To investigate the association between choline intake during pregnancy and choline metabolism in parturients and infants, and to analyze the difference in plasma choline level between premature and healthy full-term infants at birth.

Neonates who were born in the Department of Obstetrics of Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from September 2014 to May 2016 were enrolled. Demographic and clinical information of these neonates and their mothers were recorded. Dietary choline intake during pregnancy was determined on the second day after delivery using food frequency questionnaires. Free choline levels in plasma of all parturients and neonates were measured. Then, data were collected and analyzed by independent samples t-test, trend Chi-square test, Chi-square test and linear regression methods.

(1) A total of 134 parturients and their neonates were enrolled in this study including 80 full-term infants and 54 premature infants. Compared with the full-term group, the parturients in the premature group had higher pregestational BMI (22.7±3.2 vs 20.8±2.3, t=-3.720) and less education background (trend χ²=4.020) (both P<0.05). (2) The food frequency questionnaires showed that 30.0% (24/80) of pregnant women in the full-term group reached adequate intake (AI) of choline during pregnancy, while only 11.1% (6/54) in the premature group did. (3) Plasma choline level in maternal peripheral blood was positively associated with maternal dietary choline intake during pregnancy (r=0.882, r²=0.778, P<0.001). Moreover, plasma choline level in the umbilical artery was closely related to maternal plasma choline level (r=0.965, r²=0.931, P<0.001). (4) The dietary choline intake during pregnancy, maternal plasma choline level and plasma choline level in umbilical artery in premature infant group were all lower than those of full-term group [(305.24±102.17) vs (386.16±121.36) mg/d, t=4.026; (5.23±0.79) vs (7.18±1.51) μmol/L, t=9.783; (20.68±3.52) vs (27.96±3.94) μmol/L, t=10.930; all P<0.01].

Insufficient dietary intake of choline during pregnancy is common. The dietary choline intake during pregnancy in parturients of preterm delivery group is lower than that in full-term group. Dietary choline intake during pregnancy is related to plasma choline level in umbilical artery. Therefore, dietary guidance should be emphasized for pregnant and lactating women to increase the intake of foods rich in choline. It is also important to provide premature infants with choline in time to meets the needs of their development.

Pregnancy; Choline; Metabolism; Dietary supplements; Diet; Infant, premature