ABSTRACT
Choline is an essential micronutrient whose metabolic derivatives play important roles in many biological processes that are crucial to placental development and functioning. Dietary choline recommendations of 450 mg/day were established for pregnant women in 1998; however, recent data indicate that choline intakes exceeding current recommendations may
14.1 Introduction .......................................................................................................................... 210 14.1.1 Importance of Choline Metabolites in Biological Processes.................................... 210
14.1.1.1 Betaine: A Methyl Donor for One-Carbon Metabolism ............................ 210 14.1.1.2 Acetylcholine: A Signaling Molecule in Neuronal and Nonneuronal
Tissues ........................................................................................................ 211 14.1.1.3 Phosphatidylcholine: A Key Player in Cell Membrane Integrity
and Lipid Metabolism ................................................................................ 212 14.1.2 Choline Uptake by Placenta ..................................................................................... 213 14.1.3 Dietary Recommendations for Choline .................................................................... 214
14.1.3.1 Genetic Variation and Choline Requirements ........................................... 214 14.1.4 Common Food Sources ............................................................................................ 216
14.2 Choline and Placental Trophoblast Development ................................................................. 216 14.2.1 Effect of Maternal Choline Intake on Acetylcholine Production in Placenta .......... 216 14.2.2 Effect of Maternal Choline Intake on the Epigenome During Development ........... 216 14.2.3 Effect of Choline Supply on Placental Vascular Development ................................ 217 14.2.4 Effect of Choline Supply on Placental Inammation ............................................... 218 14.2.5 Effect of Choline Supply on Placental Apoptosis .................................................... 219 14.2.6 Effect of Choline Supply on Oxidative Stress in Placenta .......................................220 14.2.7 Potential Mechanisms through which Choline Supply Affects Biological
Processes in the Placenta ..........................................................................................220 14.2.7.1 Methylation ................................................................................................220 14.2.7.2 Acetylcholine Signaling .............................................................................220 14.2.7.3 PKC Signaling ............................................................................................ 221
14.3 Potential Clinical Implications ............................................................................................. 221 14.3.1 Preeclampsia and Intrauterine Growth Restriction .................................................. 222 14.3.2 Improved Fetal Development .................................................................................... 222
14.3.2.1 Maternal Choline Intake and Offspring Stress Response.......................... 222 14.3.2.2 Maternal Choline Intake and Offspring Cognitive Development .............. 223 14.3.2.3 Maternal Choline Intake and Developmental Disorders ...........................224 14.3.2.4 Maternal Choline Intake and Other Defects or Diseases ..........................224
14.4 Concluding Remarks and Future Perspectives .....................................................................224 References ......................................................................................................................................224
