Associations Between Maternal Dietary Choline Intake During Pregnancy and Developmental Outcomes in Toddlers

Abstract

Objectives Recent studies indicate that adequate choline intake in pregnancy results in increased cognitive, motor, language, and behavioral scores in toddlers. The objective was to examine the relationship between maternal choline intake during pregnancy and children's developmental scores during the first two years of life. Methods De-identified secondary data from a longitudinal study (NCT#0,328,1851) involving women with normal weight, overweight, and class I obesity (BMI:18.5- 35 kg/m,2 N = 251) during pregnancy and their children were analyzed using Pearson's correlations and linear models. Dietary choline intake was obtained by analyzing 3-day food records at each trimester using the Nutrient Data System for Research. Cognitive, motor, language, social emotional, and adaptive behavioral scores at 1 and 2 years of age were derived from the administration of the Bayley Scales of Infant and Toddler Development, Third Edition (Bayley-III). Results Adequate Intake (AI) for average maternal choline intake was only met by 4 of the 251 participants. Mean intake of maternal choline during pregnancy (281 mg/day) was significantly lower than the AI level of pregnant women (AI = 450 mg/day). Mean standard scores for Bayley-III domains were all within the normal range (102 for cognitive, 101 for motor, 96 for language, 109 for social-emotional, and 94 for adaptive behavior). Higher maternal choline intake yielded lower adaptive development at 12 months of age (P < 0.001) and 24 months of age (P = 0.044) after adjusting for gestational age and birthweight. There were no associations between maternal choline intake and cognitive, motor, language and social-emotional scores at both ages. Conclusions In this cohort from Arkansas, maternal choline intake was not associated with four of the children's neurodevelopmental outcomes. Maternal Choline intake was negatively associated with the self-reported adaptive behavior scope, which is in contrast to previously published literature. It is important to note that infant development scores were all within normal range despite 98% of women not meeting the AI recommendations for dietary choline during pregnancy. Analyses of choline serum concentration from this cohort is underway to confirm these results. Funding Sources USDA ARS Project # 6026–51,000-012–06S, NIH R01 DK107516.

Habitual Choline Intakes across the Childbearing Years: A Review

“…Mean choline intake estimates for pregnant adults from the United States ranged from 281 mg/day to 332 mg/day [16,18,34,38,43]. Intakes were similar in pregnant Canadians with mean intake estimates ranging between 306 mg/day and 383 mg/day [39,41,42,46].…”

“…The inclusion of dietary supplements did not substantially increase choline intakes. When derived from foods only, mean choline intake estimates for pregnant adults ranged from 190-383 mg/day [19,20,34,36,38,40,42]. In studies when estimates included choline from foods and supplements, mean intakes ranged from 268 to 353 mg/day and, thus, did not change substantially [16,18,35,37,39,41,43,46].…”

“…Sixteen studies recorded choline intakes during pregnancy [16,[18][19][20][34][35][36][37][38][39][40][41][42][43][44][45]. Seven documented choline intakes in the first trimester [35,[37][38][39]41,43,45], along with five in the second trimester [37,38,[41][42][43], five in the third trimester [37][38][39][40][41], and six in pregnancy overall [16,[18][19][20]34,44]. Across the trimesters, changes in choline intake were generally very small.…”