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J Pediatr. 2019 May;208:198-206.e2. doi: 10.1016/j.jpeds.2018.12.010. Epub 2019 Mar 14.

Higher Gestational Choline Levels in Maternal Infection Are Protective for Infant Brain Development.

Author information

1
Department of Psychiatry, University of Colorado Denver School of Medicine, Aurora, CO. Electronic address: Robert.freedman@ucdenver.edu.
2
Department of Psychiatry, University of Colorado Denver School of Medicine, Aurora, CO.
3
Department of Psychiatry, University of Colorado Denver School of Medicine, Aurora, CO; Department of Cell and Developmental Biology, University of Colorado Denver School of Medicine, Aurora, CO.
4
Department of Biostatistics and Informatics, Colorado School of Public Health (BDW), Aurora, CO.
5
Department of Biochemistry and Molecular Genetics, University of Colorado Denver School of Medicine, Aurora, CO.
6
Department of Anesthesiology, University of Colorado Denver School of Medicine, Aurora, CO.
7
Department of Psychiatry, University of Colorado Denver School of Medicine, Aurora, CO; Department of Obstetrics and Gynecology, University of Colorado Denver School of Medicine, Aurora, CO.

Erratum in

Abstract

OBJECTIVE:

To assess whether maternal choline decreases effects of mothers' infections on fetal brain circuit development and on expression of infant behavior at 1 year of age.

STUDY DESIGN:

A cross-sectional study was conducted in a public hospital obstetrics and midwifery service, with prenatal assessments of maternal infection, C-reactive protein, and choline level and postnatal assessments of cerebral neuronal inhibition in 162 newborns. At 1 year, 136 parents completed reports of their child's behavior.

RESULTS:

Maternal infection at 16 weeks of gestation, experienced by 41% of mothers, raised mean maternal C-reactive protein (d' = 0.47, P = .002) and decreased the development of cerebral inhibition of auditory response at 1 month of age (d' = 0.39, P < .001). Decreased newborn cerebral inhibition manifested as decreased behavioral self-regulation at 1 year. Greater choline levels in mothers with infections were associated with improved newborn inhibition of auditory cerebral response, mitigating the effect of infection (β = -0.34 [95% CI, -5.35 to -0.14], P = .002). At 1 year of age, children of mothers with infection and greater gestational choline levels had improved development of self-regulation, approaching the level of children of mothers without infection (β = 0.29 [95% CI 0.05-0.54], P = .03).

CONCLUSIONS:

Greater maternal choline, recommended by the American Medical Association as a prenatal supplement, is associated with greater self-regulation among infants who experienced common maternal infections during gestation. Behavioral problems with diminished self-regulation often lead to referrals to pediatricians and might lead to later mental illness.

KEYWORDS:

child behavior; choline; fetal development; pregnancy exposure delayed effects; receptors nicotinic; sensory gating

PMID:
30879727
PMCID:
PMC6707520
[Available on 2020-05-01]
DOI:
10.1016/j.jpeds.2018.12.010

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