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Article

The KLOTHO Birth Cohort: Maternal and Neonatal Vitamin D Status and Neurodevelopmental Outcomes at 10 Years

by
Spyridon N. Karras
1,*,
Dimitrios G. Goulis
2,
Maria Kypraiou
3,
Vikentia Harizopoulou
4,
Antonios Vlastos
5,
Marios Anemoulis
5,
Georgios Tzimagiorgis
1,
Maria Dalamaga
6,
Neoklis Georgopoulos
7,
Evanthia Kassi
8,
Georgios Mastorakos
9,
Kali Makedou
1,
Dimitrios Skoutas
10 and
Konstantinos G. Michalakis
11
1
Laboratory of Biological Chemistry, Medical School, Aristotle University, 55535 Thessaloniki, Greece
2
Unit of Reproductive Endocrinology, 1st Department of Obstetrics and Gynecology, Medical School, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
3
Assisting Nature Centre of Reproduction and Genetics, 57001 Thessaloniki, Greece
4
Medical School, Aristotle University, 54124 Thessaloniki, Greece
5
Department of Midwifery, Faculty of Health and Caring Sciences, University of West Attica, 12243 Athens, Greece
6
Department of Biological Chemistry, National and Kapodistrian University of Athens, 15771 Athens, Greece
7
Division of Endocrinology, Department of Internal Medicine, School of Health Sciences, University of Patras, 26504 Patras, Greece
8
Department of Biological Chemistry, School of Medicine, National and Kapodistrian University of Athens, 10679 Athens, Greece
9
Second Department of Surgery, Medical School, Aretaieio Athens Hospital, National and Kapodistrian University of Athens, 11528 Athens, Greece
10
Thermi Clinic, 57001 Thessaloniki, Greece
11
Endocrine Practice, Department of Obesity and Metabolism, 11521 Athens, Greece
 
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Nutrients 2026, 18(1), 76; https://doi.org/10.3390/nu18010076
Submission received: 23 November 2025 / Revised: 19 December 2025 / Accepted: 23 December 2025 / Published: 26 December 2025
(This article belongs to the Special Issue Clinical Nutrition, Metabolic Complications, and Organ Function Biomarkers in Newborns and Children with Disabilities)
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Abstract

Background: Maternal vitamin D status during pregnancy has been hypothesized to influence offspring neurodevelopment; however, the evidence remains inconsistent. Methods: We studied 66 mother–child pairs from the KLOTHO cohort with serum 25-hydroxyvitamin D [25(OH)D] measurements at delivery (maternal and umbilical cord). At 10 years of age, neurodevelopment was assessed using standardized questionnaires, generating composite z-scores for cognitive (cognitive, communication, motor) and psychosocial (social–sentimental, special interests) domains. Multivariable models were adjusted for sex, maternal body mass index and education, and neonatal birth weight and gestational age. Results: Maternal 25(OH)D deficiency (<50 nmol/L) was not associated with cognitive composite scores (p = 0.77). The psychosocial composite scores showed a non-significant negative trend (p = 0.29). Neonatal deficiency showed no consistent association with cognition (p = 0.99) or psychosocial outcomes (p = 0.30). Exploratory partial correlations suggested a positive association between maternal 25(OH)D and psychosocial development (r = 0.60, p = 0.038, n = 12). Seasonal variation in maternal vitamin D was observed (autumn: 56.0 ± 24.6 vs. winter: 32.0 ± 18.3 nmol/L; p < 0.0001), but did not translate into differences in 10-year outcomes. Conclusions: In this cohort of 66 pairs, perinatal vitamin D status was not a determinant of global cognition at 10 years of age. A potential link with psychosocial development requires replication in larger longitudinal studies. Due to the limited sample size, all findings should be interpreted as exploratory.
Keywords: vitamin D; 25-hydroxyvitamin D; KLOTHO cohort; pregnancy; neonatal; neurodevelopment; cognition; psychosocial outcomes vitamin D; 25-hydroxyvitamin D; KLOTHO cohort; pregnancy; neonatal; neurodevelopment; cognition; psychosocial outcomes

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MDPI and ACS Style

Karras, S.N.; Goulis, D.G.; Kypraiou, M.; Harizopoulou, V.; Vlastos, A.; Anemoulis, M.; Tzimagiorgis, G.; Dalamaga, M.; Georgopoulos, N.; Kassi, E.; et al. The KLOTHO Birth Cohort: Maternal and Neonatal Vitamin D Status and Neurodevelopmental Outcomes at 10 Years. Nutrients 2026, 18, 76. https://doi.org/10.3390/nu18010076

AMA Style

Karras SN, Goulis DG, Kypraiou M, Harizopoulou V, Vlastos A, Anemoulis M, Tzimagiorgis G, Dalamaga M, Georgopoulos N, Kassi E, et al. The KLOTHO Birth Cohort: Maternal and Neonatal Vitamin D Status and Neurodevelopmental Outcomes at 10 Years. Nutrients. 2026; 18(1):76. https://doi.org/10.3390/nu18010076

Chicago/Turabian Style

Karras, Spyridon N., Dimitrios G. Goulis, Maria Kypraiou, Vikentia Harizopoulou, Antonios Vlastos, Marios Anemoulis, Georgios Tzimagiorgis, Maria Dalamaga, Neoklis Georgopoulos, Evanthia Kassi, and et al. 2026. "The KLOTHO Birth Cohort: Maternal and Neonatal Vitamin D Status and Neurodevelopmental Outcomes at 10 Years" Nutrients 18, no. 1: 76. https://doi.org/10.3390/nu18010076

APA Style

Karras, S. N., Goulis, D. G., Kypraiou, M., Harizopoulou, V., Vlastos, A., Anemoulis, M., Tzimagiorgis, G., Dalamaga, M., Georgopoulos, N., Kassi, E., Mastorakos, G., Makedou, K., Skoutas, D., & Michalakis, K. G. (2026). The KLOTHO Birth Cohort: Maternal and Neonatal Vitamin D Status and Neurodevelopmental Outcomes at 10 Years. Nutrients, 18(1), 76. https://doi.org/10.3390/nu18010076

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