JMIR Publications

ABSTRACT

Background:

Vitamin D and weight status are associated factors for neurodevelopmental outcomes in children. We investigated their independent and interactive associations with neurodevelopmental outcomes in a large Chinese pediatric population aged 0-18 years.

Objective:

To evaluate the independent associations of vitamin D status and weight status with neurodevelopmental outcomes in a large pediatric cohort; and further to explore how these relationships are stratified by age and sex.

Methods:

This retrospective study analyzed electronic health records of 19,283 healthy children visiting a health management center in a tertiary children’s hospital. Neurodevelopmental outcomes were assessed using Ages & Stages Questionnaires, Third Edition (ASQ-3) (<6 years) and Conners’ Parent Rating Scale (CPRS) (≥6 years). Logistic regression analyses were applied to assess the independent and interactive impacts of vitamin D and weight status on neurodevelopmental outcomes.

Results:

Vitamin D insufficiency/deficiency was a robust associated factor for neurodevelopmental delay in younger children (OR=1.48) and behavioral problems in older children (OR=1.56). Underweight and overweight/obesity were significantly associated with gross and fine motor delay (underweight: OR=1.58; overweight/obesity: OR=1.64). Vitamin D insufficiency/deficiency was associated with adverse neurodevelopmental outcomes in normal-weight girls <6 years (OR=2.24) and normal-weight boys ≥6 years (OR=1.64). In girls ≥6 years, vitamin D insufficiency/deficiency increased behavioral risk regardless of weight status.

Conclusions:

Both vitamin D insufficiency/deficiency and abnormal weight status are risk factors for neurodevelopmental adversities. The risk profile shows a sex-specific interplay, advocating for sex-specific personalized pediatric care strategies. Clinical Trial: N/A.