Evidence map›Paper›PMID 40469665›Full record

ArticleFrontiers in nutrition2025

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.

Liwen Ding, Maolin Zhang, Esben Strodl, Xiaona Yin, Guomin Wen, Dengli Sun, Danxia Xian, Yafen Zhao, Yuxing Zheng, Feitong Liu and 4 more

Abstract read
In one paragraph

Article in Frontiers in nutrition, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Neurodevelopmental Outcomes Associated with Early-Life Exposure to Heavy Metals: A Systematic Review.International journal of environmental research and public health · 2025
    Pooled it
  2. Frontiers in nutrition · 2025
    Article
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Liwen DingDepartment of Epidemiology and Health Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China.
Maolin ZhangDepartment of Epidemiology and Health Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China.
Esben StrodlSchool of Psychology and Counselling, Queensland University of Technology, Brisbane, QLD, Australia.
Xiaona YinMaternal and Child Healthcare Hospital of Longhua District, Shenzhen, China.
Guomin WenMaternal and Child Healthcare Hospital of Longhua District, Shenzhen, China.
Dengli SunMaternal and Child Healthcare Hospital of Longhua District, Shenzhen, China.
Danxia XianMaternal and Child Healthcare Hospital of Longhua District, Shenzhen, China.
Yafen ZhaoMaternal and Child Healthcare Hospital of Longhua District, Shenzhen, China.
Yuxing ZhengBiostime (Guangzhou) Health Products Ltd., Guangzhou, China.
Feitong LiuBiostime (Guangzhou) Health Products Ltd., Guangzhou, China.
Ruibiao HuBiostime (Guangzhou) Health Products Ltd., Guangzhou, China.
Lingling ZhaoBiostime (Guangzhou) Health Products Ltd., Guangzhou, China.
Weikang YangMaternal and Child Healthcare Hospital of Longhua District, Shenzhen, China.
Weiqing ChenDepartment of Epidemiology and Health Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

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 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. Conclusion: 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.

Indexed as

counterfactual attributionfour-way decompositionmicronutrient supplementationneurobehavioral developmentpreschool childrenprobiotic intake

Identifiers

PMID40469665
PMCPMC12133521

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.