Maternal plasma choline and betaine in late pregnancy and child growth up to age 8 years in the KOALA Birth Cohort Study

Background: Sufficient choline and betaine during pregnancy are needed for fetal growth and development. Objectives: We aimed to investigate the associations between maternal plasma choline and betaine in the third trimester of pregnancy and child growth from birth up to 8 years of age. Methods: Concentrations of choline and betaine were measured in plasma of 1331 pregnant women from the KOALA (Kind. Ouders en gezondheid: Aandacht voor Leefstijl en Aanleg) Birth Cohort Study in the Netherlands. Child weight and height were measured at birth and at 1 (91% complete), 2 (86%), and 6-8 y (76%). Birth weight. weight gain in the first year, and z scores for weight and height at 1 and 2 y were used as continuous outcome variables. BMI z scores at 1 and 2 y were used as continuous and dichotomous outcomes, and BMI z scores at age 6-8 y were used to study overweight at that age. Results: Each 1-mu mol/L increase of maternal plasma choline was associated with a mean 20-g (95% CI: 1.1, 38.0 g) higher weight gain in the first year of life, and a higher BMI z score (beta: 0.02; 95% CI: 0.00, 0.04) and slightly higher odds of BMI z score >85th percentile (OR: 1.08; 95% CI: 1.03, 1.10) at 1-2 y. Each 1-mu mol/L increase of plasma betaine was associated with a mean 12-g (95% CI: 0.8, 23.9 g) higher weight gain in the first year of life and higher odds of BMI z score >85th percentile at 1-2 y (OR: 1.03: 95% Cl: 1.00, 1.07). Lastly, betaine was associated with overweight at 6-8 y (OR: 1.17: 95% CI: 1.02, 1.34). only in boys. Conclusions: Third-trimester pregnancy plasma choline and betaine were positively associated with childhood anthropometric measures. In boys, some of the associations may have persisted up to 8 y of age. Further studies may investigate the validity of maternal plasma choline and betaine concentrations as markers of maternal intake and fetal transfer.

Automated summary

Adequate choline and betaine levels during pregnancy are essential for fetal growth and development. Maternal plasma choline and betaine levels in the third trimester were found to be positively associated with childhood anthropometric measures, with some associations persisting up to 8 years of age, particularly in boys. Further studies are needed to explore the validity of maternal plasma choline and betaine concentrations as markers of maternal intake and fetal transfer.