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Purpose <p>Maternal demand for one-carbon nutrients, especially choline, increases substantially during pregnancy. Choline is vital for phospholipid synthesis, methyl group donation in epigenetic regulation, and lipid metabolism. This study aims to systematically review experimental and observational studies evaluating maternal dietary or biomarker choline status in relation to adverse pregnancy outcomes.</p> Method <p>A systematic review was conducted in accordance with PRISMA guidelines. Literature searches in Crossref, Google Scholar, PubMed, and ScienceDirect for English-language, full-text articles published between 2019 and 2024 were conducted. Eligible studies underwent critical appraisal using Joanna Briggs Institute checklists. Key outcomes from all included studies were mapped and synthesized,</p> Result <p>Eleven studies that met inclusion criteria were included. Observational evidence consistently demonstrated that higher maternal choline intake or status was associated with reduced risks of preterm birth and neural tube defects, improved homocysteine and lipid profiles, and enhanced infant neurocognitive performance. Conversely, low choline status correlated with hyperhomocysteinemia, hepatic steatosis, and restricted fetal growth.</p> Conclusion <p>This synthesis underscores choline’s pivotal role in maternal–fetal health. Future randomized trials must clarify optimal choline dose, timing, and formulation. Incorporating choline recommendations into prenatal guidelines and fortification programs promises to enhance global maternal and neonatal outcomes.</p>

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Choline in pregnancy safeguarding maternal health and minimizing fetal and neonatal anomalies: a systematic review

  • 期刊论文

  • 发表日期：

    2026年2月25日

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  • Rezky Fauzan,
  • Delmi Sulastri

摘要

Purpose

Maternal demand for one-carbon nutrients, especially choline, increases substantially during pregnancy. Choline is vital for phospholipid synthesis, methyl group donation in epigenetic regulation, and lipid metabolism. This study aims to systematically review experimental and observational studies evaluating maternal dietary or biomarker choline status in relation to adverse pregnancy outcomes.

Method

A systematic review was conducted in accordance with PRISMA guidelines. Literature searches in Crossref, Google Scholar, PubMed, and ScienceDirect for English-language, full-text articles published between 2019 and 2024 were conducted. Eligible studies underwent critical appraisal using Joanna Briggs Institute checklists. Key outcomes from all included studies were mapped and synthesized,

Result

Eleven studies that met inclusion criteria were included. Observational evidence consistently demonstrated that higher maternal choline intake or status was associated with reduced risks of preterm birth and neural tube defects, improved homocysteine and lipid profiles, and enhanced infant neurocognitive performance. Conversely, low choline status correlated with hyperhomocysteinemia, hepatic steatosis, and restricted fetal growth.

Conclusion

This synthesis underscores choline’s pivotal role in maternal–fetal health. Future randomized trials must clarify optimal choline dose, timing, and formulation. Incorporating choline recommendations into prenatal guidelines and fortification programs promises to enhance global maternal and neonatal outcomes.