Prenatal choline and long-term cognitive development in children

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Created On: 19/12/2025

Choline plays a vital role in fetal brain development, supporting cellular growth, neurotransmission, and long-term cognitive function.

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Key take away

Supplementing pregnant women with 550 mg of choline daily enhances children’s brain function and cognitive performance from infancy to early childhood.

Background

Choline plays a vital role in fetal brain development, supporting cellular growth, neurotransmission, and long-term cognitive function. Despite increased prenatal requirements, the optimal choline intake during pregnancy remains uncertain, prompting growing interest in its neurodevelopmental impact. This review aimed to determine the effect of maternal choline supplementation on cognitive outcomes in offspring from infancy through early childhood.

Method

An extensive literature search was carried out across PubMed, CINAHL, Embase, Scopus, and BioMed Central for English-language studies issued between 2012 and 2024. Eligible studies included randomized controlled trials or observational cohorts enrolling healthy pregnant women aged 18–45 without comorbidities and with sample sizes exceeding 10 participants. Cognitive outcomes were assessed via validated neurodevelopmental tools, and findings were synthesized to compare the effects of different choline doses.

Result

From 132 identified studies, 3 met the inclusion criteria—two randomized controlled trials and one longitudinal follow-up.

In two trials, infants and 7-year-old children whose mothers received 550 mg/day of choline showed remarkably superior cognitive performance compared with those whose mothers received 100 mg/day. Improvements were noted in infant saccadic reaction time (confidence interval: 1.3–43.8 ms, p=0.03) and 7-year-old sustained attention tasks (0.71, standard error=0.04, p=0.02).
The third study reported no pivotal differences in 10-month-old infants’ visuospatial memory (p=0.243), long-term memory (p=0.705), expressive vocabulary (p=0.697), or global development index (p=0.707) between 0 mg and 750 mg choline supplementation groups.

Conclusion

Maternal choline supplementation at 550 mg/day was associated with improved cognitive outcomes in infants and children, particularly in reaction time and early attentional abilities. Further research is crucial to define precise maternal choline recommendations and to comprehend long-term impacts on child cognitive outcomes.