The effects of early childhood probiotic intake on the association between prenatal micronutrient supplementation and neurobehavioral development in preschool children: a four-way decomposition analysis

作者：Liwen Ding, Maolin Zhang, Esben Strodl, Xiaona Yin, Guo‐Min Wen, Deng‐Li Sun, Dan‐Xia Xian, Yafen Zhao, Yuxing Zheng, Feitong Liu, Ruibiao Hu, Lingling Zhao, Weikang Yang, Weiqing Chen · 发表于：Frontiers in Nutrition · 年份：2025 · DOI：10.3389/fnut.2025.1614820 · 被引用次数：5 · 研究领域：Gut microbiota and health、Infant Nutrition and Health、Probiotics and Fermented Foods

Background: 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. Methods: 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. Results: Among the participants, 11.7% were identified w...