Choline, folic acid, Vitamin D, and fetal brain development in the psychosis spectrum

Choline, folic acid, and Vitamin D are essential for fetal brain development that may be the first steps in the path-ogenesis of the psychotic spectrum. Micronutrient deficiencies have been associated with changes in fetal brain development, manifest as early problems in childhood behavior, and cognition, and later as increased incidence of psychotic and autism spectrum disorders. Micronutrient supplements may not only prevent deficiency, but they may also positively affect brain development in the context of other maternal risk factors, including mater-nal infection, stress, inflammation, and substance abuse. Many genes associated with later psychotic illness are highly expressed in the fetal brain, where they are responsible for various neurodevelopmental mechanisms. In-teraction of micronutrient vitamins with these genetically programmed mechanisms to prevent pathological brain development associated with later psychosis is under active investigation. In addition to their effects on brain development, micronutrient vitamins have effects on other aspects of gestation and fetal development, in-cluding the prevention of premature delivery and other developmental abnormalities. Supplemental micronutri-ent vitamins should be part of good prenatal care, as has already happened for folic acid and Vitamin D and is now advocated by the American Medical Association for choline. The benefits of these micronutrient supplements in-clude protection of brain development and the possibility of decreased risk for future psychotic disorders in those children who are either genetically or environmentally vulnerable. The purpose of this review is to present the current evidence supporting the safety and effectiveness of micronutrients in gestation and to suggest areas for future research. (c) 2021 Elsevier B.V. All rights reserved.

Automated summary

Choline, folic acid, and Vitamin D are essential for fetal brain development. Micronutrient deficiencies are associated with changes in brain development and increased incidence of psychiatric disorders. Micronutrient supplements can prevent deficiency and positively affect brain development, potentially decreasing the risk of future psychotic disorders.