Association of choline levels in maternal peripheral venous blood and neonatal umbilical cord blood with early neurobehavioral development in infants

WENG Yuwei; LIU Yufeng; QIN Yangzhe; ZHANG Feng; DONG Hongli; CHEN Zhifang

doi:10.11852/zgetbjzz2025-0832

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Chinese Journal of Child Health Care ›› 2026, Vol. 34 ›› Issue (5) : 525-531. DOI: 10.11852/zgetbjzz2025-0832

Special Column on Nurturing Care & Growth and Development

Association of choline levels in maternal peripheral venous blood and neonatal umbilical cord blood with early neurobehavioral development in infants

WENG Yuwei¹, LIU Yufeng², QIN Yangzhe³, ZHANG Feng², DONG Hongli¹, CHEN Zhifang¹

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Abstract

Objective To investigate the potential effect of internal choline exposure on early neurobehavioral development in infants, so as to provide a scientific basis for promoting infants neurobehavioral development. Methods In this prospective cohort study, singleton full-term pregnant women who delivered at the Affiliated Maternity and Child Health Care Hospital of Nantong University between December 2023 and October 2024 and their infants were recruited by convenience sampling. Dietary choline intake in late pregnancy was assessed, and choline levels in maternal blood and cord blood were measured. Infant neurobehavioral development was evaluated at 1, 3, and 6 months of age using the Bayley Scales of Infant Development Revised in Chinese Cities (BSID-CR). Spearman's rank correlation was used to analyze the correlations between dietary choline intake and choline levels in maternal and cord blood. Generalized estimating equations were used to examine the associations between maternal/cord blood choline levels and infant neurobehavioral development. Results A total of 159 mother-infant pairs were included. Energy-adjusted dietary choline intake was positively correlated with maternal blood choline levels (r_s=0.300, P<0.001). The choline content in maternal blood was 2.84 (2.21, 3.98) mmol/L. After dichotomization by the median, infants in the higher maternal blood choline group had higher mental raw scores and mental development index at 3 months of age than those in the lower group (Wald χ²=4.571, 4.622, P<0.05). The choline content in cord blood was assayed at 1.35 (1.01, 1.96) mmol/L. After dichotomization by the median, infants in the higher cord blood choline group had higher mental raw scores at 1 month of age than those in the lower group (Wald χ²=3.979, P=0.046). Conclusions Higher maternal blood choline levels are associated with cognitive development in infants at 3 months of age, whereas cord blood choline levels are associated with cognitive development in infants at 1 month of age. Attention should be paid to dietary choline intake during pregnancy and to infant neurobehavioral development, so as to promote maternal and child health.

Key words

choline / maternal blood / cord blood / neurobehavioral development / liquid chromatography-tandem mass spectrometry

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WENG Yuwei, LIU Yufeng, QIN Yangzhe, ZHANG Feng, DONG Hongli, CHEN Zhifang. Association of choline levels in maternal peripheral venous blood and neonatal umbilical cord blood with early neurobehavioral development in infants[J]. Chinese Journal of Child Health Care. 2026, 34(5): 525-531 https://doi.org/10.11852/zgetbjzz2025-0832

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