{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,9]],"date-time":"2026-11-09T21:04:51Z","timestamp":1794258291325,"version":"4.9.0"},"reference-count":43,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2025,2,28]],"date-time":"2025-02-28T00:00:00Z","timestamp":1740700800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Australian Eggs Ltd.","award":["APP2033062"],"award-info":[{"award-number":["APP2033062"]}]},{"name":"National Health and Medical Research Council (NHMRC) Australia","award":["APP2033062"],"award-info":[{"award-number":["APP2033062"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Background: Most pregnant women have choline intakes below recommendations. Animal studies suggest that choline supplementation during pregnancy improves cognitive outcomes in the offspring. This review aims to determine whether higher choline levels during pregnancy are associated with improved child brain development. Methods: We systematically reviewed the evidence for the role of choline in pregnancy for human neurodevelopment in clinical trials and observational studies. Results: We identified four randomized trials of choline supplementation in pregnancy and five observational studies of prenatal choline. Neurodevelopmental assessments of these studies were reported across 20 eligible publications. Within both the trials and observational studies, most neurodevelopmental outcomes assessed did not support the hypothesis that higher prenatal choline benefits neurodevelopment. Among identified clinical trials, there were some instances where children whose mothers received choline supplementation had a better score on a neurodevelopmental measure. Still, each trial included multiple outcomes, and most were null. Observational studies were mixed as to whether an association between prenatal choline and an aspect of child neurodevelopment was identified. Critical limitations were present across clinical trials and observational studies, preventing confidence in the results and evidence base. Conclusions: Current evidence is insufficient to support or refute the hypothesis that increasing choline intake in pregnancy improves the neurodevelopmental outcomes of the child.<\/jats:p>","DOI":"10.3390\/nu17050886","type":"journal-article","created":{"date-parts":[[2025,3,4]],"date-time":"2025-03-04T05:41:51Z","timestamp":1741066911000},"page":"886","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Choline During Pregnancy and Child Neurodevelopment: A Systematic Review of Randomized Controlled Trials and Observational Studies"],"prefix":"10.3390","volume":"17","author":[{"given":"Jacqueline F.","family":"Gould","sequence":"first","affiliation":[{"name":"Women and Kids Theme, South Australian Health and Medical Research Institute, Adelaide, SA 5006, Australia"},{"name":"School of Psychology, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA 5005, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sonia","family":"Hines","sequence":"additional","affiliation":[{"name":"Flinders University Rural and Remote Health SA, Flinders University, Alice Springs, NT 0870, Australia"},{"name":"Mparntwe Centre for Evidence in Health, Flinders University: A JBI Centre of Excellence, Alice Springs, NT 0870, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7653-5074","authenticated-orcid":false,"given":"Karen P.","family":"Best","sequence":"additional","affiliation":[{"name":"Women and Kids Theme, South Australian Health and Medical Research Institute, Adelaide, SA 5006, Australia"},{"name":"Adelaide Medical School, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA 5005, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8554-4696","authenticated-orcid":false,"given":"Luke E.","family":"Grzeskowiak","sequence":"additional","affiliation":[{"name":"Women and Kids Theme, South Australian Health and Medical Research Institute, Adelaide, SA 5006, Australia"},{"name":"Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Adelaide, SA 5042, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olivia","family":"Jansen","sequence":"additional","affiliation":[{"name":"Women and Kids Theme, South Australian Health and Medical Research Institute, Adelaide, SA 5006, Australia"},{"name":"College of Nursing and Health Sciences, Flinders University, Adelaide, SA 5042, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tim J.","family":"Green","sequence":"additional","affiliation":[{"name":"Women and Kids Theme, South Australian Health and Medical Research Institute, Adelaide, SA 5006, Australia"},{"name":"College of Nursing and Health Sciences, Flinders University, Adelaide, SA 5042, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,2,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"615","DOI":"10.1111\/j.1753-4887.2009.00246.x","article-title":"Choline: An essential nutrient for public health","volume":"67","author":"Zeisel","year":"2009","journal-title":"Nutr. 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