693 - Association of Child Microbiome and Nutrition with Neurodevelopmental Outcomes
Sunday, April 30, 2023
3:30 PM – 6:00 PM ET
Poster Number: 693 Publication Number: 693.308
TERRAH MARIE. KECK-KESTER, Pennsylvania State University College of Medicine, Hershey, PA, United States; Steven Hicks, Pennsylvania State University College of Medicine, Hershey, PA, United States
Assistant Professor Pennsylvania State University College of Medicine Hershey, Pennsylvania, United States
Background: Bright Futures recommends neurodevelopmental (ND) surveillance at every preventive visit and validated screening at 9, 18, and 30 months of age (moa).This approach successfully identifies ND deficits. However, the complex factors that shape ND remain poorly understood. Understanding how environment factors impact ND could shift current treatment paradigms from delay recognition to delay prevention. Objective: The objective of this study was to define how nutrition, microbiome, and social environment impact ND in the first 18 moa. Design/Methods: This prospective cohort study of 221 term infants, enrolled at birth and followed through 18 moa. The primary outcome was presence/absence of developmental concern on the Survey of Wellbeing in Young Children (SWYC) at 18 moa. Infant nutrition was assessed with the Infant Feeding Practices (IFP)-II Survey, at 6 and 12 moa and family nutritional habits with the Dietary Screener Questionnaire (DSQ) at birth. Activity of bacterial phyla were measured with shotgun RNA sequencing of infant saliva at 6 moa. Social determinants of health were assessed with the PhenX toolkit, geographic-level social vulnerability index scores, and the National Survey of Lead and Allergens in Housing (NSLAH), at 1 moa. A feed-backward logistic regression model was used to identify factors that contributed significantly (p < 0.05) to ND at 18 moa. Results: Of the 142 children who completed all study measures, the majority were female (67, 54%), White (102, 72%), and non-Hispanic (119, 83%). 24 (16%) received a “needs review” score on the SWYC. A logistic regression model employing two microbial factors, one nutritional factor, and two SDOH accounted for 33.3% of the variance between ND groups (p < 0.001, AIC = 77.7). A "needs review" score was associated with Hispanic ethnicity (OR 18.1, 2.36-139.3; p=0.003), no infant fish consumption at 12 moa (OR 10.6, 2.0-54.1; p=0.003), and increased Candidatus Gracilibacteria activity (OR 1.43, 1.00 – 2.07; p = 0.007). Whereas home age after 1977 (OR 0.02, 0.001-0.53; p = 0.004) and Chlorobi activity in the oropharynx (OR 0.76, 0.62-0.93, p = 0.001) were associated with reduced risk of ND concern. Microbial alpha diversity modulated the effect of fish consumption on ND outcomes (X2 = 5.7, p = 0.017).
Conclusion(s): Consistent with prior studies, we identify an association between fish consumption and childhood ND.This relationship may be modulated by microbiome activity. The findings are limited by reliance on a ND screening tool, and lack of developmental outcomes beyond 18 moa. Validation in a larger, more diverse cohort is necessary.
