Choline and Betaine Levels in Plasma Mirror Choline Intake in Very Preterm Infants.

Publisher: MDPI Publishing Country of Publication: Switzerland NLM ID: 101521595 Publication Model: Electronic Cited Medium: Internet ISSN: 2072-6643 (Electronic) Linking ISSN: 20726643 NLM ISO Abbreviation: Nutrients Subsets: MEDLINE

Original Publication: Basel, Switzerland : MDPI Publishing

Betaine* ; Infant, Premature, Diseases*; Infant ; Infant, Newborn ; Humans ; Female ; Pregnancy ; Infant, Premature ; Choline ; Placenta ; Infant, Very Low Birth Weight ; Milk, Human ; Lecithins

Choline is essential for cell membrane formation and methyl transfer reactions, impacting parenchymal and neurological development. It is therefore enriched via placental transfer, and fetal plasma concentrations are high. In spite of the greater needs of very low birth weight infants (VLBWI), choline content of breast milk after preterm delivery is lower (median (p25-75): 158 mg/L (61-360 mg/L) compared to term delivery (258 mg/L (142-343 mg/L)). Even preterm formula or fortified breast milk currently provide insufficient choline to achieve physiological plasma concentrations. This secondary analysis of a randomized controlled trial comparing growth of VLBWI with different levels of enteral protein supply aimed to investigate whether increased enteral choline intake results in increased plasma choline, betaine and phosphatidylcholine concentrations. We measured total choline content of breast milk from 33 mothers of 34 VLBWI. Enteral choline intake from administered breast milk, formula and fortifier was related to the respective plasma choline, betaine and phosphatidylcholine concentrations. Plasma choline and betaine levels in VLBWI correlated directly with enteral choline intake, but administered choline was insufficient to achieve physiological (fetus-like) concentrations. Hence, optimizing maternal choline status, and the choline content of milk and fortifiers, is suggested to increase plasma concentrations of choline, ameliorate the choline deficit and improve growth and long-term development of VLBWI.

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D.30.14150 Nestlé (Germany); PK-2012 Universitätsklinikum Tübingen

Keywords: betaine; breast milk; choline; enteral feeding; infant; nutrition; preterm; very low birth weight infant

3SCV180C9W (Betaine)
N91BDP6H0X (Choline)
0 (Lecithins)

Date Created: 20231125 Date Completed: 20231127 Latest Revision: 20231127

20231215

PMC10675502

10.3390/nu15224758

38004152