Choline in Pregnancy: New Oct 2026 RCT

Choline is not a nutrient that the human body can synthesize in sufficient quantities; it must be obtained from dietary sources (eggs, meat, fish, dairy products, grains, and nuts). Its a water-soluble amine that serves as a precursor for phospholipids, which are vital components of cell membranes. Plus, it’s a vital component of acetylcholine, a neurotransmitter involved in numerous brain functions. Inadequate choline intake during fetal organogenesis is associated with neural tube defects and cognitive deficits in offspring. In the mother, low choline use has been associated with preeclampsia, preterm birth and possible fetal growth restriction. While choline is crucial for fetal development and maternal outcomes, studies suggest that many pregnant women don’t meet the recommended dietary intake, potentially risking maternal and fetal health. ACOG recommends that pregnant women consume 450 mg of choline each day, although there is no universal internationally agreed upon dose for proper maternal supplementation. Of note, the current recommendations for pregnant women were set in 1998 and were based on the amount of choline needed to prevent liver dysfunction in men, not on the more relevant outcome of offspring neurocognitive development. In this episode, we will highlight a new RCT (Article in Press-AJOG; Oct 19, 2026) on Choline supplementation in pregnancy and early childhood behavioral and cognitive outcomes. While the results were promising, there are some limitations to this study. Listen in for details.

1. Jaiswal A, Dewani D, Reddy LS, Patel A. Choline Supplementation in Pregnancy: Current Evidence and Implications. Cureus. 2023 Nov 8;15(11):e48538. doi: 10.7759/cureus.48538. PMID: 38074049; PMCID: PMC10709661.

2. Hunter S, Hoffman M, Law A .Prenatal Maternal Phosphatidylcholine and Children’s Behavior and Cognition through 4 Years of Age: Randomized Clinical Trial. American Journal of Obstetrics & Gynecology, 2026;

3. Bahnfleth CL, Strupp BJ, Caudill MA, Canfield RL. Prenatal choline supplementation improves child sustained attention: A 7-year follow-up of a randomized controlled feeding trial. FASEB J. 2022 Jan;36(1):e22054.

4. Cai F, Young BK, Mccoy JA. Commercially Available Prenatal Vitamins Do Not Meet American College of Obstetricians and Gynecologists Nutritional Guidelines. Am J Perinatol. 2024 May;41(S 01):e2547-e2554.