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

Published online by Cambridge University Press:  25 January 2021

Sharon K. Hunter*
Affiliation:
Department of Psychiatry, University of Colorado School of Medicine, Aurora, CO 80045, USA
M. Camille Hoffman
Affiliation:
Department of Psychiatry, University of Colorado School of Medicine, Aurora, CO 80045, USA Department of Obstetrics and Gynecology, Division of Maternal and Fetal Medicine, University of Colorado School of Medicine, Aurora, CO 80045, USA
Angelo D'Alessandro
Affiliation:
Department of Biochemistry and Molecular Genetics, University of Colorado School of Medicine, Aurora, CO 80045, USA
Anna Wyrwa
Affiliation:
Department of Psychiatry, University of Colorado School of Medicine, Aurora, CO 80045, USA
Kathleen Noonan
Affiliation:
Department of Psychiatry, University of Colorado School of Medicine, Aurora, CO 80045, USA
Steven H. Zeisel
Affiliation:
Departments of Nutrition and Pediatrics, University of North Carolina, Chapel Hill, NC 27599, USA
Amanda J. Law
Affiliation:
Department of Psychiatry, University of Colorado School of Medicine, Aurora, CO 80045, USA Department of Cell and Developmental Biology, University of Colorado School of Medicine, Aurora, CO 80045, USA
Robert Freedman
Affiliation:
Department of Psychiatry, University of Colorado School of Medicine, Aurora, CO 80045, USA
*
Author for correspondence: Sharon K. Hunter, E-mail: Sharon.Hunter@cuanschutz.edu

Abstract

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 μM, 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 The Attention Problems and Withdrawn Syndrome scales on Child Behavior Checklist 1½–5 were the principal outcomes.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.

Type
Original Article
Copyright
Copyright © The Author(s) 2021. Published by Cambridge University Press

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