Choline could prevent fetal brain problems caused by maternal infection

Robert Freedman

Infections during pregnancy have been linked to behavioral problems in children. According to recent findings, however, higher levels of the vitamin B nutrient choline can promote greater self-regulation in infants of mothers who experienced infection during gestation.

“Many pregnant women report common infections,” Robert Freedman, MD, professor of psychiatry at the University of Colorado School of Medicine, told Infectious Diseases in Children. “These seemingly benign infections increase risk to the fetus for later attention deficit disorder, autism, and even schizophrenia.”

Researchers identified pregnant women who were admitted to Denver Health Medical Center before the 16th week of gestation. The women were assessed at various times for infection, C-reactive protein and choline levels.

The infants’ brain development was analyzed at 1 and 3 months of age, and when the children reached 1 year of age, their parents completed the Infant Behavior Questionnaire – Revised Short Form (IBQ-R).

Of the 162 women who brought their infant to the 1-month post-gestation visit, 66 (41%) had an infection by 16 weeks’ gestation, according to the researchers. After 1 year, 136 parents completed the IBQ-R.

Maternal infection at 16 weeks’ gestation was associated with increased maternal C-reactive protein (d’ = 0.47; P = .002) and decreased development of cerebral inhibition of auditory response in newborns aged 1 month (d’ = 0.39, P < .001), which led to decreased behavioral self-regulation when the child was 1 year of age.

However, the researchers found that higher levels of choline at 16 weeks’ gestation were associated with improved newborn inhibition of auditory cerebral responses, mitigating the effect of maternal infection (beta = 0.34; 95% CI, 5.35 to 0.14; P = .002). At 1 year of age, children of infected mothers with higher levels of gestational choline were closer to the level of self-regulation attained by children of mothers without infection (beta = 0.29; 95% CI 0.05-0.54; P = .03).

In 2017, the American Medical Association updated their guidelines to recommend evidence-based amounts of choline in all prenatal vitamins. Specifically, Freedman recommended 2,700 mg of phosphatidylcholine twice daily to prevent adverse effects on fetal development caused by maternal infection.

“Women cannot predict if they will become infected, despite precautions, but by increasing their choline levels, their clinicians can help protect their babies,” he said. – by Erin Michael

References:

AMA. Memorial Resolutions Adopted Unanimously. https://www.ama-assn.org/sites/ama-assn.org/files/corp/media-browser/public/hod/a17-resolutions.pdf#page=56. Accessed April 3, 2019.

Freedman R, et al. J Pediatr. 2019;doi:10.1016/j.jpeds.2018.12.010.

Disclosure: Freedman reports no relevant financial disclosures.