# Cognitive and Executive Function Scores at Age 7 in Relation to Maternal Mid-Pregnancy Plasma Nutrient Mixtures in a Singaporean Family Follow-Up Cohort

## TL;DR

This study found that a specific mix of nutrients in a mother's blood during pregnancy is linked to better visual analysis skills in children at age 7.

## Contribution

The study introduces a novel approach to analyzing nutrient mixtures, not individual nutrients, in relation to child cognitive outcomes.

## Key findings

- A positively weighted nutrient mixture was associated with higher block design T-scores in children.
- A negatively weighted mixture was linked to lower block design and perceptual reasoning scores in boys only.
- No association was found between nutrient mixtures and executive function scores measured by BRIEF-2.

## 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 essential 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 Towards 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 cognition 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 covariate-adjusted multivariable regressions was performed as a sensitivity analysis. Results: A one-quartile increase in the positively weighted nutrient mixture index was associated 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 greater ability in children to analyze and understand abstract visual items.