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01-08-2015 | Original Contribution

Choline concentrations are lower in postnatal plasma of preterm infants than in cord plasma

Authors: Wolfgang Bernhard, Marco Raith, Rebecca Kunze, Vera Koch, Martin Heni, Christoph Maas, Harald Abele, Christian F. Poets, Axel R. Franz

Published in: European Journal of Nutrition | Issue 5/2015

Abstract

Background

Choline is essential to human development, particularly of the brain in the form of phosphatidylcholine, sphingomyelin and acetylcholine, for bile and lipoprotein formation, and as a methyl group donator. Choline is actively transported into the fetus, and maternal supply correlates with cognitive outcome. Interruption of placental supply may therefore impair choline homeostasis in preterm infants.

Objective

Determination of postnatal plasma concentrations of choline and its derivatives betaine and dimethylglycine (DMG) in preterm infants compared to cord and maternal blood matched for postmenstrual age (PMA).

Design

We collected plasma of very low-birth-weight infants undergoing neonatal intensive care (n = 162), cord plasma of term and preterm infants (n = 176, 24–42-week PMA), serum of parturients (n = 36), and plasma of healthy premenopausal women (n = 40). Target metabolites were analyzed with tandem mass spectrometry and reported as median (25th/75th percentiles).

Results

Cord plasma choline concentration was 41.4 (31.8–51.2) µmol/L and inversely correlated with PMA. In term but not in preterm infants, cord plasma choline was lower in girls than in boys. Prenatal glucocorticoid treatment did not affect choline levels in cord plasma, whereas betaine was decreased and DMG increased. In parturients and non-pregnant women, choline concentrations were 14.1 (10.3–16.9) and 8.8 (5.7–11.2) µmol/L, respectively, whereas betaine was lowest in parturients. After delivery, preterm infant plasma choline decreased to 20.8 (16.0–27.6) µmol/L within 48 h. Betaine and DMG correlated with plasma choline in all groups.

Conclusions

In preterm infants, plasma choline decreases to 50 % of cord plasma concentrations, reflecting choline undernourishment and postnatal metabolic adaptation, and potentially contributing to impaired outcome.

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Title: Choline concentrations are lower in postnatal plasma of preterm infants than in cord plasma
Authors: Wolfgang Bernhard
Marco Raith
Rebecca Kunze
Vera Koch
Martin Heni
Christoph Maas
Harald Abele
Christian F. Poets
Axel R. Franz
Publication date: 01-08-2015
Publisher: Springer Berlin Heidelberg
Published in: European Journal of Nutrition / Issue 5/2015
Print ISSN: 1436-6207
Electronic ISSN: 1436-6215
DOI: https://doi.org/10.1007/s00394-014-0751-7

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