Maternal Plasma Choline Levels Are Positively Correlated with Maternal and Placental Phospholipid-DHA Content in Females with Obesity Who Receive DHA Supplementation.

Background: Pregnancies complicated by maternal obesity are characterized by metabolic differences affecting placental nutrient transport and fetal development. Docosahexaenoic acid (DHA) is critical for fetal brain development and is primarily incorporated into phosphatidylcholine (PC). Recent evidence suggests that choline may enhance PC-DHA synthesis; however, data on the impact of maternal plasma choline on placental phospholipid DHA content in females with obesity are limited.

Methods: We conducted a secondary analysis of a DHA supplementation trial (800 mg/d) in 38 pregnant females with obesity (body mass index ≥30 kg/m²). Blood samples at 36 wk gestation and term placentas were analyzed for phospholipids using mass spectrometry. Choline transporter-like (CTL) proteins in the syncytiotrophoblast microvillous (MVM) and basal plasma membranes were quantified by Western blot.

Results: Daily DHA supplementation from 25 wk gestation was associated with higher maternal plasma and placental PC- and lysophosphatidylcholine (LPC)-DHA. A significant interaction (P interaction <0.05) between DHA supplementation and choline indicated that higher choline enhanced the incorporation of DHA into plasma PC. MVM CTL-1 expression was correlated with placental total PC-DHA and LPC-DHA content, suggesting that CTL-1 has a predominate role in placental choline uptake and phospholipid synthesis.

Conclusions: These findings suggest that choline may influence maternal PC- and LPC-DHA synthesis and plasma levels, as well as the expression of placental choline transporters and the resulting PC- and LPC-DHA content in females with obesity. These relationships may have implications for DHA transport to the fetus and overall fetal development.