Prenatal choline trial links supplement to higher IQ and fewer social difficulties at four

A randomised trial found children born to women given phosphatidylcholine during pregnancy scored higher on cognitive tests and showed fewer social-behaviour difficulties, although researchers say larger studies are needed.

Researchers at the University of Colorado Anschutz say a prenatal nutritional supplement may help shape children’s brain development well beyond birth, with a randomised clinical trial linking phosphatidylcholine taken during pregnancy to stronger cognitive scores and fewer social-behaviour difficulties in early childhood. The study, published in the American Journal of Obstetrics & Gynecology, compared women who received the supplement with those given a placebo and followed their children until age four.

According to the researchers, 206 pregnant women were enrolled from 16 weeks of gestation and assigned either phosphatidylcholine or placebo until delivery, while all were encouraged to continue standard prenatal vitamins and eat foods naturally rich in choline, such as eggs and meat. Among the children whose parents completed behavioural assessments, the supplement group showed fewer signs of social withdrawal, a pattern that can include limited engagement with other people, reduced eye contact and reluctance to join in social activity. The same group also recorded higher scores on standard cognitive testing, including measures of memory and visual-spatial ability.

Robert Freedman, the study’s senior author, said it was the largest randomised trial of prenatal choline supplementation yet conducted. He said the children of mothers who took phosphatidylcholine showed an average rise of about eight IQ points at age four, which he said moved more of them into higher percentiles on the test used. The researchers also reported fewer language and social difficulties associated with autism spectrum disorder, although the treatment did not significantly reduce attention problems, one of the study’s main outcomes.

The findings fit with a broader body of research suggesting that choline is important during pregnancy because it supports the development of the fetal nervous system. The National Institutes of Health says choline needs rise during pregnancy and notes that the nutrient plays a central role in fetal brain development. Earlier studies have also linked higher maternal choline intake with faster infant information processing and better sustained attention in later childhood, while a review in The Journal of Pediatrics described choline as a nutrient with lasting effects on brain function. Even so, the Colorado team cautioned that its results need careful interpretation because about a third of participants did not complete the full follow-up and some behavioural outcomes were reported by parents rather than measured directly. The researchers said larger trials with longer follow-up are needed to determine whether the benefits persist as children grow.