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Abstract With the worldwide increase of only-child families, it is crucial to understand the influence of growth without siblings (GWS) on human health, but there is limited knowledge regarding the effects of GWS on human brain. Besides, existing studies have reported paradoxical associations between GWS and mental health, most likely due to mismatched confounders and overlooked growth environments. Here, using 2,305 pairs of individuals with and without siblings well matched in confounders, we comprehensively examined the impact of GWS on changes in adult brain structure, function, and behaviors, as well as pathways from GWS, growth environments to brain and behaviors. Our findings uncovered novel associations, including GWS being linked to higher language-fiber integrity, lower motor-fiber integrity, larger regional cerebellum volume, and lower frontotemporal spontaneous brain activity. Contrary to stereotypical associations between GWS and problem behaviors, we found positive correlations of GWS with neurocognition and mental health. Despite direct effects, GWS affects most adult brain and behavioral outcomes through modifiable environments, such as socioeconomic status, maternal care, and family support, suggesting targets for interventions to enhance children’s healthy growth.
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