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. 2023 Jun 28;62(7):2855–2872. doi: 10.1007/s00394-023-03186-w

Table 5.

Factors associated with estimated mean change and relative contribution to daily dietary total choline intake and total choline-containing compounds levels at 28 weeks of gestation

Daily total choline dietary Intake (mg/d) Total choline-containing compounds in serum (µmol/l)a
β 95%CI p value Relative contributionb (%) β 95%CI p value Relative contributionb (%)
Sociodemographic
 Mother's age at conception (years) − 2.09 − 3.44, − 0.74 0.002 0.8 9 3.27, 14.73 0.002 1.12
 Father's age at conception (years) − 0.24 − 1.36, 0.89 0.678 − 0.08 2.16 − 2.66, 6.98 0.379 0.25
 Median maternal and paternal education 5.27 − 0.98, 11.51 0.098 0.17 9.44 − 17.3, 36.17 0.489 0.24
 SEIFA IRSD in lowest tertile − 0.39 − 14.03, 13.25 0.955 − 0.1 12.42 − 46.27, 71.1 0.678 0.23
 Mother is university-educated 7.41 − 5.39, 20.21 0.256 0.03 18.7 − 36.4, 73.8 0.506 0.21
 Father is university-educated − 4.57 − 18.1, 8.95 0.507 − 0.06 − 6.94 − 65.05, 51.17 0.815 0.3
Family
 All grandparents of North European descent 14.12 − 0.51, 28.74 0.058 0.26 6.94 − 55.38, 69.26 0.827 0.22
 Parity above 1 − 1.43 − 14.31, 11.46 0.828 − 0.09 12.63 − 42.83, 68.09 0.655 0.19
 Birth order 0.23 0.29
  First Reference Reference
  Second − 0.31 − 15.12, 14.5 0.967 25.36 − 38.81, 89.53 0.438
  Third 15.14 − 4.07, 34.35 0.122 − 37.63 − 120.35, 45.1 0.372
  Fourth or later − 24.97 − 60.22, 10.28 0.165 111.11 − 40.26, 262.49 0.15
 Multiple Birth Indicator − 0.09 0.99
  None Reference Reference
  1st twin − 26.75 − 103.88, 50.38 0.496 429.62 79.25, 779.99 0.016
  2nd twin − 30.3 − 102.49, 41.89 0.41 325.92 1.41, 650.42 0.049
 Number of children in household at birth (0–10 years) 0.29 0.27
  None Reference Reference
  One 6.46 − 8.09, 21 0.384 − 0.69 − 63.74, 62.35 0.983
  Two 21.95 2.31, 41.59 0.029 − 66.85 − 151.45, 17.76 0.121
  Three − 20.41 − 75.48, 34.66 0.467 103.38 − 138.34, 345.1 0.401
  Four 111.04 − 92.11, 314.19 0.284 − 534.93 − 1393.88, 324.03 0.222
 Birth interval–BIS child and prior sibling (years) 6.46 − 8.09, 21 0.384 0.47 − 5.6 − 17.26, 6.05 0.346 − 0.09
Prenatal
 Pre-pregnancy BMI (kg/m2) − 1.37 − 2.57,− 0.17 0.025 0.45 − 6.82 − 12.24, − 1.39 0.014 1.01
 Maternal weight at 28-week interview (kg) − 0.4 − 0.85, 0.04 0.074 0.27 − 1.32 − 3.36, 0.72 0.203 0.52
 Maternal weight gain (kg)c 0.86 − 0.5, 2.21 0.216 0.07 7.05 0.93, 13.17 0.024 0.95
 Fever 3rd trimester 43.36 7.8, 78.92 0.017 0.53 − 46.93 − 194.71, 100.84 0.533 0.19
 Gestational diabetes mellitusg 29.15 − 3.07, 61.37 0.076 0.25 − 186.63 − 332.95, − 40.31 0.012 1.07
 Folate (red cell) (nmol/l) 0.01 − 0.01, 0.03 0.17 0.13 0.01 − 0.07, 0.09 0.803 0.01
 Perceived stress (pregnancy and 1st 6 months) 0.13 − 0.88, 1.13 0.802 − 0.09 − 1.8 − 6.11, 2.5 0.412 0.2
 Seasonal indicator at trimester 2d − 1.6 − 6.54, 3.33 0.524 − 0.06 − 16.56 − 37.73, 4.62 0.125 0.42
 Maternal vitamin D (nmol/l) 0.25 − 0.2, 0.69 0.273 0.06 0.06 − 1.77, 1.89 0.947 − 0.19
 Any maternal pregnancy smoking − 8.39 − 26.41, 9.63 0.361 − 0.02 − 44.63 − 120.93, 31.68 0.251 0.33
 Any ETS during preconception or pregnancyg − 6.79 − 24.5, 10.93 0.452 − 0.04 − 92.62 − 166.06, − 19.17 0.014 0.79
Nutrition and nutrients
 Energy (kJ/day) 0.03 0.03, 0.03  < 0.001 48.06 0 − 0.01, 0.01 0.643 0.01
 Fibre (g/day) 6.75 6, 7.51  < 0.001 23.21 1.82 − 1.99, 5.63 0.348 0.09
 Protein (g/day) 2.9 2.75, 3.05  < 0.001 58.96 − 0.04 − 1.06, 0.98 0.94 − 0.01
 Iron (g/day) 14.12 12.97, 15.27  < 0.001 36.4 0.73 − 5.64, 7.09 0.823 0
 Total dietary omega-3 (g/day) 103.74 95.3, 112.18  < 0.001 36.39 24.67 − 21.6, 70.94 0.296 0.11
 Omega-3 supplementation in preg. (yes vs no) 8.61 − 7.03, 24.25 0.28 0.03 29.8 − 41.75, 101.35 0.414 0.11
 Total dietary omega-6 (g/day) 11.07 9.73, 12.41  < 0.001 20.55 5.48 − 1.17, 12.12 0.106 0.27
 Alcohol (g/day) 4.74 − 0.03, 9.5 0.051 0.28 4.28 − 16.22, 24.78 0.682 0.01
 Consistent fish oil supp. in preg. (yes vs no) − 12.03 − 33.61, 9.54 0.274 0.03 23.62 − 77.78, 125.02 0.647 − 0.19
 Folate (ug/day) 0.58 0.52, 0.64  < 0.001 27.58 0.02 − 0.28, 0.32 0.89 − 0.01
 Folate supplementation in preg. (yes vs no) − 5.6 − 46.84, 35.64 0.79 − 0.09 69.72 − 98.49, 237.94 0.416 0.24
Dietary patterns
 Modern healthy dietary pattern (PC1 z-score per 1 SD)e 25.6 19.44, 31.77  < 0.001 6.05 24.15 − 3.96, 52.26 0.092 0.3
 Western dietary pattern (PC2 z-score per 1SD)f 60.55 55.37, 65.72  < 0.001 34.17 − 5.33 − 33.24, 22.58 0.708 0.01
 Traditional Anglo-Australian diet (PC3 z-score per 1 SD) 3.11 − 3.26, 9.49 0.38 − 0.01 10.89 − 17.52, 39.29 0.452 0.05
 ARFS score (per unit) 5.83 5.12, 6.54  < 0.001 20.21 − 0.25 − 3.76, 3.27 0.89 − 0.01
 Vegetarian diet (yes vs no) − 71 − 153.92, 11.91 0.093 0.18 − 193.78 − 546.34, 158.79 0.281 0.12
 Choline supplementation in preg. (yes vs no) − 33.25 − 73.05, 6.54 0.101 0.17 − 17.03 − 202.74, 168.69 0.857 0.22

β—mean change per unit increase in factor

SEIFA Socio-economic Indexes for Areas; IRSD Index of Relative Socioeconomic Disadvantage; BMI body mass index; ETS environmental tobacco smoke; BIS Barwon Infant Study; ARFS score Australian Recommended Food Score based on adherence to Australian Dietary Guidelines

aSerum total choline-containing compounds regression adjusted for gestational age at blood collection, child’s sex and time interval between maternal serum collection and storage

bR2 for the predictive model = 0.48 i.e. the model explains 48% of the variance in dietary choline intake

cMaternal weight gain during pregnancy calculated as the difference between pre-pregnancy weight and maternal weight gain at 28 weeks of gestation

dEstimated as UVR exposure in standard erythemal doses (trimester 1 and trimester 3 also not significant)

Omega-6 supplementation excluded due to low power N = 2

eModern healthy dietary pattern: high positive loadings on fish, nuts, eggs, green vegetables, and wholegrains; for every increase in one standard deviation of Modern healthy dietary pattern the mean increase of dietary total choline was 25 mg

fWestern dietary pattern: high loadings of full-cream milk, pasta, chips, meat and take-away foods, sweet biscuits, and confectionery products

Detailed PCA loadings plot previously published33

gGestational diabetes and any ETS during preconception and pregnancy were associated with higher maternal serum choline-containing compounds at 28 weeks of gestation, however, after adjusting for maternal weight at 28 weeks, these factors were no longer significant (p = 0.056, p = 0.066)

p < 0.05 in bold