Sex-specific association between maternal integrative endocrine and metabolic status during pregnancy and

Hualong Zhen1, Shidie Chen1, Manyu Zhang1

  • 1Department of Maternal, Child & Adolescent Health, School of Public Health, Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, NHC Key Laboratory of Study On Abnormal Gametes and Reproductive Tract, Anhui Provincial Key Laboratory of Environment and Population Health Across the Life Course, Anhui Medical University, Hefei, 230032, China.

This prospective cohort study investigates the longitudinal associations between comprehensive maternal endocrine and metabolic profiles across pregnancy and emotional-behavioral outcomes in preschool children. Utilizing data from the Ma'anshan Birth Cohort (2013-2014 enrollment), we analyzed 2,040 singleton mother-child dyads with complete biomonitoring data. Maternal endocrine and metabolic parameters including blood pressure, fasting glucose, and thyroid hormones were assessed. Child emotional-behavioral outcomes at age 4 were evaluated using the Strengths and Difficulties Questionnaire (SDQ). We employed the quantile g-computation regression (Q-gcomp) model to analyze the effects of the combined mixture of maternal endocrine and metabolic factors during pregnancy on offspring emotional and behavioral development. The Q-gcomp analysis revealed significant associations between the mixture and conduct problems, with odds ratios (OR) of 1.43 (95% CI: 1.07-1.91) and 1.35 (95% CI: 1.01-1.79) for mid- and late-pregnancy, respectively. After stratification by gender, we found that the mixture during mid- and late pregnancy was associated with an increased risk of conduct problems in boys (OR: 1.66, 95% CI: 1.12-2.47 and OR: 1.67, 95% CI: 1.15-2.43, respectively). However, no significant association was observed between prenatal mixture and emotional or behavioral development in girls. Our study demonstrates a significant sex-specific association between the mixture during pregnancy and offspring emotional and behavioral development.

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