Choline supplementation during pregnancy improves infant attention span

Mothers who consume twice the recommended amount of choline during their third trimester of pregnancy give birth to children with significantly better sustained attention at age 7 years, according to a recent trial.

“These findings suggest that the choline Adequate Intake (AI) for pregnant women may not be sufficient for optimal child cognition because consumption of 930-mg choline/day produced superior child cognition relative to consumption of approximately the AI,” the researchers said. Current guidelines set AI during pregnancy at 480 mg choline/day.

The present study was a long-term follow-up of children born to women (n=29) who were randomized to receive 480- (AI; n=16) or 93-mg choline/day (n=13) during their third trimester of pregnancy. The primary outcome of interest was sustained attention as measured by the Sustained Attention Test (SAT) at age 7 years.

Twenty children were able to complete the 7-year follow-up, of whom nine were born to mothers who received the AI choline intervention and 11 to those given 930 mg choline/day. On average, the participants correctly identified the presence of a signal on 78 percent of signal trials and its absence on 78 percent of nonsignal trials. Children had greater difficulty detecting the 17-ms signals than the 29- or 50-ms signals. [FASEB J 2021;doi:10.1096/fj.202101217R]

Children in the AI group achieved a mean SAT score of 0.56, while comparators in the 98-mg/day arm had a mean score of 0.71. Mixed model analysis revealed a significant main effect of choline treatment, such that those in the higher dose group were significantly more accurate at identifying signals and rejecting nonsignals (p=0.02).

The impact of maternal choline on SAT scores showed no interaction with signal duration alone (p=0.74) or with trial block (p=0.79).

Focusing on signal trials showed that children in the higher dose group had much better stimulus detection than those in the AI group. The resulting mean percentage hits were 84 percent and 76 percent, respectively, though the main effect of maternal choline intake was not significant (p=0.12). A similar effect was found in nonsignal trials, with children in the higher dose group showing marginally lower rates of false alarm (15.3 percent vs 22.9 percent; main effect of choline dose, p=0.29).

“In summary, maternal intake of the recommended amount of choline during the third trimester resulted in poorer offspring sustained attention than was demonstrated by the offspring of mothers who consumed twice that amount,” the researchers said.

“If subsequent research confirms the adverse effects of low choline intake on offspring sustained attention, it is likely that such effects would extend beyond performance on a laboratory task,” they added, pointing out that sustained attention and attentional control are attributes that contribute to several higher order cognitive functions.