Abstract
Background: Prenatal maternal infection is associated with increased risk in the offspring for a variety of neuropsychiatric illnesses including schizophrenia, autism, and ADHD. Higher prenatal maternal serum choline levels have been shown in basic science experiments to mitigate the impact of prenatal infection. This report addresses whether higher prenatal maternal serum choline levels mitigates the impact of prenatal infection on 3-month-old human infant behavior. Methods: 153 initially healthy pregnant women reported at 16 weeks gestation whether they had experienced symptoms of an infection in the previous 6 weeks. Women who reported moderate–severe symptoms and/or who sought treatment were considered positive for an infection. Serum was drawn for choline levels at the same time. Infant behavior was assessed via a parent-report instrument, the Infant Behavior Questionnaire (IBQ), at 12 weeks of age (age adjusted for gestational age at birth). The IBQ produces three summary scores: Surgency/Extraversion, Negative Affectivity, and Orienting/Regulation. Results: For Orienting/Regulation, regression analysis demonstrated a trend towards an effect of maternal serum choline level (adjusted beta = .194, P = .059) with significant effects of maternal infection (adjusted beta = −.226, P = .016) and the interaction between maternal choline levels and maternal infection (adjusted beta = .360, P = .002). There was a significant main effect for maternal infection on Surgency/Extraversion (standardized beta = .214, P = .042). No other significant main or interaction effects were identified. Conclusion: Prenatal exposure to maternal infection in the late first trimester/early second trimester period has previously been associated with a lifelong increase in risk for a variety of psychiatric and behavioral problems. These results suggest that the relationship between prenatal infection and risk for behavioral problems can be identified as early as 3 months of age. Higher maternal serum choline levels mitigate this impact of maternal infection. Maternal prenatal choline supplementation emerges as a potential primary prevention strategy to mitigate risk for later severe mental disorder.