5 Benefits of Choline in Pregnancy (& Why Most Women Don’t Get Enough)

Choline is increasingly being recognised as a critical nutrient during pregnancy, yet it remains largely under-consumed. From supporting fetal brain development to aiding neural tube formation, choline plays multiple vital roles throughout gestation.

According to the National Health and Nutrition Examination Survey (NHANES), only about 10% of women meet their recommended choline intake - a gap that raises concerns for both maternal and fetal outcomes [1]. Adding to the concern, most prenatal vitamins on the market either exclude choline or provide insufficient doses [2].

What Is Choline?

Choline is a water-soluble compound often grouped with the B-vitamin family. It is essential for numerous physiological processes including cell membrane integrity, neurotransmitter synthesis (especially acetylcholine), and methylation. Importantly, choline works synergistically with folate, particularly in neural tube development [3].

During pregnancy, large amounts of choline cross the placenta to support fetal growth - leading to significant depletion of maternal stores. Research also shows that choline concentrations in amniotic fluid can be up to 10 times higher than in maternal blood, underscoring its critical role in fetal development [4].

Recommended Choline Intake

• General pregnancy RDI: 450-550 mg per day (The Prenatal contains 550mg of choline to support pregnancy and postpartum requirements).
• Increased needs: Up to 900 mg per day may be beneficial for those with MTHFR polymorphisms or limited dietary intake [5]

Why Choline Matters in Pregnancy

1. Minimises Risk of Neural Tube Defects (NTDs): Like folate, choline is involved in one-carbon metabolism, which is essential for DNA synthesis and methylation. Studies have shown that inadequate choline intake in early pregnancy is associated with increased risk of NTDs, especially in women with low folate status [6].

2. Supports Fetal Brain Development and Cognitive Function: Choline is required for synthesis of phosphatidylcholine and sphingomyelin - key components of the developing fetal brain. Higher maternal choline intake has been associated with improved memory and attention span in children [7, 8].

3. May Reduce Risk of Intrauterine Growth Restriction (IUGR): Animal and human studies suggest that choline supplementation can improve placental function and reduce markers associated with growth restriction [9].

4. Essential for Cell Membrane Structure and Signalling: Choline-derived compounds are integral to cell membrane structure and signalling, supporting healthy tissue development and cellular communication [3].

5. Supports Maternal Liver and Placental Function: Choline helps regulate fat metabolism in the liver, which can reduce the risk of pregnancy-associated fatty liver disease. It also supports optimal placental transport and vascular development [10].

Who Might Benefit The Most from Supplementing?

• Individuals with MTHFR polymorphisms
• Those with low dietary choline intake (e.g., do not consume eggs or liver)

• Women with a history of NTDs or midline defects in prior pregnancies

Best Choline Sources for Pregnant Women

• Eggs (especially yolks)
• Liver (beef, chicken, turkey)
• Salmon
• Beef, lamb, pork, poultry
• Brussels sprouts, broccoli, and other cruciferous vegetables

Preferred Supplement Form

• Choline Bitartrate when it comes to pregnancy is a well-absorbed and widely used supplemental form.

References

1. Jensen, H. et al. (2007). Choline in the diets of the U.S. population: NHANES 2003-2004. ResearchGate

2. Zeisel, S.H. et al. (2009). Choline: critical role during fetal development and dietary requirements. PMC2782876

3. Institute of Medicine. (1998). Dietary Reference Intakes for Thiamin, Riboflavin, Niacin, Vitamin B6, Folate, Vitamin B12, Pantothenic Acid, Biotin, and Choline.

4. Shaw, G. et al. (2009). Choline and neural tube defects in a folate-fortified population. PMC2441939

5. Fennema, D. et al. (2017). Bioavailability of different choline forms in foods and supplements. FASEB Journal

6. Yan, J. et al. (2012). Maternal choline intake modulates fetal brain development in humans. PMC5579609

7. Caudill, M.A. et al. (2018). Maternal choline supplementation during the third trimester improves infant information processing speed. PubMed PMID: 29217669

8. Wu, B.T. et al. (2011). Choline intake during pregnancy improves child cognition. PubMed PMID: 19593156

9. Jiang, X. et al. (2012). Maternal choline supplementation improves placental nutrient transport. PMC5579609

10. Fischer, L. et al. (2010). Effects of choline on liver and placental function in pregnancy. PMC

This article is intended for educational purposes only. Please consult your healthcare provider before making any changes to your supplement routine, especially during pregnancy.