AURORA, Colo . (Oct. 20, 2026) — A nutritional supplement taken during pregnancy may support fetal brain development and improve children’s cognitive performance and social behavior, according to new research from the University of Colorado Anschutz .
The randomized clinical trial, published this week in the American Journal of Obstetrics & Gynecology , found that children whose mothers took phosphatidylcholine, a form of choline found naturally in foods, had fewer social withdrawal problems and scored higher on cognitive tests than children whose mothers received a placebo.
“This is the largest randomized clinical trial of prenatal choline supplementation ever conducted,” said the study’s senior author Robert Freedman, MD, professor of psychiatry at CU Anschutz. “What this study showed that we have not observed before was an increase in the overall IQ of about eight points when measured at age 4. That put significantly more children into the higher IQ percentile on the test we used.”
The study, Freedman said, showed that children of mothers who received phosphatidylcholine supplements had fewer problems with language development and social skills, compared to women who had received placebos. All women in the study were encouraged to take standard prenatal vitamins and eat a diet that contained eggs, meat and other natural sources of phosphatidylcholine.
“This study provides additional evidence that choline supplements during pregnancy can have lasting effects on children’s brain development,” said Freedman.
Choline is an essential nutrient that helps support brain development. The researchers investigated whether increasing maternal intake during pregnancy could improve children’s early development, building on previous research suggesting that choline plays a critical role in the formation of connections between brain cells.
Researchers enrolled 206 pregnant women, randomly assigning them at 16 weeks of pregnancy to receive either 9,000 milligrams of phosphatidylcholine daily or a placebo until delivery. Researchers assessed children’s behavior from 18 months to 4 years of age and measured cognitive performance at ages 3 and 4.
Among children whose parents completed behavioral assessments, 4% in the supplement group had elevated social withdrawal problems, compared with 24% in the placebo group. These behaviors can include limited interest in other people, withdrawing from social activities and reduced eye contact.
Children in the supplement group also scored an average of nearly eight points higher on standardized cognitive tests than children in the placebo group. The assessments measured overall intellectual performance, including working memory and visual-spatial skills.
Researchers also observed significantly fewer children with behavioral profiles and language difficulties commonly associated with autism spectrum disorder in the supplement group.
The supplement did not significantly reduce attention problems, another primary outcome of the study.
Freedman said choline works because it activates a receptor made by the CHRNA 7 gene in developing nerve cells that helps them develop the machinery to receive signals from other nerve cells before birth.
“Choline in the baby’s circulation comes from the choline eaten by the mother which activates this receptor,” he said. “But many mothers don’t get enough choline in their diets to fully give the baby all that it needs to complete the activation of its neurons. Unfortunately, once the opportunity to do so before birth passes there is no way to go back and correct the problem in brain development.”
Freedman said it was nearly impossible to get enough choline in a normal diet to fully activate the CHRNA7 receptor – eating 10 eggs a day for example – so supplements are necessary.
“We think the dose we recommended in this trial was a bit higher than needed so we are recommending 7200 mg of phosphatidylcholine or 900 mg of choline itself,” he said. “Both are available in drug and grocery stores.”
The researchers reported no significant supplement-related safety problems among mothers or children. But they cautioned that the findings require careful interpretation: about one-third of participants did not complete the study through the four-year assessments, and parents reported their children’s behavioral symptoms.
The findings add to evidence that choline is important for fetal brain development and could help inform future research into prenatal nutrition. The researchers said larger studies with longer follow-up are needed to determine whether the observed differences persist as children grow.
Study co-authors include: Sharon K. Hunter PhD, M. Camille Hoffman MD, MSCS, Amanda J. Law PhD, Uwe Christians MD, PhD, Angelo D’Alessandro PhD and Robert Freedman MD.
The study was supported by the National Institutes of Health, the Institute for Children’s Mental Health and The Anschutz Foundation.
The University of Colorado Anschutz is a world-class academic medical campus leading transformative advances in science, medicine, education and patient care. The campus includes the University of Colorado’s health professional schools, more than 60 centers and institutes, and two nationally ranked independent hospitals – UCHealth University of Colorado Hospital and Children’s Hospital Colorado – which see nearly three million adult and pediatric patient visits each year. Innovative, interconnected and highly collaborative, CU Anschutz delivers life-changing treatments, exceptional patient care and top-tier professional training. The campus conducts world-renowned research supported by $890 million in funding, including $762 million in sponsored awards and $128 million in philanthropic gifts for research.
Find the latest CU Anschutz news here: http://www.cuanschutztoday.org/
Randomized controlled/clinical trial
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