4.7 Article

Prenatal choline, cannabis, and infection, and their association with offspring development of attention and social problems through 4 years of age

Journal

PSYCHOLOGICAL MEDICINE
Volume 52, Issue 14, Pages 3019-3028

Publisher

CAMBRIDGE UNIV PRESS
DOI: 10.1017/S0033291720005061

Keywords

choline; pregnancy; cognition; inflammation; cannabis

Funding

  1. National Institute of Child Health and Human Development [K12HD001271-11]
  2. National Center for Advancing Translational Sciences [UL1 TR001082]
  3. Anschutz Foundation
  4. NIDDK [R01DK56350]
  5. Institute for Children's Mental Disorders

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The study aimed to investigate the impact of high maternal plasma choline concentrations on early childhood behaviors, with results showing that higher choline levels were associated with children's attention problems and social issues.
Background Prenatal choline is a key nutrient, like folic acid and vitamin D, for fetal brain development and subsequent mental function. We sought to determine whether effects of higher maternal plasma choline concentrations on childhood attention and social problems, found in an initial clinical trial of choline supplementation, are observed in a second cohort. Methods Of 183 mothers enrolled from an urban safety net hospital clinic, 162 complied with gestational assessments and brought their newborns for study at 1 month of age; 83 continued assessments through 4 years of age. Effects of maternal 16 weeks of gestation plasma choline concentrations > 7.07 mu M, 1 s.d. below the mean level obtained with supplementation in the previous trial, were compared to lower levels. The Attention Problems and Withdrawn Syndrome scales on Child Behavior Checklist 11/2-5 were the principal outcomes. Results Higher maternal plasma choline was associated with lower mean Attention Problems percentiles in children, and for male children, with lower Withdrawn percentiles. Higher plasma choline concentrations also reduced Attention Problems percentiles for children of mothers who used cannabis during gestation as well as children of mothers who had gestational infection. Conclusions Prenatal choline's positive associations with early childhood behaviors are found in a second, more diverse cohort. Increases in attention problems and social withdrawal in early childhood are associated with later mental illnesses including attention deficit disorder and schizophrenia. Choline concentrations in the pregnant women in this study replicate other research findings suggesting that most pregnant women do not have adequate choline in their diets.

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