Choline and pregnancy: a key nutrient for fetal neurodevelopment

During pregnancy, the focus is usually on folic acid , iron , or iodine . However, scientific evidence accumulated in recent decades and leading maternal nutrition organizations show that there is a fundamental nutrient for fetal development that often goes unnoticed: choline .

Despite being an essential nutrient, most prenatal supplements on the market include zero or irrelevant amounts, ignoring that the demand for choline skyrockets during pregnancy.

In this article we explain what choline is, why its demand increases during pregnancy , what studies have observed, and what the usual doses and possible side effects described in the scientific literature are .

What is choline and what role does it play during pregnancy?

Choline is an essential nutrient involved in several key bodily processes and serves as a building block for the membranes of all cells in the body . It is a component of the phospholipids that make up cell membranes, is necessary for the synthesis of the neurotransmitter acetylcholine , and contributes to the metabolism of methyl groups, processes involved in the regulation of gene expression .

During pregnancy, these functions become especially important . The fetus is completely dependent on the mother's supply of choline, and the placenta actively transports this nutrient to the fetal compartment . This mechanism indicates that the body prioritizes its availability during gestation, particularly during phases of rapid cell growth and nervous system development.

Nevertheless, various dietary studies agree that many pregnant women do not achieve the intakes considered adequate solely through their usual diet.

Key functions of the hill

• Brain construction : It is a precursor to acetylcholine , a neurotransmitter essential for memory, learning, and communication between neurons.

• Neural connections : The choline participates in the formation of neuronal connections involved in memory and learning processes.

• Prevention of defects : It participates in processes involved in the formation of the neural tube and in the regulation of gene expression, according to observational studies in humans.

What does science say?

Choline and early embryonic development

Scientific interest in choline in pregnancy began with observational studies focused on the periconceptional period.

In a case-control study, Shaw et al. (2004) analyzed dietary choline intake before and at the start of pregnancy. Women with higher intakes were less likely to have offspring with neural tube defects compared to those with lower intakes.

The study was one of the first human studies to identify choline as a potentially relevant nutrient in early embryonic development.

Cognitive development in early stages

Experimental evidence in humans comes from clinical trials conducted on healthy pregnant women with controlled diets.

In a randomized, double-blind trial, Caudill et al. (2018) evaluated the effect of choline supplementation during the third trimester of pregnancy. Participants received controlled diets with varying levels of choline, ensuring actual intake of the nutrient.

The primary outcome of the study was information processing speed in infants, assessed using visual habituation tasks in the first months of life. Infants of mothers with higher choline intake showed faster information processing compared to the group with lower intake.

The study did not assess clinical complications of pregnancy or long-term health outcomes, so its findings should be interpreted as early functional effects and not as evidence of overall clinical benefits.

The big deficit: why diet is often not enough

Typical intakes are clearly below recommendations, falling far short of the 450 mg/day recommended during pregnancy . This nutrient is found primarily in egg yolks, but it is difficult to achieve adequate intake through diet alone , which is why various professional organizations have pointed out the low presence of choline in common prenatal supplements.

Safety and possible side effects

In studies conducted in healthy pregnant women, choline has been shown to be well tolerated at the amounts used . No clinically relevant adverse effects have been described in association with the studied intakes during pregnancy.

The side effects described in the literature appear mainly with very high intakes and come mostly from studies in the general population . These include digestive discomfort, nausea, and a characteristic body odor related to choline metabolism.

The IVB strategy

Choline is an essential nutrient with a significant physiological role during pregnancy. Studies show that it participates in key processes of fetal development and that many women do not achieve adequate intakes through their usual diet.

The available evidence indicates that a higher intake of choline is associated with measurable biological changes during gestation and in early life stages.

From IVB Wellness's perspective, the message is clear and prudent: ensuring adequate choline intake during pregnancy is physiologically reasonable , while supplementation should be carefully considered. individually .

Doses adapted to each stage

At IVB we have designed a strategic nutritional escalation to accompany you with a dose adapted to the nutritional recommendations of each choline stage at each moment:

• VitalNatal Woman (Preconception): 425 mg . Dose aligned with adequate intakes for the pre-conception stage, aimed at avoiding deficiencies before pregnancy.

• GestaNatal (Pregnancy): 450 mg . Adjusted to the increased physiological requirements to support cell division and fetal neurodevelopment during the 9 months.

• LactaNatal (Breastfeeding): 550 mg . The time of peak demand. Choline is crucial for the quality of breast milk, and the baby continues to need large amounts for rapid brain growth after birth.

References

1. Caudill MA, Strupp BJ, Muscalu L, Nevins JEH, Canfield RL. Maternal choline supplementation during the third trimester of pregnancy improves infant information processing speed: a randomized, double-blind, controlled feeding study. FASEB J. 2018 Apr;32(4):2172-2180. doi: 10.1096/fj.201700692RR. Epub 2018 Jan 5. PMID: 29217669; PMCID: PMC6988845.

2. Ross RG, Hunter SK, McCarthy L, Beuler J, Hutchison AK, Wagner BD, Leonard S, Stevens KE, Freedman R. Perinatal choline effects on neonatal pathophysiology related to later schizophrenia risk. Am J Psychiatry. 2013 Mar;170(3):290-8. doi: 10.1176/appi.ajp.2012.12070940. Erratum in: Am J Psychiatry. 2013 May 1;170(5):566. PMID: 23318559; PMCID: PMC3640283.

3. Shaw GM, Carmichael SL, Yang W, Selvin S, Schaffer DM. Periconceptional dietary intake of choline and betaine and neural tube defects in offspring. Am J Epidemiol. 2004 Jul 15;160(2):102-9. doi: 10.1093/aje/kwh187. PMID: 15234930.