Associations Between Micronutrient Status, Hormones, and Immune Status During Pregnancy and Child Growth in Rural...

Poor growth in early childhood is associated with increased mortality, impaired cognitive development, and reduced adult economic productivity, which may result in higher risks of social immobility and intergenerational poverty.

We aimed to evaluate whether maternal hormones, immune status, and micronutrient status during all trimesters of pregnancy were associated with child growth outcomes in the first two years after birth.

This observational study used data collected from the WASH Benefits trial in rural Bangladesh to examine associations between maternal hormones [plasma cortisol, estriol], immune status [C-reactive protein, α-1-acid glycoprotein (AGP), cytokine sum score], and micronutrient status [vitamin D (25-hydroxy-D [25(OH)D]), ferritin, soluble transferrin receptor, retinol binding protein (RBP)] during pregnancy and subsequent measures of child growth. Length-for-age z-score (LAZ), weight-for-length z-score (WLZ), and insulin-like growth factor 1 (IGF-1) at 3, 14, and 28 mo were measured as the primary outcomes. All outcomes were adjusted for confounding variables, and the P values were adjusted using the Benjamini-Hochberg procedure. We used generalized additive models, adjusted for covariates, and reported the mean difference in outcomes between the 25th and 75th percentiles of the exposure distribution.

In the adjusted models of this study (n = 636), at 3 mo of age, maternal AGP and RBP were positively associated with infant WLZ. By 14 mo, higher maternal estriol was linked with higher LAZ, and RBP remained positively associated with WLZ. At 28 mo, maternal estriol showed a negative association with IGF-1, and a higher cytokine sum score was negatively associated with WLZ.

These findings suggest the possible pathways through which maternal biomarkers influence early childhood growth, highlighting the intrauterine environment's critical role in shaping developmental outcomes.The parent trial was registered at clinicaltrials.gov (NCT01590095).