Dietary choline intake during pregnancy and birth weight in a Chinese population: a cross-sectional study

Previous studies on dietary choline and fetal growth are limited and inconsistent, and the impacts of choline subtypes on fetal growth remain unexplored. We aimed to investigate the associations of maternal intakes of dietary choline and choline subtypes during pregnancy with birth weight, low birth weight (LBW), and small for gestational age (SGA). We used a multi-stage stratified cluster random sampling method to recruit 7310 women in Shaanxi China. Maternal diets during pregnancy was collected using a validated food frequency questionnaire. Multilevel linear or logistic regression models were applied to assess the associations. Dose-response relationships were evaluated using restricted cubic spline curves. The mean total choline intake was 331.0 (SD: 162.4) mg/d, and the mean birth weight was 3263.7 (SD: 440.1) g. Each 100 mg increase in total choline, free choline, glycerophosphocholine, phosphocholine, phosphatidylcholine, and sphingomyelin was associated with an increase in birth weight of 18.7 (95% CI = 8.8–28.6), 25.0 (3.4–46.6), 51.1 (0.6-101.7), 128.3 (7.5-249.2), 15.3 (2.2–28.4), and 105.4 (33.5-177.3) g, respectively. Comparing the highest with the lowest tertiles of total choline, phosphatidylcholine, sphingomyelin, glycerophosphocholine, and phosphocholine intakes, participants had lower odds of LBW and SGA, with the ORs for LBW ranging from 0.50 (0.30–0.81) to 0.62 (0.45–0.87) and for SGA from 0.71 (0.57–0.88) to 0.81 (0.68–0.96). There were L-shaped relationships between total choline and choline subtypes intakes and the odds of LBW. Higher maternal intakes of dietary choline and choline subtypes during pregnancy was associated with higher birth weight and lower odds of LBW and SGA.