(PTFS10-06-26) Effect of Periconceptional Diet on Child Cognitive Outcomes Based on the NEwborn Epigenetic STudy (NEST) Data

Objectives: To examine the associations between maternal diet during the periconceptional period and child cognitive outcomes and assess moderation by neighborhood deprivation and sex.

Methods: In this secondary data analysis of 194 mother-child dyads of the NEST cohort, a prospective pre-birth cohort study, multivariate linear regression models were used to explore the association between quality of maternal periconceptional diet with child cognitive and executive function performance. Diet quality was determined using two indices – the Health Eating Index–2010 and Mediterranean Diet Score. Child cognitive abilities were assessed at ages 3 – 9 years using the NIH Toolbox cognitive battery and the BRIEF instrument to measure child executive function. Models were adjusted for race, household income, maternal education, pre-pregnancy BMI, and breastfeeding history.

Results: Improved cognitive performance was positively but modestly associated with maternal diet quality. Each 10-point increase in maternal HEI-2010 score was associated with a 0.315 increase in composite cognitive performance (p < 0.001), and, in maternal MDS score was also positively associated with improved Flanker Inhibitory Control and Attention (FICA) (B = 0.121, p = 0.028). Maternal MDS was also associated with lower BRIEF score indicating positive outcomes: Inhibition (B = -0.074, p = 0.033), Working Memory (B = 0.245, p = 0.013), Emergent Metacognition Index (B = -0.08, p = 0.034), and Global Executive Composite (B = -0.032, p = 0.044). Neighborhood deprivation did not significantly moderate the associations between maternal diet and child cognitive outcomes except Mediterranean Diet Score and Census Tract interaction on NIH picture vocabulary remained significant (MDS x CT, B = -0.155, p = 0.013).

Conclusions: Periconceptional maternal diet quality was modestly positively associated with child cognitive and executive function outcomes in early-to-middle childhood. Associations were largely consistent across neighborhood contexts, with little evidence of moderation overall. Thus, interventions targeting maternal diet around conception may support child development, regardless of neighborhood.

Funding Sources: The study was supported by NIH grant R01ES016772, P30ES025128 and the HRSA MCH epidemiology training program (T03MC07643).