{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T06:43:36Z","timestamp":1792219416823,"version":"4.4.0"},"reference-count":87,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2024,4,12]],"date-time":"2024-04-12T00:00:00Z","timestamp":1712880000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/501100004391","name":"China Medical University Hospital","doi-asserted-by":"publisher","award":["CMU112-SR-158"],"award-info":[{"award-number":["CMU112-SR-158"]}],"id":[{"id":"10.13039\/501100004391","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004391","name":"China Medical University Hospital","doi-asserted-by":"publisher","award":["DMR-111\u20131168"],"award-info":[{"award-number":["DMR-111\u20131168"]}],"id":[{"id":"10.13039\/501100004391","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,2,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>\u2003<\/jats:title>\n                  <jats:p>Context: Choline is a critical nutrient. Inadequate choline intake during pregnancy increases the risk of adverse maternal and offspring health.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>A systematic review and meta-analysis were conducted to examine the current recommendations for choline intake by pregnant women, estimate the overall prevalence of pregnant women with adequate choline intake, and explore associations between maternal choline level and adverse pregnancy outcomes (APOs).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Choline recommendations for pregnant women were assessed from eight nutrient guidelines of the United States, United Kingdom, Canada, Australia, Asia, International Federation of Gynecology and Obstetrics, and World Health Organization. Data on the prevalence of pregnant women with adequate choline intake and the association between maternal choline level and APOs were collected from 5 databases up to May 2023. Meta-analyses with random effects and subgroup analyses were performed for the pooled estimate of prevalence and association.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Five recent nutrition guidelines from the United States (United States Department of Agriculture), United States (Food and Drug Administration), Canada, Australia, and the International Federation of Gynecology and Obstetrics have emphasized the importance of adequate choline intake for pregnant women. Of 27 publications, 19 articles explored the prevalence and 8 articles explored the association. Meta-analysis of 12 prevalence studies revealed a concerning 11.24% (95% confidence interval, 6.34\u201317.26) prevalence of pregnant women with adequate choline intake recommendations. A meta-analysis of 6 studies indicated a significant association between high maternal choline levels and a reduced risk of developing APOs, with an odds ratio of 0.51 (95% confidence interval, 0.40\u20130.65).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>The existing guidelines highlight the importance of choline in supporting maternal health and fetal development during pregnancy. Furthermore, a high maternal choline level was likely to be associated with a lower risk of APOs. However, 88.76% of pregnant women do not achieve the optimal choline intake. Therefore, specific policies and actions may be necessary to improve choline intake in pregnant women\u2019s care and support the well-being of pregnant women.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Systematic Review Registration<\/jats:title>\n                  <jats:p>PROSPERO registration no. CDR42023410561.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/nutrit\/nuae026","type":"journal-article","created":{"date-parts":[[2024,4,12]],"date-time":"2024-04-12T14:29:14Z","timestamp":1712932154000},"page":"e273-e289","source":"Crossref","is-referenced-by-count":24,"title":["Choline in pregnant women: a systematic review and meta-analysis"],"prefix":"10.1093","volume":"83","author":[{"given":"Hoan Thi","family":"Nguyen","sequence":"first","affiliation":[{"name":"College of Health Care Science, China Medical University , Taichung,","place":["Taiwan"]},{"name":"Nursing and Medical Technology, University of Medicine and Pharmacy , Ho Chi Minh City, VietNam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pande Putu Ida","family":"Oktayani","sequence":"additional","affiliation":[{"name":"Department of Public Health, China Medical University , Taichung,","place":["Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shin-Da","family":"Lee","sequence":"additional","affiliation":[{"name":"College of Health Care Science, China Medical University , Taichung,","place":["Taiwan"]},{"name":"Department of Physical Therapy, China Medical University , Taichung,","place":["Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1152-6596","authenticated-orcid":false,"given":"Li-Chi","family":"Huang","sequence":"additional","affiliation":[{"name":"College of Health Care Science, China Medical University , Taichung,","place":["Taiwan"]},{"name":"School of Nursing, China Medical University , Taichung,","place":["Taiwan"]},{"name":"Department of Nursing, China Medical University Children Hospital , 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