Journal
JOURNAL OF PEDIATRICS
Volume 208, Issue -, Pages 198-+Publisher
MOSBY-ELSEVIER
DOI: 10.1016/j.jpeds.2018.12.010
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Funding
- National Institutes of Health Eunice Kennedy Shriver National Institute of Child Health and Human Development [K12HD001271-11]
- National Center for Advancing Translational Sciences [UL1 TR001082]
- Institute for Children's Mental Disorders
- Anschutz Foundation
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Objective To assess whether maternal choline decreases effects of mothers' infections on fetal brain circuit development and on expression of infant behavior at 1 year of age. Study design A cross-sectional study was conducted in a public hospital obstetrics and midwifery service, with prenatal assessments of maternal infection, C-reactive protein, and choline level and postnatal assessments of cerebral neuronal inhibition in 162 newborns. At 1 year, 136 parents completed reports of their child's behavior. Results Maternal infection at 16 weeks of gestation, experienced by 41% of mothers, raised mean maternal C-reactive protein (d' = 0.47, P = .002) and decreased the development of cerebral inhibition of auditory response at 1 month of age (d' = 0.39, P < .001). Decreased newborn cerebral inhibition manifested as decreased behavioral self-regulation at 1 year. Greater choline levels in mothers with infections were associated with improved newborn inhibition of auditory cerebral response, mitigating the effect of infection (beta = -0.34 [95% CI, -5.35 to -0.14], P = .002). At 1 year of age, children of mothers with infection and greater gestational choline levels had improved development of self-regulation, approaching the level of children of mothers without infection (b = 0.29 [95% CI 0.05-0.54], P = .03). Conclusions Greater maternal choline, recommended by the American Medical Association as a prenatal supplement, is associated with greater self-regulation among infants who experienced common maternal infections during gestation. Behavioral problems with diminished self-regulation often lead to referrals to pediatricians and might lead to later mental illness.
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