ArticleJMIR public health and surveillance2026
Association of Vitamin D and Weight Status With Neurodevelopmental Outcomes in a Large Pediatric Population: Cross-Sectional Study.
Article in JMIR public health and surveillance, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundVitamin D and weight status are key determinants for neurodevelopmental outcomes in children. However, their independent and interactive associations with neurodevelopmental outcomes represent a critical yet insufficiently explored issue in pediatric health.
objectiveThis study aims to evaluate the independent associations of vitamin D status and weight status with neurodevelopmental outcomes in a large pediatric cohort and to explore how these relationships are stratified by age and sex.
methodsThis retrospective study analyzed the electronic health records of 19,283 healthy children who visited a health management center in a tertiary children's hospital. Neurodevelopmental outcomes were assessed using the Ages and Stages Questionnaire, 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.
resultsThe study included 19,283 children, 10,065 (52.2%) of whom were under 6 years old and 9218 (47.8%) who were between 6 and 18 years old. Among them, 1275 (12.67%) children under 6 were at risk for neurodevelopmental delay, and 1483 (16.09%) children aged between 6 and 18 years had behavioral challenges. Multivariable logistic regression revealed that vitamin D insufficiency/deficiency was significantly associated with suboptimal neurodevelopment in both the younger (odds ratio [OR] 1.48, 95% CI 1.23-1.79; P<.001) and older cohorts (OR 1.56, 95% CI 1.39-1.74; P<.001. A subgroup analysis revealed that vitamin D insufficiency/deficiency significantly increased the risk of neurodevelopmental delay among normal-weight girls under 6 years (OR 2.24, 95% CI 1.60-3.15; P<.001; q<.006) after the Benjamini-Hochberg false discovery rate correction. In the 6-to-18-year-old cohort, similar robust associations with behavioral challenges were observed in normal-weight girls (OR 1.61, 95% CI 1.30-2.00; P<.001; q<.006) and boys (OR 1.64, 95% CI 1.36-1.96; P<.001; q<.006).
conclusionsVitamin D insufficiency/deficiency is associated with suboptimal neurodevelopmental outcomes in a sex-dependent manner modulated by weight status, challenging "one-size-fits-all" clinical models. We advocate for stratified, sex-specific screening and personalized pediatric care strategies.
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