Topical Area: Maternal, Perinatal and Pediatric Nutrition
Objectives : Adequate intake of dietary choline, an essential nutrient, is pivotal for an optimal pregnant outcome and fetal programming, which may be affected by choline-metabolising genetic polymorphisms. This case-control study aims to investigate the interaction between choline intake during pregnancy and genetic polymorphisms in choline dehydrogenase (CHDH) and betaine-homocysteine methyltransferase (BHMT) on preterm birth risk among Chinese women.
129 women with preterm delivery and 141 parturients with full-term delivery were recruited respectively at Xinhua Hospital, Shanghai between March 2016 and July 2018. Dietary choline intake during pregnancy was assessed by a validated food frequency questionnaire, genotyping was conducted for CHDH (G233C, rs12676) and BHMT (G742A, rs3733890), and plasma homocysteine (Hcy) levels were assayed. X2 test, Kruskal-Wallis H test, and unconditional logistic regression were conducted for statistical analysis.
Neither choline intake during pregnancy nor CHDH rs12676 or BHMT rs3733890 alone was significantly correlated with the incidence of preterm birth after adjustment for total energy intake, folate consumption, delivery age, occupation, prepregnancy BMI, parity, hypertensive disorders of pregnancy, and gestational diabetes. However, signiﬁcant interactions were observed between maternal choline intake during pregnancy and CHDH rs12676 (Pinteraction=0.023) or BHMT rs373389 (Pinteraction=0.045) on preterm delivery risk after adjusting for multiple confounding variables. Plasma Hcy level was about 38 % higher in the case women carrying CC genotype of CHDH rs12676 who consumed less choline than the median during pregnancy, compared to the control women with GG genotype who had more choline intake than the median level (P＜0.001). Similarly, the case women carrying AA genotype of BHMT rs373389 who consumed less choline than the median showed about 21 % higher Hcy levels, compared with the control women with GG genotype who had more choline intake than the median level (P＜0.001).
Our results indicate that genetic polymorphism of CHDH rs12676 or BHMT rs3733890 may interact with maternal choline intake, which may modify preterm birth risk among Chinese women partially through the disturbance in choline metabolism. This study was registered at clinic trails (No. NCT02841813 ).
Funding Sources :
This study was supported by the Danone Nutrition Research and Education Grant (DIC2017-09).
Shanghai Jiao Tong University School of Medicine