Greater Gestational Vitamin D Status is Associated with Reduced Childhood Behavioral Problems in the Environmental Influences on Child Health Outcomes Program
Date
2023-05-03
Journal Title
Journal ISSN
Volume Title
Publisher
The Journal of Nutrition
Abstract
Background:
Vitamin D deficiency is common in pregnancy. Vitamin D plays an important role in the developing brain, and deficiency may impair childhood behavioral development.
Objectives:
This study examined the relationship between gestational 25(OH)D concentrations and childhood behavior in the Environmental influences on Child Health Outcomes (ECHO) Program.
Methods:
Mother-child dyads from ECHO cohorts with data available on prenatal (first trimester through delivery) or cord blood 25(OH)D and childhood behavioral outcomes were included. Behavior was assessed using the Strengths and Difficulties Questionnaire or the Child Behavior Checklist, and data were harmonized using a crosswalk conversion. Linear mixed-effects models examined associations of 25(OH)D with total, internalizing, and externalizing problem scores while adjusting for important confounders, including age, sex, and socioeconomic and lifestyle factors. The effect modification by maternal race was also assessed.
Results:
Early (1.5–5 y) and middle childhood (6–13 y) outcomes were examined in 1688 and 1480 dyads, respectively. Approximately 45% were vitamin D deficient [25(OH)D < 20 ng/mL], with Black women overrepresented in this group. In fully adjusted models, 25(OH)D concentrations in prenatal or cord blood were negatively associated with externalizing behavior T-scores in middle childhood [−0.73 (95% CI: −1.36, −0.10) per 10 ng/mL increase in gestational 25(OH)D]. We found no evidence of effect modification by race. In a sensitivity analysis restricted to those with 25(OH)D assessed in prenatal maternal samples, 25(OH)D was negatively associated with externalizing and total behavioral problems in early childhood.
Conclusions:
This study confirmed a high prevalence of vitamin D deficiency in pregnancy, particularly among Black women, and revealed evidence of an association between lower gestational 25(OH)D and childhood behavioral problems. Associations were more apparent in analyses restricted to prenatal rather than cord blood samples. Interventions to correct vitamin D deficiency during pregnancy should be explored as a strategy to improve childhood behavioral outcomes.
Abbreviations:
CBCL, Child Behavior Checklist; ECHO; Environmental influences on Child Health Outcomes; IPTW, inverse probability of treatment weighting; SDQ, Strengths and Difficulties Questionnaire; VDR, vitamin D receptor
Description
This article was originally published in The Journal of Nutrition. The version of record is available at: https://doi.org/10.1016/j.tjnut.2023.03.005. This article will be embargoed until 05/03/2024. © 2023 American Society for Nutrition. Published by Elsevier Inc. All rights reserved.
Keywords
pregnancy, prenatal nutrition, vitamin D, 25-hydroxyvitamin D, behavioral problems, externalizing behaviors, internalizing behaviors
Citation
Melough, Melissa M., Mingyi Li, Ghassan Hamra, Meredith Palmore, Katherine A. Sauder, Anne L. Dunlop, Kaja Z. LeWinn, et al. “Greater Gestational Vitamin D Status Is Associated with Reduced Childhood Behavioral Problems in the Environmental Influences on Child Health Outcomes Program.” The Journal of Nutrition 153, no. 5 (2023): 1502–11. https://doi.org/10.1016/j.tjnut.2023.03.005.