Associations Between Maternal Folate Status and Choline Intake During Pregnancy and Neurodevelopment at Three to Four Years of Age in the Alberta Pregnancy Outcomes and Nutrition (APrON) Study

• Published in: Journal of developmental origins of health and disease 2023-03, Vol.14 (3), p.402-414
• Main Authors: Irvine, Nathalie, England-Mason, Gillian, Field, Catherine J., Letourneau, Nicole, Bell, Rhonda C., Giesbrecht, Gerald F., Kinniburgh, David W., MacDonald, Amy M., Martin, Jonathan W., Dewey, Deborah, Team, APrON Study
• Format: Article
• Language: English
• ISSN: 2040-1744; 2040-1752
• DOI: 10.1017/S2040174423000041

Folate and choline are methyl donor nutrients that may play a role in fetal brain development. Animal studies have reported that prenatal folate and choline supplementation are associated with better cognitive outcomes in offspring and that these nutrients may interact and affect brain development. Human studies that have investigated associations between maternal prenatal folate or choline levels and neurodevelopmental outcomes have reported contradictory findings and no human studies have examined the potential interactive effect of folate and choline on children’s neurodevelopment. During the second trimester of pregnancy, maternal red blood cell folate was measured from blood samples and choline intake was estimated using a 24-hour dietary recall. At 3-4 years of age, children’s neurodevelopment was assessed using the Wechsler Preschool and Primary Scales of Intelligence - Fourth Edition CND , NEPSY-II language, and memory subtests, four behavioral executive function tasks, and the Movement Assessment Battery for Children - Second Edition. Adjusted regressions revealed no associations between maternal folate and choline levels during pregnancy and most of the child outcomes. On the Dimensional Change Card Sort, an executive function task, there was an interaction effect; at high levels of choline intake (i.e., 1 SD above the mean; 223.03mg/day), higher maternal folate status was associated with decreased odds of receiving a passing score (β = −0.44; 95%CI −0.81, −06). In conclusion, maternal folate status and choline intake during the second trimester of pregnancy were not associated with children’s intelligence, language, memory, or motor outcomes at 3-4 years of age; however, their interaction may influence children’s executive functioning.