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Cognitive and executive function scores at age 7 in relation to maternal mid-pregnancy plasma nutrient mixtures in a Singaporean family follow-up cohort

Cognitive and executive function scores at age 7 in relation to maternal mid-pregnancy plasma nutrient mixtures in a Singaporean family follow-up cohort
Cognitive and executive function scores at age 7 in relation to maternal mid-pregnancy plasma nutrient mixtures in a Singaporean family follow-up cohort
Background: although there is substantial research into individual nutrients during pregnancy, such as folate, iron, and vitamin D, little is known about the impact of mixtures of essential nutrients. We investigated the associations between mixtures of maternal es-sential minerals and vitamin concentrations and child cognition and executive functions at age 7.

Methods: data from 348 mother–child pairs in the Growing up in Singapore To-wards Healthy Outcomes birth cohort with both plasma nutrient and neurodevelopmental outcome data were used. Gestational fasting plasma samples between 26 and 28 weeks of gestation were analyzed for 10 essential minerals and 12 B and D vitamers. Child cogni-tion and executive functions at 7 years were assessed using the Wechsler Abbreviated Scale of Intelligence 2nd Edition (WASI-II) [n = 331] and the Behavior Rating Inventory of Executive Function 2nd Edition (BRIEF-2) [n = 348], respectively. Generalized weighted quantile sum regression (gWQS) was used to investigate the associations between nutrient mixtures and child cognitive executive function scores. Single-nutrient analysis using co-variate-adjusted multivariable regressions was performed as a sensitivity analysis.

Results: a one-quartile increase in the positively weighted nutrient mixture index was asso-ciated with higher block design T-scores (β = 2.17, 95% CI: 0.03, 4.31). Additionally, the negatively weighted mixture was associated with lower block design (β = −2.25, 95% CI: −4.92, 0.41, p = 0.02) and perceptual reasoning (β = −1.94, 95% CI: −5.17, 1.29, p = 0.04) scores in boys only. We found no association between the nutrient mixture and BRIEF-2 subscale T-scores.

Conclusions: in this study, we found that a positively weighted nutrient mixture index of maternal gestational minerals and vitamins was associated with a great-er ability in children to analyze and understand abstract visual items.
2072-6643
Leader, Jordana
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Li, Shiwen
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Renzetti, Stefano
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Lai, Jun Shi
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Chong, Yap-Seng
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Tan, Kok Hian
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Eriksson, Johan G.
eb96b1c5-af07-4a52-8a73-7541451d32cd
Godfrey, Keith M.
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Law, Evelyn C.
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Chong, Mary Foong-Fong
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Chan, Shiao-Yng
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Valvi, Damaskini
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Huang, Jonathan
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Oulhote, Youssef
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Leader, Jordana
e395d0e5-2b4d-4aee-8885-a9607ff3fc02
Li, Shiwen
06004bee-5a1e-4c46-b477-b70148bef8e4
Renzetti, Stefano
8db72351-c845-4efc-9468-799732be5a0c
Lai, Jun Shi
d23d8c38-bad8-4dfa-b5a6-82871897c01b
Chong, Yap-Seng
7043124b-e892-4d4b-8bb7-6d35ed94e136
Tan, Kok Hian
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Eriksson, Johan G.
eb96b1c5-af07-4a52-8a73-7541451d32cd
Godfrey, Keith M.
0931701e-fe2c-44b5-8f0d-ec5c7477a6fd
Law, Evelyn C.
49ba55c6-ffc3-40a4-9ac4-6c05b5fd7f85
Chong, Mary Foong-Fong
1e188259-b1ab-4448-9e65-5b6a0fd99502
Chan, Shiao-Yng
3c9d8970-2cc4-430a-86a7-96f6029a5293
Valvi, Damaskini
b0e21526-a247-4c73-b249-8caf860cf2d4
Huang, Jonathan
a0a566ec-2048-46b1-89c5-555418371526
Oulhote, Youssef
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Leader, Jordana, Li, Shiwen, Renzetti, Stefano, Lai, Jun Shi, Chong, Yap-Seng, Tan, Kok Hian, Eriksson, Johan G., Godfrey, Keith M., Law, Evelyn C., Chong, Mary Foong-Fong, Chan, Shiao-Yng, Valvi, Damaskini, Huang, Jonathan and Oulhote, Youssef (2026) Cognitive and executive function scores at age 7 in relation to maternal mid-pregnancy plasma nutrient mixtures in a Singaporean family follow-up cohort. Nutrients, 18 (5), [818].

Record type: Article

Abstract

Background: although there is substantial research into individual nutrients during pregnancy, such as folate, iron, and vitamin D, little is known about the impact of mixtures of essential nutrients. We investigated the associations between mixtures of maternal es-sential minerals and vitamin concentrations and child cognition and executive functions at age 7.

Methods: data from 348 mother–child pairs in the Growing up in Singapore To-wards Healthy Outcomes birth cohort with both plasma nutrient and neurodevelopmental outcome data were used. Gestational fasting plasma samples between 26 and 28 weeks of gestation were analyzed for 10 essential minerals and 12 B and D vitamers. Child cogni-tion and executive functions at 7 years were assessed using the Wechsler Abbreviated Scale of Intelligence 2nd Edition (WASI-II) [n = 331] and the Behavior Rating Inventory of Executive Function 2nd Edition (BRIEF-2) [n = 348], respectively. Generalized weighted quantile sum regression (gWQS) was used to investigate the associations between nutrient mixtures and child cognitive executive function scores. Single-nutrient analysis using co-variate-adjusted multivariable regressions was performed as a sensitivity analysis.

Results: a one-quartile increase in the positively weighted nutrient mixture index was asso-ciated with higher block design T-scores (β = 2.17, 95% CI: 0.03, 4.31). Additionally, the negatively weighted mixture was associated with lower block design (β = −2.25, 95% CI: −4.92, 0.41, p = 0.02) and perceptual reasoning (β = −1.94, 95% CI: −5.17, 1.29, p = 0.04) scores in boys only. We found no association between the nutrient mixture and BRIEF-2 subscale T-scores.

Conclusions: in this study, we found that a positively weighted nutrient mixture index of maternal gestational minerals and vitamins was associated with a great-er ability in children to analyze and understand abstract visual items.

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Accepted/In Press date: 25 February 2026
e-pub ahead of print date: 3 March 2026

Identifiers

Local EPrints ID: 510736
URI: http://eprints.soton.ac.uk/id/eprint/510736
ISSN: 2072-6643
PURE UUID: 04f099e5-308c-4ae9-88b5-3a5cd82e2e34
ORCID for Keith M. Godfrey: ORCID iD orcid.org/0000-0002-4643-0618

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Date deposited: 20 Apr 2026 16:49
Last modified: 21 Apr 2026 01:33

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Contributors

Author: Jordana Leader
Author: Shiwen Li
Author: Stefano Renzetti
Author: Jun Shi Lai
Author: Yap-Seng Chong
Author: Kok Hian Tan
Author: Johan G. Eriksson
Author: Evelyn C. Law
Author: Mary Foong-Fong Chong
Author: Shiao-Yng Chan
Author: Damaskini Valvi
Author: Jonathan Huang
Author: Youssef Oulhote

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