Ding Liwen, Zhang Maolin, Strodl Esben, Yin Xiaona, Wen Guomin, Sun Dengli, Xian Danxia, Zhao Yafen, Zheng Yuxing, Liu Feitong, Hu Ruibiao, Zhao Lingling, Yang Weikang, Chen Weiqing
Department of Epidemiology and Health Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China.
School of Psychology and Counselling, Queensland University of Technology, Brisbane, QLD, Australia.
Front Nutr. 2025 May 21;12:1614820. doi: 10.3389/fnut.2025.1614820. eCollection 2025.
Neurobehavioral developmental disorder (NDD) significantly impact children's long-term wellbeing and contribute to global disease burden. While prenatal micronutrient supplementation has shown promise in improving fetal neurodevelopment, its association with offspring's neurobehavioral outcomes remains controversial, and the potential effect of early childhood probiotic intake on this association is still underexplored. This study aimed to evaluate the association between prenatal micronutrient supplementation and neurobehavioral development in preschool children, and to explore and quantify the effect of early childhood probiotic intake on this association.
We included 15,636 mother-child dyads in Shenzhen, China, in 2022. Mothers provided information on prenatal micronutrient supplementation (calcium, folic acid, iron, and multivitamins) and early childhood probiotic intake through a structured questionnaire. Neurobehavioral development was assessed using the Ages and Stages Questionnaire (ASQ-3). Logistic regression was used to examine the association between prenatal micronutrient supplementation and NDD across crude, adjusted, and full-inclusion models. The effect of early childhood probiotic intake on the association between prenatal micronutrient supplementation and NDD was evaluated through four-way decomposition analysis and quantified using counterfactual attribution under three scenarios.
Among the participants, 11.7% were identified with NDD. Prenatal multivitamin supplementation was significantly associated with a reduced risk of NDD (OR = 0.73, 95% CI = 0.66-0.81). Early childhood probiotic intake was associated with an enhanced protective effect (Total EOR = -0.33, 95% CI = -0.54 to -0.12), with 48% of the effect attributable to interactions. Early childhood probiotic intake could prevent an additional 73 NDD cases (a 59% increase), particularly benefiting the gross motor, fine motor and personal-social domains.
Prenatal multivitamin supplementation has a protective effect against NDD in preschool children, and early childhood probiotic intake is associated with an enhancement of this protective effect. These findings underscore the potential effect of early-life dietary supplements for NDD prevention. Further studies are recommended to confirm these effects and explore underlying mechanisms.
神经行为发育障碍（NDD）对儿童的长期幸福有着重大影响，并加重了全球疾病负担。虽然产前补充微量营养素已显示出改善胎儿神经发育的前景，但其与后代神经行为结果的关联仍存在争议，而且幼儿期摄入益生菌对这种关联的潜在影响仍未得到充分研究。本研究旨在评估产前补充微量营养素与学龄前儿童神经行为发育之间的关联，并探索和量化幼儿期摄入益生菌对这种关联的影响。
2022年，我们纳入了中国深圳的15636对母婴。母亲们通过结构化问卷提供了产前微量营养素补充（钙、叶酸、铁和多种维生素）以及幼儿期益生菌摄入的信息。使用年龄与发育阶段问卷（ASQ-3）评估神经行为发育。在粗模型、调整模型和全纳入模型中，采用逻辑回归来检验产前微量营养素补充与NDD之间的关联。通过四向分解分析评估幼儿期益生菌摄入对产前微量营养素补充与NDD之间关联的影响，并在三种情景下使用反事实归因进行量化。
在参与者中，11.7%被确定患有NDD。产前补充多种维生素与NDD风险降低显著相关（OR = 0.73，95%CI = 0.66 - 0.81）。幼儿期摄入益生菌与增强的保护作用相关（总效应比 = -0.33，95%CI = -0.54至 -0.12），其中48%的效应归因于相互作用。幼儿期摄入益生菌可额外预防73例NDD病例（增加59%），尤其有益于大运动、精细运动和个人社交领域。
产前补充多种维生素对学龄前儿童的NDD具有保护作用，幼儿期摄入益生菌与这种保护作用的增强相关。这些发现强调了生命早期膳食补充剂对预防NDD的潜在作用。建议进一步研究以证实这些作用并探索潜在机制。
