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Most studies analyze single exposures or outcomes. We conducted a narrative review summarizing the findings published by the Okayama University group on diverse health and developmental outcomes.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We reviewed 59 LSN21 papers (2013\u20132025), extracting data on exposures, outcomes, and methods. Evidence was categorized into four exposure types (infant feeding, sleep, environmental, and perinatal) and three outcome domains (obesity, allergies\/respiratory tract infections, and neurobehavioral development), including cohort comparisons.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Exclusive breastfeeding was associated with a lower obesity risk at ages 7 (adjusted odds ratio 0.55, 95% confidence interval 0.39\u20130.78) and 15, later puberty, and fewer hospitalizations. Short or irregular sleep before age 3 was linked to behavioral problems and injuries. Maternal smoking and prenatal air pollution were associated with respiratory conditions and developmental challenges. Preterm birth and small\u2010for\u2010gestational\u2010age predicted delays, especially without catch\u2010up growth by age 2. Pneumococcal vaccination likely contributed to declining otitis media after 2010. Additional findings included associations between outdoor play and reduced obesity risk, and complex relationships between breastfeeding and food allergies that varied by infantile eczema status.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>LSN21 findings highlight modifiable early\u2010life factors (breastfeeding, sleep patterns, and smoke\u2010free environments) and identify preterm and growth\u2010restricted children for priority monitoring. While LSN21's strength lies in longitudinal social assessments, complementary perspectives from other Japanese cohorts could enhance understanding of biological mechanisms and intergenerational effects.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ped.70258","type":"journal-article","created":{"date-parts":[[2025,11,11]],"date-time":"2025-11-11T05:48:32Z","timestamp":1762840112000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Early\u2010life exposures and child health outcomes: A narrative review of\n                    <scp>LSN21<\/scp>\n                    research in Japan"],"prefix":"10.1111","volume":"67","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9980-6092","authenticated-orcid":false,"given":"Naomi","family":"Matsumoto","sequence":"first","affiliation":[{"name":"Department of Epidemiology, Faculty of Medicine Dentistry and Pharmaceutical Sciences, Okayama University  Okayama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rumi","family":"Matsuo","sequence":"additional","affiliation":[{"name":"Department of Epidemiology Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences  Okayama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuka","family":"Yamamura","sequence":"additional","affiliation":[{"name":"Department of Epidemiology Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences  Okayama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takahiro","family":"Tsuge","sequence":"additional","affiliation":[{"name":"Department of Epidemiology Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences  Okayama Japan"},{"name":"Department of Rehabilitation Kurashiki Medical Center  Kurashiki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomoka","family":"Kadowaki","sequence":"additional","affiliation":[{"name":"Department of Epidemiology Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences  Okayama Japan"},{"name":"Center for Public Health Action in Applied Epidemiology National Institute of Infectious Diseases, Japan Institute for Health Security  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kensuke","family":"Uraguchi","sequence":"additional","affiliation":[{"name":"Department of Epidemiology Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences  Okayama Japan"},{"name":"Department of Otolaryngology\u2010Head &amp; Neck Surgery Kagawa Rosai Hospital  Kagawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3343-1590","authenticated-orcid":false,"given":"Kei","family":"Tamai","sequence":"additional","affiliation":[{"name":"Department of Epidemiology Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences  Okayama Japan"},{"name":"Division of Neonatology NHO Okayama Medical Center  Okayama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazue","family":"Nakamura","sequence":"additional","affiliation":[{"name":"Department of Epidemiology Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences  Okayama Japan"},{"name":"Okayama City Public Health Center  Okayama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4332-4075","authenticated-orcid":false,"given":"Akihito","family":"Takeuchi","sequence":"additional","affiliation":[{"name":"Division of Neonatology NHO Okayama Medical Center  Okayama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takashi","family":"Yorifuji","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Faculty of Medicine Dentistry and Pharmaceutical Sciences, Okayama University  Okayama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,11,10]]},"reference":[{"key":"e_1_2_10_2_1","unstructured":"Ministry of Health Labour and Welfare Japan.Longitudinal survey of newborns born in the 21st century (2001 Cohort) [21 Seiki Shusshou Ji Jyudan Chousa (Heisei 13 Nen Shusshou Ji)].https:\/\/www.mhlw.go.jp\/toukei\/list\/27\u20109.html. 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