Additionally, we tested the mediation effects of three CpG sites that were identified in a recent DCHS study in association with severe neurodevelopmental delay in the cognitive (cg26971411 [SPTBN4], cg00490349 [intergenic], and cg15660740 [intergenic]), language (cg26971411 [SPTBN4] & cg00490349 [intergenic]), and motor (cg26971411 [SPTBN4] & cg00490349 [intergenic]) domains using causal mediation analysis [14]. Here, SPTBN4 is linked to Neurodevelopmental delay.