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Relationships of maternal plasma pro-vitamin A carotenoids and children's neurocognitive outcomes

Published online by Cambridge University Press:  10 June 2020

Jun Shi Lai
Affiliation:
Singapore Institute for Clinical Sciences, Agency for Science and Technology Research, Singapore, Singapore
Shirong Cai
Affiliation:
Singapore Institute for Clinical Sciences, Agency for Science and Technology Research, Singapore, Singapore Department of Obstetrics and Gynaecology, National University of Singapore, Singapore, Singapore
Bee Lan Lee
Affiliation:
Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
Keith M. Godfrey
Affiliation:
MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, United Kingdom
Peter D. Gluckman
Affiliation:
Singapore Institute for Clinical Sciences, Agency for Science and Technology Research, Singapore, Singapore Liggins Institute, University of Auckland, Auckland, New Zealand
Lynette P. Shek
Affiliation:
Singapore Institute for Clinical Sciences, Agency for Science and Technology Research, Singapore, Singapore Department of Paediatrics, National University of Singapore, Singapore, Singapore
Fabian Yap
Affiliation:
Duke-NUS Medical School, Singapore, Singapore Department of Paediatric Endocrinology, KK Women's and Children's Hospital, Singapore, Singapore
Kok Hian Tan
Affiliation:
Department of Maternal Fetal Medicine, KK Women's and Children's Hospital, Singapore, Singapore
Yap Seng Chong
Affiliation:
Singapore Institute for Clinical Sciences, Agency for Science and Technology Research, Singapore, Singapore Department of Obstetrics and Gynaecology, National University of Singapore, Singapore, Singapore
Choon Nam Ong
Affiliation:
Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
Michael J. Meaney
Affiliation:
Singapore Institute for Clinical Sciences, Agency for Science and Technology Research, Singapore, Singapore Department of Psychiatry and Neurology and Neurosurgery, McGill University, Montreal, Canada
Birit F.P. Broekman
Affiliation:
Department of Psychiatry, VU Medical Centre, Amsterdam, Netherlands
Anne Rifkin-Graboi
Affiliation:
Singapore Institute for Clinical Sciences, Agency for Science and Technology Research, Singapore, Singapore Office of Education Research, National Institute of Education, Singapore, Singapore
Mary F.F. Chong
Affiliation:
Singapore Institute for Clinical Sciences, Agency for Science and Technology Research, Singapore, Singapore Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
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Abstract

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Introduction

Pro-vitamin A carotenoids namely α-, β-carotene and β-cryptoxanthin have potential roles in neurocognitive development, but current literature on these carotenoids mainly focused on preventing cognitive decline in the elderly. This study examined the associations of maternal plasma pro-vitamin A carotenoids concentrations with offspring cognitive development up to 54 months in the GUSTO mother-offspring cohort study.

Materials and Methods

Maternal plasma pro-vitamin A carotenoids concentrations at delivery were determined by ultra-performance liquid chromatography. At age 24 months, the Bayley Scales of Infant and Toddler Development (BSID-III) was used to assess children's development for the following domains: cognitive, receptive and expressive language, and fine and gross motor. At age 54 months, the Kaufman Brief Intelligence Test (KBIT-2) was used to assess children's verbal and non-verbal intelligence. Associations of maternal pro-vitamin A carotenoids with offspring cognitive development at each time point were examined in 419 mother-offspring pairs using linear regressions adjusted for confounders (e.g. maternal demographics, antenatal mental health and breastfeeding duration).

Results

Median (IQR) maternal plasma concentrations (mg/L) were: α-carotene 0.052 (0.032–0.081), β-carotene 0.189 (0.134–0.286), and β-cryptoxanthin 0.199 (0.123–0.304). In 24 months old infants, higher maternal β-cryptoxanthin (per SD increment) were associated with higher scores in most of BSID-III domains: cognitive [β 0.18, (0.08, 0.28) SD], receptive language [β 0.17 (0.07, 0.27) SD], fine motor [β 0.16 (0.06, 0.27) SD], and gross motor [β 0.16 (0.06, 0.27) SD]. Additionally, a 1-SD increment in maternal β-carotene concentrations were associated with 0.16 SD higher scores in BSID-III cognitive domain (95%: 0.04, 0.28), which was attenuated after adjusting for breastfeeding duration. No significant associations were observed between maternal α-carotene concentrations and BSID-III in children at 24 months of age, or between maternal pro-vitamin A carotenoids and KBIT-2 in children at 54 months of age.

Discussion

Our study provides novel data suggesting a role of maternal pro-vitamin A carotenoids, especially β-cryptoxanthin, in offspring early cognitive development. This adds support to the importance of consuming sufficient amounts of red- and orange-coloured fruit and vegetables (rich sources of β-cryptoxanthin and β-carotene) during pregnancy. Further studies are required in other mother-offspring cohort with larger sample sizes, and intervention trials to confirm an effect of pro-vitamin A carotenoids on neurocognitive development.

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Copyright © The Authors 2020
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