Sex-specific association between maternal integrative endocrine and metabolic status during pregnancy and preschoolers' emotional-behavioral development: A birth cohort study.

This prospective cohort study investigates the longitudinal associations between comprehensive maternal endocrine and metabolic profiles across pregnancy and emotional-behavioral outcomes in preschool children. Utilizing data from the Ma'anshan Birth Cohort (2013-2014 enrollment), we analyzed 2,040 singleton mother-child dyads with complete biomonitoring data. Maternal endocrine and metabolic parameters including blood pressure, fasting glucose, and thyroid hormones were assessed. Child emotional-behavioral outcomes at age 4 were evaluated using the Strengths and Difficulties Questionnaire (SDQ). We employed the quantile g-computation regression (Q-gcomp) model to analyze the effects of the combined mixture of maternal endocrine and metabolic factors during pregnancy on offspring emotional and behavioral development. The Q-gcomp analysis revealed significant associations between the mixture and conduct problems, with odds ratios (OR) of 1.43 (95% CI: 1.07-1.91) and 1.35 (95% CI: 1.01-1.79) for mid- and late-pregnancy, respectively. After stratification by gender, we found that the mixture during mid- and late pregnancy was associated with an increased risk of conduct problems in boys (OR: 1.66, 95% CI: 1.12-2.47 and OR: 1.67, 95% CI: 1.15-2.43, respectively). However, no significant association was observed between prenatal mixture and emotional or behavioral development in girls. Our study demonstrates a significant sex-specific association between the mixture during pregnancy and offspring emotional and behavioral development.