Choline and Pregnancy. How Does Choline Boost Fetal Brain Development?

Joseph R. Anticaglia, MD
Medical Advisory Board

“The risk of mental illness in a child is about one in 10. The risk of spinal bifida in a child is about one in 1000. Yet, every woman takes folic acid to avoid spina bifida risk. We ought to think about every woman taking choline to avoid that mental illness risk which is one in 10. If we could make sure that a baby builds a better brain before it was born perhaps we could prevent it from ever becoming mentally ill,” according to Robert Freeman, MD.

“The nutrient choline has been shown to support fetal brain development, and supplements taken during pregnancy may lead to improve attention concentration spans in childhood as well as decreased risk of schizophrenia for these children in later life.”

j. r. a. Woman holding a bottle of Choline

What is Choline?

Choline is an essential nutrient, a natural substance found in foods needed by the body for nourishment, and growth. The body produces a small amount of choline which is not enough to meet the body’s daily needs. Therefore, we must get choline from our diet in foods such as eggs, beef, fish , nuts, beans and vegetables. The Institute of Medicine (IOM) in 1998 officially recognized choline as an essential nutrient. Choline is vital for many biologic functions.

Choline’s Functions

Although choline is neither a vitamin, nor a mineral, it plays a pivotal role in a wide range of essential bodily functions which include:

Cell Membrane

Cell membranes separate the inside of the cell from the outside environment. They protect, support and regulate the movement of substances in and out of the cell. Choline is a forerunner for certain fats, a precursor for phospholipids, a major component of cell membranes.

Fat Transport

Choline helps remove fat stored in the liver, cholesterol, to other parts of the body where it can be used for energy and storage.

Neurotransmission

Neurotransmission is the relaying of nerve impulses between nerve cells (neurons), or between nerve cells and muscle, or another structure. Choline is a nutrient precursor that the body uses to make acetylcholine, a neurotransmitter that sends nerve impulse messages that are involved in memory and cognition, muscle control, and many other functions.

DNA Synthesis

Choline is essential for DNA synthesis, along with vitamins B12 and folate.

Choline is a vital nutrient that’s involved in many bodily functions. The risk of mental illness increases significantly in fetuses of pregnant women who have an insufficient amount of choline in their system. Consider discussing with your Obstetrician the advisability of taking a blood sample to measure the amount of choline present, and supplementation to support the baby’s brain development, and brain health..

Glossary

Cell Membrane: Choline is used in the synthesis of certain phospholipids (phosphatidylcholine, and sphingomyelin) that are essential structural components of cell membrane. About 95% of choline is found in phosphatidylcholine, a lipid-soluble form of choline.

CHRNA 7 gene has been associated with the risk of mental illness such as schizophrenia, bipolar disorder, and attention deficit disorder.

References

  1. Robert R. Freedman, MD, M. Camille Hoffman, M. D, MSc; Higher Maternal Choline Levels in Pregnancy Had Protective Role in Infant Brain Development; Brain and Behavior, January 9, 2022
  2. Barbara Strupp; Choline during pregnancy impacts children’s sustained attention; Cornell University, College of Human Ecology, 2022
  3. Robert Freedman, M. D; Prenatal Choline and Brain Health; Healthy Minds, Host, Jeffrey Borenstein, MD, May 1, 2024
  4. National Institute of Health; Choline, June 2, 2022
  5. Zeisel, S. H., & da Costa, K. A. (2009). Choline: an essential nutrient for public health. Nutrition, 2009
  6. Emma Derbyshire, and Rima Obeid; Choline, Neurological Development and Brain Function: A Systematic Review Focusing on the First 1000 Days; Nutrients, June 10, 2020
  7. Katherine Marengo and Jamie Eske; What is choline? Benefits, deficiency, and sources;; MedicalNewsToday, Nov 26, 2019
  8. Mary Jane Brown, PhD; What Is Choline? An Essential Nutrient With Many Benefits; Healthline, Jul 3, 2023
  9. Food and Nutrition Board, Institute of Medicine. Dietary Reference Intakes: Thiamin, Riboflavin, Niacin, Vitamin B-6, Vitamin B012, Pantothenic Acid, Biotin, and Choline. Washington, D. C.: National Academy of Sciences; 1998. pp. 390–422.

This article is intended solely as a learning experience. Please consult your physician for diagnostic and treatment options.