Prenatal Choline May Ameliorate Effects of Prenatal Alcohol Exposure

Prenatal supplements with the nutrient choline may help protect against alcohol-related deficits in children born to women who drink alcohol during pregnancy, according to a small clinical trial supported by the National Institute on Alcohol Abuse and Alcoholism (NIAAA). The new findings were reported in the July 2018 issue of Alcoholism: Clinical and Experimental Research.

Choline is found in large quantities in meat, dairy products, eggs, and some vegetables. It readily crosses the placenta and accumulates in the fetal brain, where it plays an important role in cell membrane integrity, transmembrane signaling, and lipid and cholesterol transport and metabolism. It’s also an important precursor to acetylcholine, as well as a methyl-group donor for DNA methylation, and thus influences downstream alterations in gene expression.

Previous studies conducted in animals have found that choline supplementation during pregnancy appears to protect animals’ offspring from both physical and brain effects of prenatal alcohol exposure. Prenatal choline supplementation in animals has also been shown to protect against other forms of neurotoxicity and injury-induced brain impairments in the offspring.

In the new study, researchers led by Sandra W. Jacobson, Ph.D., and Joseph L. Jacobson, Ph.D., NIAAA grantees at Wayne State University School of Medicine in Detroit, worked with scientists from the University of Cape Town in South Africa to investigate the effectiveness of choline supplementation among a group of pregnant women in Cape Town. Pregnant women who drank heavily were recruited into the study.

The 69 women in the study were recruited in midpregnancy, having started prenatal care by the 23rd week of gestation. They were randomly assigned to receive a daily oral dose of either 2 grams of choline or placebo from the time of their enrollment in the study until they gave birth. Each dose consisted of a powder that, when mixed with water, produced a sweet-tasting, grape-flavored drink.

Children born to the women in the study were tested at ages 6 months and 12 months on a variety of measures, including physical growth as well as cognitive, learning, and memory performance. The researchers reported that, although infants in both groups were small at birth, choline-exposed infants showed considerable catchup growth in weight and head circumference at 6 months and at 12 months, when compared with infants in the placebo group. Also, at 12 months, the infants in the choline treatment group scored higher than infants in the placebo group on tests of visual recognition memory.

While this study is promising, replicating the results in a larger, and perhaps different, population will help determine if these results can be generalized. According to the study’s authors, future studies should follow the exposed children beyond 12 months to assess the durability of the benefits and whether there are additional advantages to choline supplementation.