Pregnancy alters choline dynamics: results of a randomized trial using stable isotope methodology in pregnant and nonpregnant women

Abstract

The enhanced use of choline for PC production via both the CDP-choline and PEMT pathways shows the substantial demand for choline during late pregnancy. Selective partitioning of PEMT-PC to the fetal compartment may imply a unique requirement of PEMT-PC by the developing fetus.

Maternal Choline Status, but Not Fetal Genotype, Influences Cord Plasma Choline Metabolite Concentrations

“…These findings suggest that choline supplementation may provide benefits to the developing fetus by increasing concentrations of methyl donors in maternal and fetal compartments. The rise in maternal plasma choline concentrations during pregnancy is due to the mobilization of maternal hepatic choline stores and increase in estrogen, which induces PEMT (8,27). The decrease in betaine, more than accounted for by hemodilution (9), reflects the rapid turnover of betaine and the high demand for methyl donors during pregnancy (28).…”

“…A choline intake above the AI was shown to increase concentrations of choline-derived one-carbon donors (8), improve placental function (17), and attenuate fetal response to stress (18). Despite cholineÕs importance in fetal development, most pregnant American women consume amounts of choline well below the AI (19), and a recent report from the province of Alberta suggests that intake in a Canadian population is also low (20).…”

“…Pregnancy-induced alterations in choline metabolism (Figure 1) (7) include the following: partitioning of dietary choline to the cytidine diphosphate choline pathway rather than oxidation to betaine; increased use of betaine for methionine production; and increased use of choline-derived methyl groups for phosphatidylcholine synthesis via the phosphatidylethanolamine N-methyltransferase (PEMT) 12 pathway (8). Increased choline intake may alter choline and one-carbon metabolism by enhancing the use of choline as a methyl donor in maternal and fetal compartments (9).…”

Polymorphic variants of genes involved in choline pathway and the risk of intrauterine fetal death

“…Notably, increased consumption of dietary choline during pregnancy can improve biomarkers of choline metabolism. For example, consumption of 930 versus 480 mg choline/day by third-trimester pregnant women led to higher circulating concentrations of several choline-derived methyl donors and restored choline partitioning between the CDP-choline and betaine pathways (which compete for choline as a substrate) to a nonpregnant state [6,19].…”

“…1) [3][4][5]. In human pregnancy, PEMT-phosphatidylcholine (vs phosphatidylcholine produced by the CDP-choline pathway) is preferentially partitioned from the maternal to the fetal compartment [6]. Thus, supplementing the maternal diet with extra choline during early pregnancy may increase supply of choline and DHA to the developing fetus.…”