Recent Choline Intake Is Inversely Associated with Inflammation in Pregnancy – Evidence from the Canadian APrON Cohort

Background: Maternal nutrition plays a role in regulating inflammation during pregnancy, which can impact maternal and fetal health. Objectives: This study explored the association between recent maternal dietary choline intake and high-sensitivity C-reactive protein (hs-CRP) in the third trimester of pregnancy, leveraging data from the Alberta Pregnancy Outcomes and Nutrition (APrON) cohort. Methods: Dietary choline intake was assessed using a validated 24-h dietary recall and hs-CRP was measured from nonfasting maternal blood samples. Statistical analyses included natural spline regression models to assess the relationship between recent choline intake and hs-CRP, with interaction terms for consumption of other methyl donor nutrients. We also assessed the likelihood of clinically elevated hs-CRP based on choline intake categories. Results: Our analyses of 1300 pregnant people revealed a significant nonlinear inverse association between maternal choline intake and hs-CRP concentrations. Additionally, participants with higher choline intakes had reduced odds of having had hs-CRP above the clinical cutoff of 5 mg/L when compared with those with lower choline intakes (e.g. intake >700 compared with 200 mg/d, odds ratio = 0.07, 95% confidence interval: 0.02, 0.15). Conclusions: These findings suggest that higher dietary choline intake may be associated with lower inflammation during pregnancy, highlighting the importance of adequate choline consumption for maternal health.