Maternal choline intake modulates maternal and fetal biomarkers of choline metabolism in humans

Am J Clin Nutr. 2012 May;95(5):1060-71. doi: 10.3945/ajcn.111.022772. Epub 2012 Mar 14.


Background: In 1998 choline Adequate Intakes of 425 and 450 mg/d were established for nonpregnant and pregnant women, respectively. However, to our knowledge, no dose-response studies have been conducted to evaluate the effects of pregnancy or maternal choline intake on biomarkers of choline metabolism.

Objective: We sought to quantify the effects of pregnancy and maternal choline intake on maternal and fetal indicators of choline metabolism.

Design: Healthy pregnant (n = 26; 27 wk gestation) and nonpregnant (n = 21) women were randomly assigned to receive 480 or 930 mg choline/d for 12 wk. Fasting blood samples and placental tissue and umbilical cord venous blood were collected and analyzed for choline and its metabolites.

Results: Regardless of the choline intake, pregnant women had higher circulating concentrations of choline (30%; P < 0.001) but lower concentrations of betaine, dimethylglycine, sarcosine, and methionine (13-55%; P < 0.001). Obligatory losses of urinary choline and betaine in pregnant women were ∼2-4 times as high (P ≤ 0.02) as those in nonpregnant women. A higher choline intake yielded higher concentrations of choline, betaine, dimethylglycine, and sarcosine (12-46%; P ≤ 0.08) in both pregnant and nonpregnant women without affecting urinary choline excretion. The higher maternal choline intake also led to a doubling of dimethylglycine in cord plasma (P = 0.002).

Conclusion: These data suggest that an increment of 25 mg choline/d to meet the demands of pregnancy is insufficient and show that a higher maternal choline intake increases the use of choline as a methyl donor in both maternal and fetal compartments. This trial was registered at as NCT01127022.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adult
  • Betaine / blood*
  • Betaine / urine
  • Biomarkers / blood
  • Biomarkers / urine
  • Choline / administration & dosage*
  • Choline / metabolism*
  • Choline / urine
  • Female
  • Fetal Blood / chemistry*
  • Fetus / metabolism
  • Humans
  • Methionine / metabolism
  • Methionine / urine
  • Pregnancy
  • Sarcosine / analogs & derivatives
  • Sarcosine / blood
  • Sarcosine / urine
  • Young Adult


  • Biomarkers
  • Betaine
  • dimethylglycine
  • Methionine
  • Choline
  • Sarcosine

Associated data