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Findings from animal studies suggest that choline supplementation during pregnancy can mitigate adverse effects of prenatal alcohol exposure on growth and neurocognitive function. We conducted a randomized, double\u2010blind exploratory trial to examine feasibility and acceptability of a choline supplementation intervention during pregnancy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Seventy heavy drinkers, recruited in mid\u2010pregnancy, were randomly assigned to receive a daily oral dose of 2\u00a0g of choline or a placebo from time of enrollment until delivery. Each dose consisted of an individually wrapped packet of powder that, when mixed with water, produced a sweet tasting grape\u2010flavored drink. Adherence was assessed by collecting used and unused drink packets on a monthly basis and tabulating the number used. Side effects were assessed in monthly interviews. Blood samples obtained at enrollment and at 4 and 12\u00a0weeks after randomization were assayed for plasma choline concentration.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Adherence was good\u2010to\u2010excellent (median doses taken\u00a0=\u00a074.0%; interquartile range\u00a0=\u00a053.9 to 88.7%) and was not related to a range of sociodemographic characteristics or to alcohol consumption ascertained using a timeline follow\u2010back interview. By 4\u00a0weeks, plasma choline concentrations were significantly higher in the choline supplementation than the placebo arm, and this group difference continued to be evident at 12\u00a0weeks. The only side effect was a small increase in nausea\/dyspepsia. No effects were seen for diarrhea, vomiting, muscle stiffness, blood pressure, or body odor changes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This study demonstrated that a choline supplementation program with very heavy drinkers during pregnancy is feasible even among highly disadvantaged, poorly educated women. The broad acceptability of this intervention is indicated by our finding that adherence was not related to maternal education, intellectual function, depression, nutritional status, or alcohol use.<\/jats:p><\/jats:sec>","DOI":"10.1111\/acer.13768","type":"journal-article","created":{"date-parts":[[2018,5,11]],"date-time":"2018-05-11T13:14:39Z","timestamp":1526044479000},"page":"1315-1326","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Feasibility and Acceptability of Maternal Choline Supplementation in Heavy Drinking Pregnant Women: A Randomized, Double\u2010Blind, Placebo\u2010Controlled Clinical Trial"],"prefix":"10.1111","volume":"42","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9768-2671","authenticated-orcid":false,"given":"Sandra W.","family":"Jacobson","sequence":"first","affiliation":[{"name":"Department of Psychiatry and Behavioral Neurosciences Wayne State University School of Medicine Detroit Michigan"},{"name":"Department of Human Biology Faculty of Health Sciences University of Cape Town Cape Town South Africa"},{"name":"Department of Psychiatry and Mental Health Faculty of Health Sciences University of Cape Town Cape Town South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1554-6914","authenticated-orcid":false,"given":"R. 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University School of Medicine Detroit Michigan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9282-161X","authenticated-orcid":false,"given":"Steven H.","family":"Zeisel","sequence":"additional","affiliation":[{"name":"Nutrition Research Institute University of North Carolina at Chapel Hill Kannapolis North Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8083-8193","authenticated-orcid":false,"given":"Christopher P.","family":"Duggan","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Hepatology and Nutrition Center for Nutrition Boston Children's Hospital\/Harvard Medical School Boston Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8271-280X","authenticated-orcid":false,"given":"Joseph L.","family":"Jacobson","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and 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