income countries that involved 1529 children (780 with pneumonia and 749 with severe or very severe pneumonia). We identified problems with the study methods and reporting, resulting in lack of precision in the included studies. The quality of the evidence was very low, except for time to resolution of acute illness, which we assessed as low quality. However, there was no significant difference between groups for these outcomes. Vitamin D may slightly decrease the time taken to get better from acute pneumonia (by 60 minutes) and the risk of death, and Vitamin D may increase the length of time in hospital (by 30 minutes) and the time taken for fever to resolve (by 90 minutes). We are uncertain as to whether vitamin D has an important effect on outcomes due to the very-low quality of the evidence.
One study was funded by the New Zealand Aid Corporation one was funded by an institutional grant and five studies were unfunded. One study reported the cause of children's pneumonia. One study excluded children whose vitamin D levels were normal. In four studies, a single large dose of vitamin D was used either when the child joined the study or within 24 hours of admission to hospital in two studies, vitamin D was used for five days and in one study, vitamin D was used for two days. We included seven studies involving a total of 1529 children (780 with pneumonia (4 studies) and 749 with severe or very severe pneumonia (3 studies)) aged under 5 years from low-income countries. Vitamin D boosts immune defences and reduces excessive inflammation, effects that may help children recover from an acute episode of pneumonia. Treatment for pneumonia includes antibiotics, providing supplementary oxygen to air that is breathed in through a mask, and other supportive therapies. Pneumonia is an acute lower respiratory tract infection that affects the lungs. We wanted to find out if vitamin D helps children with acute pneumonia who are also receiving antibiotic treatment get better faster.
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