Effect of Maternal Choline Intake on Choline Status and Health Biomarkers During Pregnancy and Lactation

Choline is a micronutrient used for the structural integrity of cell membranes, lipid
transport/metabolism, methylation reactions and cholinergic neurotransmission. Prenatal and
early postnatal choline exposure plays a critical role in brain development and cognition
based on animal data. Although it is recognized that choline use is particularly high
during pregnancy and lactation, the level of choline intake needed to optimize maternal and
fetal health outcomes is unknown. The primary objective of this study is to investigate
the metabolic and genomic effects of two doses of choline intake, 450 mg/d (the adequate
intake level) and 900 mg/d in pregnant, lactating, and nonpregnant control women. A
secondary objective is to examine the effect of extra maternal choline intake on the child's
cognitive performance (i.e, learning, memory and attention). To accomplish these objectives,
pregnant women (wk 27 gestation), nonpregnant control women, and lactating women will
consume controlled choline intakes of 450 or 900 mg/d for 10 to 12 weeks. The basal diet
will provide 350 mg/d; supplemental choline chloride, 100 or 550 mg/d, will be used to
achieve the target intake levels. During the last half of the study, a small portion (~
20%) of the total choline intake will be derived from deuterium labeled choline, a stable
isotope. Blood, urine and/or breast milk will be collected at baseline and at select
timepoints throughout the study duration. For pregnant women, a maternal blood sample will
be obtained at the time of delivery along with a cord blood sample and the placental tissue.
Genomic and metabolomic profiling will be performed on the collected biological samples
along with specific measurements of choline status. Non-invasive tests assessing cognitive
function will be performed on the children of the pregnant and lactating study participants.
Because of the highly controlled nutrient intake throughout the duration of this study, IRB
approval was sought and obtained for assessing status indicators for other micronutrients
including biotin and vitamin D.