Heng Zhang

The rising prevalence of autism spectrum disorder (ASD) significantly impacts children’s development. Emerging evidence suggests that modulating gut microbiota may alleviate neurodevelopmental disorders, including ASD. Probiotics represent a promising approach for targeting gut microbiota in ASD management due to their safety profile and absence of side effects. This study evaluated a 12-week intervention with Bifidobacterium longum subsp. longum CCFM1077 in children with ASD. The probiotic group showed significant reductions in childhood autism rating scale (CARS) scores with notable improvements in affect and anxiety reactions. 16S rRNA sequencing revealed that the intervention significantly increased the relative abundances of Bifidobacterium, Lactobacillus, and Roseburia, which were initially depleted in these children. Concurrent with symptom improvement, serum 25-hydroxyvitamin D (25OHD) levels significantly increased in the probiotic group. In contrast, the placebo group exhibited no significant symptom alleviation, gut microbiota modulation, or changes in serum 25OHD levels. These findings highlight the potential of probiotic intervention as a food science-based adjunctive therapeutic approach for ASD in clinical practice.

Sleep care significantly impacts children's development; however, caregivers' knowledge and practices regarding sleep care remain understudied. This study aims to comprehensively assess caregivers' knowledge, attitudes, and practices (KAP) concerning sleep care for infants and toddlers aged 0-3 years. This cross-sectional study was collected from July to October 2024 among caregivers at two maternal and child health hospitals (Wuxi and Xuzhou) in Jiangsu Province, China. A standardized questionnaire assessed caregivers' knowledge, attitudes, and practices (KAP) regarding sleep care for children aged 0-3 years. A total of 2,009 valid responses were obtained, with 1,750 (87.11%) were female caregivers. The median (Q₁, Q₃) scores for knowledge, attitude, and practice were 8.00 (7.00, 9.00), 22.00 (20.00, 24.00), and 37.00 (33.00, 40.00), respectively. Spearman's rank correlation analysis revealed statistically significant positive correlations between caregivers' knowledge and their attitudes (r = 0.119, P < 0.001) and practices (r = 0.167, P < 0.001), as well as attitude and practice (r = 0.258, P < 0.001). Logistic regression analysis revealed that higher knowledge scores [OR = 1.154, 95% confidence interval (CI): 1.034-1.288, P < 0.001], positive attitudes (OR = 1.188, 95% CI: 1.136-1.243, P < 0.001), higher household income (OR = 1.634, 95% CI: 1.066-2.505, P = 0.024), and better child sleep quality (OR < 1, 95% CI: 0.102-0.928, P < 0.05) were independently associated with better sleep care practices. Structural equation modeling showed direct effects of knowledge on both the attitudes (β = 1.346, P < 0.001) and practices (β = 1.152, P < 0.001), as well as of attitude on practice (β = 0.492, P < 0.001). Although caregivers demonstrated adequate knowledge, positive attitudes, and generally sufficient sleep care practices, targeted educational interventions remain necessary, particularly for caregivers with lower education and income, to further optimize sleep care behaviors.

Objectives: To examine the associations of maternal vitamin D (VitD) concentrations in early- and mid-pregnancy with offspring growth trajectories from birth to 6 years of age, as well as childhood overweight. Methods: This study was a prospective observational cohort study including 1,100 mother–child dyads from the Wuxi Birth Cohort. Offspring weight-, height-, and BMI-for-age Z-scores (WAZ, HAZ, and BAZ) were collected from birth to 6 years of age. Growth trajectories were identified using group-based trajectory modeling (GBTM). Restricted cubic spline (RCS) analyses explored the nonlinear associations. Multivariable logistic regression was used to assess associations of maternal VitD tertiles (T1-T3) with growth trajectory groups and overweight risk, with exploratory analyses stratified by child sex. Results: Lower early pregnancy VitD concentrations (T1 vs. T2) were associated with higher odds of increasing HAZ (aOR, 1.84; 95% CI, 1.16, 2.92) and BAZ (aOR, 1.63; 95% CI, 1.09, 2.43) trajectories. Lower mid-pregnancy VitD concentrations were associated with higher odds of increasing WAZ (aOR, 3.21; 95% CI, 1.41, 7.34) and HAZ (aOR, 1.94; 95% CI, 1.03, 3.66) trajectories. Higher early pregnancy VitD concentrations (T3 vs. T2) were associated with higher odds of increasing BAZ, particularly among boys (aOR, 2.11; 95% CI, 1.16, 3.82). Sex-stratified analyses suggested stronger associations for WAZ- and BAZ-related trajectories in boys and HAZ-related trajectories in girls. RCS analyses showed nonlinear associations, with the lowest odds of adverse trajectories observed at 27.6–72.6 nmol/L in early pregnancy and 28.8–76.2 nmol/L in mid-pregnancy. Overweight at age 6 was nearly ten times more common in children with increasing vs. stable BAZ trajectories. Conclusion: Maternal VitD levels in early- and mid-pregnancy showed nonlinear and sex-specific associations with offspring growth trajectories. Both low and high maternal VitD levels during these gestational periods were associated with higher odds of unstable growth trajectories.

Background: Although the problem of malnutrition among children in China has greatly improved in recent years, there is a gap compared to developed countries, and there are differences between provinces. Research on long-term comprehensive trends in child growth failure (CGF) in China is needed for further improvement. Objective: The purpose of this study was to examine trends in stunting, wasting, and underweight among children younger than 5 years in China from 2000 to 2019, and predict CGF till 2030. Methods: We conducted a cross-sectional analysis using data from the local burden of disease (LBD) database. Using Joinpoint Regression Software, we examined trends in CGF among children younger than 5 years in China from 2000 to 2019, and predicted the trends of prevalence in 2030, using the Holt-Winters model with trends but without seasonal components. The assessment was performed with Stata 17 (StataCorp). Data were analyzed from October 17, 2023, to November 22, 2023. Results: In 2019, the prevalences of stunting, wasting, and underweight decreased to 12%, 3%, and 4%, respectively (decreases of 36.9%, 25.0%, and 42.9%, respectively, compared with the values in 2000). The prevalence of CGF decreased rapidly from 2000 to 2010, and the downward trend slowed down after 2010. Most provinces had stagnated processes of trends after 2017. The age group with the highest stunting prevalence was children aged 1 to 4 years, and the highest prevalence of wasting and underweight was noted in early neonatal infants. From 2000 to 2019, the prevalence of CGF declined in all age groups of children. The largest relative decrease in stunting and underweight was noted in children aged 1 to 4 years, and the largest decrease in wasting was noted in early neonatal infants. The prevalences of stunting, wasting, and underweight in China are estimated to decrease to 11.4%, 3.2%, and 4.1%, respectively, by 2030. China has nationally met the World Health Organization’s Global Nutrition Targets for 2030 for stunting but not for wasting. Conclusions: This study provides data on the prevalence and trends of CGF among children younger than 5 years and reports declines in CGF. There remain areas with slow progress in China. Most units have achieved the goal for stunting prevalence but not wasting prevalence.

Arsenic pollution is widespread worldwide. The association between gestational arsenic exposure and adverse birth outcomes has been demonstrated in previous studies; however, few investigations have examined whether gestational arsenic exposure has adverse effects on infant growth and development after birth. Our study was designed to evaluate particular associations between gestational arsenic exposure during pregnancy and newborn birth size and to investigate whether these associations continue to affect infants after birth. An ongoing prospective cohort study of 1100 pregnant women was conducted at the Wuxi Maternity and Child Health Care Hospital. The total urinary arsenic concentrations in the 2nd and 3rd trimester were determined using atomic fluorescence spectrometry. The relationships between urinary arsenic concentration and foetal growth parameters (birth weight, head circumference, length, and ponderal index), SGA (Small for gestational age), and physical growth of infants within one year after birth were analysed. Urinary arsenic concentration in the 3rd trimester was associated with an increased incidence of SGA [adjusted model: OR = 2.860 (95% CI: 1.168, 7.020), P = 0.021)]. Arsenic exposure in late pregnancy had an adverse effect on the physical development of infants before the age of 1 year, and there was an interaction effect with the sex of infants. The weight and length of boys at 6 and 12 months negatively correlated with maternal urinary arsenic levels during late pregnancy. In addition to affecting foetal growth, exposure to arsenic in the 3rd trimester also negatively affected the growth of offspring within the first year of life.