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Updated: Oct 8, 2025
Author Spotlight: Studying the Impact of Maternal Dietary Deficiencies on Long-Term Offspring Health Outcomes
Published on: June 28, 2024
Prenatal choline supplementation improves child sustained attention: A 7-year follow-up of a randomized controlled
Charlotte L Bahnfleth1, Barbara J Strupp1,2, Marie A Caudill1
1Division of Nutritional Sciences, Cornell University, Ithaca, New York, USA.
Insights
Higher maternal choline intake during pregnancy improved sustained attention in 7-year-old children. This study highlights the importance of adequate choline for offspring cognitive development, especially attention.
Area of Science:
- Neuroscience
- Developmental Biology
- Nutritional Science
Background:
- Maternal choline intake during pregnancy is crucial for offspring cognitive development, as shown in rodent studies.
- Prenatal choline deprivation negatively impacts cognition, while supplementation offers benefits.
- Human studies on maternal choline supplementation and long-term offspring cognition are limited.
Purpose of the Study:
- To evaluate the effect of maternal choline supplementation during the third trimester on sustained attention in offspring at age 7 years.
- To compare cognitive outcomes between children whose mothers consumed the Adequate Intake (AI) versus double the AI of choline during pregnancy.
Main Methods:
- A controlled feeding study randomized pregnant women to 480 mg/d or 930 mg/d choline during the 3rd trimester.
- Offspring sustained attention was assessed at age 7 years using a signal detection task (SAT).
- Performance metrics included SAT score, hit rate across the session, and vigilance decrement for varying signal durations.
Main Results:
- Children of mothers consuming 930 mg/d choline showed superior SAT scores (p=.02) and maintained correct detections better (p=.02) compared to the 480 mg/d group.
- The higher choline group exhibited improved vigilance, particularly for brief (17 ms) signals, showing a 1.5% increase in hits versus a 22.9% decline in the lower choline group (p=.04).
- No group differences were observed in false alarms, omissions, or off-task behaviors, supporting enhanced sustained attention in the higher choline group.
Conclusions:
- Maternal choline intake of 930 mg/d during the third trimester enhances sustained attention in offspring at age 7 years.
- Consuming only the choline AI (480 mg/d) resulted in poorer sustained attention, raising concerns given average intake is below AI.
- These findings underscore the critical role of adequate choline for prenatal programming of cognitive functions like sustained attention.
Abstract:
Numerous rodent studies demonstrate developmental programming of offspring cognition by maternal choline intake, with prenatal choline deprivation causing lasting adverse effects and supplemental choline producing lasting benefits. Few human studies have evaluated the effect of maternal choline supplementation on offspring cognition, with none following children to school age. Here, we report results from a controlled feeding study in which pregnant women were randomized to consume 480 mg choline/d (approximately the Adequate Intake [AI]) or 930 mg choline/d during the 3rd trimester. Sustained attention was assessed in the offspring at age 7 years (n = 20) using a signal detection task that showed benefits of maternal choline supplementation in a murine model. Children in the 930 mg/d group showed superior performance (vs. 480 mg/d group) on the primary endpoint (SAT score, p = .02) and a superior ability to maintain correct signal detections (hits) across the 12-min session (p = .02), indicative of improved sustained attention. This group difference in vigilance decrement varied by signal duration (p = .04). For the briefest (17 ms) signals, the 480 mg/d group showed a 22.9% decline in hits across the session compared to a 1.5% increase in hits for the 930 mg/d group (p = .04). The groups did not differ in vigilance decrement for 29 or 50 ms signals. This pattern suggests an enhanced ability to sustain perceptual amplification of a brief low-contrast visual signal by children in the 930 mg/d group. This inference of improved sustained attention by the 930 mg/d group is strengthened by the absence of group differences for false alarms, omissions, and off-task behaviors. This pattern of results indicates that maternal 3rd trimester consumption of the choline AI for pregnancy (vs. double the AI) produces offspring with a poorer ability to sustain attention-reinforcing concerns that, on average, choline consumption by pregnant women is approximately 70% of the AI.
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