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Maternal and neonatal blood vitamin D status and neurodevelopment at 24 months of age: a prospective birth cohort study

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Abstract

Background

This study aimed to explore the relationship of 25-hydroxyvitamin D [25(OH)D] in three trimesters and at birth with neurodevelopment at 24 months of age.

Methods

From 2013 to 2016, pregnant women from the Shanghai Birth Cohort in China were recruited for the study. Altogether, 649 mother-infant pairs were included. Serum 25(OH)D was measured with mass spectrometry in three trimesters, and cord blood was divided into deficiency (< 20 and < 12 ng/mL, respectively), insufficiency (20–30 and 12–20 ng/mL, respectively), and sufficiency (≥ 30 and ≥ 20 ng/mL, respectively). Bayley-III scale was used to assess cognitive, language, motor, social-emotional, and adaptive behavior development at 24 months of age. The Bayley-III scores were grouped into quartiles, and scores within the lowest quartile were defined as suboptimal development.

Results

After adjusting for confounding factors, cord blood 25(OH)D in the sufficient group was positively correlated with cognitive [β = 11.43, 95% confidence interval (CI) = 5.65–17.22], language (β = 6.01, 95% CI = 1.67–10.3), and motor scores (β = 6.43, 95% CI = 1.73–11.1); cord blood 25(OH)D in the insufficient group was also positively correlated with cognitive scores (β = 9.42, 95% CI = 3.74–15.11). Additionally, sufficient vitamin D status in the four periods and persistent 25(OH)D ≥ 30 ng/mL throughout pregnancy were associated with a lower risk of suboptimal cognitive development in adjusted models, although the effects were attenuated after applying the false discovery rate adjustment.

Conclusions

Cord blood 25(OH)D ≥ 12 ng/mL has a significant positive association with cognitive, language, and motor development at 24 months of age. Sufficient vitamin D status in pregnancy might be a protective factor for suboptimal neurocognition development at 24 months of age.

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Data availability

The data that support the findings of this study are available from the corresponding author upon reasonable request.

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Acknowledgements

We are extremely grateful to all the families who took part in this study. And we would like to thank the doctors, midwives, and nurses involved in our study for patient management.

Funding

This work was supported by the National Key Research and Development Program of China (No. 2022YFC2705203), the National Natural Science Foundation of China (No. 81773411), the Special Program for Women and Children Health (No. 2020YJZX0212), Shanghai Municipal Education Commission-Gaofeng Clinical Medicine Grant Support (No. 20152220), the Cultivation Project of Clinical Research from SCMC (No. LY-SCMC2020-06), Shanghai Children’s Health Services Capacity Program (No. GDEK201708), the Key Program for Clinical Nutrition (No. 2019ZB0103) from Shanghai Municipal Health Commission. The funding agencies played no role in the design, analyses, or interpretation of this study.

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Authors and Affiliations

  1. Department of Developmental and Behavioral Pediatrics, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China

    Yue Zhang, Xi-Rui Wang, Luan-Luan Li, Chen Chen & Xiao-Dan Yu

  2. Translational Medicine Institute, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China

    Chun-Yan Zhou

  3. MOE-Shanghai Key Lab of Children’s Environmental Health, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200092, China

    Xian-Ting Jiao, Jun Zhang, Ying Tian & Xiao-Dan Yu

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  1. Yue Zhang
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Contributions

ZY, ZCY, and WXR contributed equally to this work. YXD conceived of the research idea and designed the study, revised and supervised the manuscript. ZY performed 25(OH)D measurements, analyzed the data and performed the statistical analysis, and drafted the manuscript. ZCY performed 25(OH)D measurements and drafted the manuscript. WXR analyzed the data and performed the statistical analysis, and drafted the manuscript. JXT performed 25(OH)D measurements. ZJ and TY conceived of the research idea and designed the study. LLL and CC performed 25(OH)D measurements. All the authors read and approved the final manuscript.

Corresponding author

Correspondence to Xiao-Dan Yu.

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Ethical approval

The study was approved by the Medical Ethics Committee of Shanghai XinHua Hospital affiliated to Shanghai Jiao Tong University School of Medicine (XHEC-C-3–001-3) and written informed consents were obtained from all participants.

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All authors declare no conflict of interest.

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Zhang, Y., Zhou, CY., Wang, XR. et al. Maternal and neonatal blood vitamin D status and neurodevelopment at 24 months of age: a prospective birth cohort study. World J Pediatr 19, 883–893 (2023). https://doi.org/10.1007/s12519-022-00682-7

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