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Vitamin D status during pregnancy and child neurocognitive functioning at 4 Years

Pediatric Research (2025)Cite this article

Abstract

Background

Hypovitaminosis D is prevalent during pregnancy and may affect fetal brain development, leading to neurocognitive issues. This study investigated the association between vitamin D levels during pregnancy and children’s neurocognitive functioning in 289 mother-child pairs, controlling for confounding variables.

Methods

Prenatal serum 25-hydroxyvitamin D (25(OH)D) concentrations were measured in the first and third trimesters, and offspring underwent a neurocognitive assessment at age 4 using the Wechsler Preschool and Primary Scale of Intelligence—Fourth Edition (WPPSI-IV), subtests of the Developmental Neuropsychological Assessment-II (NEPSY-II), and the Behavior Rating Inventory of Executive Function—Preschool Version (BRIEF-P) completed by parents. Socio-demographic data, obstetric information, lifestyle habits, maternal emotional health, and parental intellectual performance were collected.

Results

The adjusted regression models have shown that insufficient 25(OH)D levels throughout pregnancy were associated with poorer Visual-Motor Precision of the NEPSY-II. In the third trimester, inadequate 25(OH)D levels were associated with poorer executive functioning, as indicated by neuropsychological and behavioural assessments. Specifically, lower scores were observed in Working Memory on the WPPSI-IV, as well as in the metacognitive index and Inhibition on the BRIEF-P.

Conclusion

Maintaining adequate prenatal 25(OH)D levels may promote optimal neurocognitive functioning in early childhood.

Impact

  • Inadequate maternal 25(OH)D concentrations throughout pregnancy are associated with lower Visual-Motor Precision in children, and third-trimester deficiency is linked to poorer executive functioning.

  • This study highlights the importance of maintaining adequate vitamin D levels throughout pregnancy.

  • Findings support the implementation of public health strategies to ensure proper vitamin D intake and the monitoring of maternal serum 25(OH)D levels during pregnancy to promote adequate infant neurodevelopment.

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Data availability

The datasets analysed during the current study are not publicly available due to ethical and legal restrictions, but are available from the corresponding author on reasonable request.

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Acknowledgements

We thank the entities and participants involved in the ECLIPSES study, the personnel of the Research Group in Nutrition and Mental Health (NUTRISAM), the Sexual and Reproductive Health Care Services (ASSIR) of Tarragona (Spain), the Institut d’Atenció Primària IDIAP Jordi Gol, and the Institut Català de la Salut, Barcelona (Spain). This work was financially supported by the Instituto de Salud Carlos III, Fondo de Investigación Sanitaria, Ministerio de Sanidad y Consumo [grant numbers PI12/02777 and PI17/01574] and co-funded by the European Regional Development Fund (ERDF).

Author information

Authors and Affiliations

  1. Research Group on Nutrition and Mental Health (NUTRISAM), Universitat Rovira i Virgili, Tarragona and Reus, Spain

    Núria Voltas, Esther Cendra-Duarte, Josefa Canals & Victoria Arija

  2. Research Center for Behavior Assessment (CRAMC), Psychology Department, Universitat Rovira i Virgili, Tarragona, Spain

    Núria Voltas & Josefa Canals

  3. Pere Virgili Institute for Health Research (IISPV), Universitat Rovira i Virgili, Tarragona, Spain

    Núria Voltas, Esther Cendra-Duarte, Josefa Canals & Victoria Arija

  4. Collaborative Group on Lifestyles, Nutrition, and Tobacco (CENIT), Institut d’Investigació en Atenció Primària IDIAP Jordi Gol, Institut Català de la Salut (ICS), Reus, Spain

    Esther Cendra-Duarte & Victoria Arija

  5. Serra-Húnter Fellow, Psychology Department, Universitat Rovira i Virgili, Tarragona, Spain

    Núria Voltas

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  1. Núria Voltas
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  2. Esther Cendra-Duarte
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  4. Victoria Arija
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All authors contributed substantially to the conception and design of the study, acquisition of data, analysis and interpretation of data, drafting the article, and revising it critically for important intellectual content. All authors approved the final version to be published.

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Correspondence to Victoria Arija.

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Voltas, N., Cendra-Duarte, E., Canals, J. et al. Vitamin D status during pregnancy and child neurocognitive functioning at 4 Years. Pediatr Res (2025). https://doi.org/10.1038/s41390-025-04258-9

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