Journal Article

Socioeconomic and nutritional determinants outweigh gut microbiota influence on neurodevelopment in young children from Antananarivo, Madagascar

Rambolamanana, Valérie, Doria, Maria V., Rajaonarivo, Tatamo, Tamarelle, Jeanne, Randremanana, Rindra Vatosoa, Sansonetti, Philippe, Vonaesch, Pascale, Ferreira, Ana Sousa, Rakotondrainipiana, Maheninasy

2026

Overview

In 2024, stunted child growth affected 150 million children under the age of five years, underscoring its critical impact on global health. Stunting has also been associated with neurodevelopmental delays. This study explores the relationship between stunting, the fecal microbiota, and neurodevelopment in 2–5-year-old children from the Afribiota cross-sectional study in Madagascar. Children were assessed using the Ages and Stages Questionnaire (ASQ-3), covering five developmental domains (communication, personal-social, problem-solving, fine and gross motor). Fecal samples were analyzed via 16S rRNA gene amplicon sequencing. Classical bi- and multivariate analysis was combined with Structural Equation Modelling to evaluate direct and indirect associations between different clinical factors, the microbiota and neurodevelopment. Our study shows that stunting and low socioeconomic status are consistently linked to poorer neurodevelopmental outcomes, while low branched-chain amino acids and hemoglobin levels are associated with stunting. Furthermore, a higher microbial diversity within individuals (α-diversity—specifically the Shannon index-) was directly linked to improved neurodevelopment scores in one of the tested models, while gut microbiota variation between individuals (β-diversity) was not associated with neurodevelopment. These findings support the hypothesis of neurodevelopment being primarily influenced by nutritional and social factors, with a more limited role for microbiota diversity.

• Publisher: Nature Publishing Group UK,Nature Publishing Group,Nature Portfolio
• Subject: 631/326/107 / 631/326/2565/2134 / 692/499 / 692/699/1702/295 / 692/699/375/2764 / Age / Anemia / Brain research / Breastfeeding & lactation / Child Development / Child, Preschool / Children / Children & youth / Cross-Sectional Studies / Diarrhea / Fecal microflora / Feces / Feces - microbiology / Female / Food and Nutrition / Gastrointestinal Microbiome / Global health / Growth Disorders - epidemiology / Growth Disorders - microbiology / Hemoglobin / Human health and pathology / Humanities and Social Sciences / Humans / Intestinal microflora / Life Sciences / Madagascar - epidemiology / Male / Metabolites / Microbiota / multidisciplinary / Multivariate analysis / Neurodevelopment / Neurodevelopmental Disorders - epidemiology / Neurodevelopmental Disorders - microbiology / Neurons and Cognition / Nutritional Status / Pediatrics / Problem solving / Public health / RNA, Ribosomal, 16S - genetics / rRNA 16S / Santé publique et épidémiologie / Science / Science (multidisciplinary) / Social factors / Socioeconomic Factors / Socioeconomics / Statistical analysis