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A hospital-based case–control study enrolled pregnant women delivering in Northwest China and assessed maternal dietary choline and derivatives using a validated food frequency questionnaire plus a standardized pregnancy information questionnaire. Mixed logistic regression estimated odds ratios for CHD associations. Higher intakes of multiple choline forms were linked to reduced risks of overall CHD and specific defects, with effects largely consistent across maternal factors and more pronounced in urban areas. Findings support choline intake promotion for primary prevention of fetal CHD.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/dietary-choline-intake-during-pregnancy-and-congenital-heart-defects-in-a-chinese-population/467556/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/dietary-choline-intake-during-pregnancy-and-congenital-heart-defects-in-a-chinese-population/467556.png","ImageObject",300,407,{"name":92,"@type":93},"RuangKosong","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-31","2026-09-30",true,{"@type":102,"interactionType":103,"userInteractionCount":39},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What was the study’s main objective regarding choline and CHD?","Question",{"text":112,"@type":113},"To investigate associations between maternal dietary intake of choline and choline derivatives during pregnancy and congenital heart defects.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How were maternal dietary intakes measured during pregnancy?",{"text":117,"@type":113},"Pregnant women completed a validated food frequency questionnaire to assess dietary intake, and a standardized questionnaire was used to collect additional pregnancy-related information.",{"name":119,"@type":110,"acceptedAnswer":120},"What choline-related findings were reported for congenital heart defects?",{"text":121,"@type":113},"Higher intakes of several choline forms were associated with reduced risks of total CHD and specific defects such as ventricular septal defects and atrial septal defects.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},467556,1790815298,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":39,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":139,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":145,"preview_page_count":4},962090883219,"https://ap-avatar.wpscdn.com/davatar_276721f389ce27ea32af1340a28f341c","Article  \nDietary Choline Intake During Pregnancy and Congenital Heart Defects in a Chinese Population  \nYue-Hua Li 1, Ziqi Xiao 1, Rui Guo 1, Baligen Rekemubieke 1, Wanting Hu 1, Xin Liu 1 and Jiaomei Yang 1,2, *  \nAcademic Editors: Maria Luz Fernandez, Antonios Siargkas and Ioannis Tsakiridis  \nReceived: 29 October 2025  \nRevised: 30 November 2025  \nAccepted: 1 December 2025  \nPublished: 31 December 2025  \nCopyright: © 2026 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license.  \n1 Department of Epidemiology and Biostatistics, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an 710061, China  \n2 Key Laboratory of Environment and Genes Related to Diseases, Xi’an Jiaotong University, Ministry of Education, Xi’an 710061, China  \n* [Correspondence: violetyjm18@xjtu.edu.cn](Correspondence: violetyjm18@xjtu.edu.cn); Tel.: +86-029-8265-5104  \nAbstract  \nBackground/Objectives: The impact of choline on congenital heart defects (CHDs) in humans remains unclear. This study aimed to investigate the associations between maternal dietary intakes of choline and choline derivatives during pregnancy and CHD. Methods: This case–control study included 474 cases and 948 controls from hospitals in Northwest China. Pregnant women admitted for delivery were enrolled and completed a validated food frequency questionnaire to assess their dietary intake during pregnancy. A standardized questionnaire was also administered to collect additional pregnancy-related information. Mixed logistic regression models were used to estimate ORs (95%CIs) for CHDin association with choline intake. Results: Higher intakes of total choline, phosphatidylcholine, sphingomyelin, glycerophosphocholine, and phosphocholine in pregnancy were associated with reduced risks of total CHD, ventricular septal defects, and atrial septal defects, with all trend tests showing statistical significance (all p \u003C 0.05) . The ORs (95%CIs) of total CHD, comparing the highest with the lowest tertiles of intake, were 0.38 (0.24–0.61) for total choline, 0.51 (0.38–0.70) for phosphatidylcholine, 0.37 (0.26–0.51) for sphingomyelin, 0.34 (0.21–0.53) for glycerophosphocholine, and 0.53 (0.34–0.82) for phosphocholine. The inverse associations remained unchanged according to maternal age, work, education, parity, passive smoking, anemia, medication use, or folate/iron supplements use in pregnancy; however, these associations appeared to be more pronounced among pregnant women in urban areas. Conclusions: Higher maternal intake of dietary choline during pregnancy may be associated with a lower risk of CHD. Promoting choline intake in pregnant women could serve as a potential strategy for the primary prevention of fetal CHD in China.  \nKeywords: choline; pregnancy; congenital heart defects; phosphatidylcholine; sphingomyelin; free choline; glycerophosphocholine; phosphocholine  \n1. Introduction  \nCongenital heart defects (CHD) comprise the most common group of congenital malformations worldwide [1] . CHD affects around 1 in 100 newborns in the world [1], and caused more than 0.26 million deaths in 2017 [2], causing great burdens on families and society [2] . The prevalence of CHD at birth has increased in China during the last few decades [3,4], with over 150,000 incident cases yearly [3] . Previous studies have indicated that both genetic and environmental factors may be associated with the development of the fetal cardiovascular system [5]; however, the etiologies of CHD remain largely  \nunknown [5] . It is warranted to identify modifiable risk factors for CHD to provide evidence for primary prevention.  \nMaternal nutrition in pregnancy, a primary modifiable factor, is crucial for fetal development [6–8] . Previous studies have observed that several nutrients in one-carbon metabolism (a critical network of folate-driven biochemical reactions ","cbCaivcQ35SgvNht","https://ap.wps.com/l/cbCaivcQ35SgvNht","pdf",1155220,13,"English","# Abstract\n## Background/Objectives\n## Methods\n## Results\n## Conclusions\n# 1. Introduction\n# 2. Materials and Methods\n## 2.1 Study Design and Participants","[{\"question\":\"What was the study’s main objective regarding choline and CHD?\",\"answer\":\"To investigate associations between maternal dietary intake of choline and choline derivatives during pregnancy and congenital heart defects.\"},{\"question\":\"How were maternal dietary intakes measured during pregnancy?\",\"answer\":\"Pregnant women completed a validated food frequency questionnaire to assess dietary intake, and a standardized questionnaire was used to collect additional pregnancy-related information.\"},{\"question\":\"What choline-related findings were reported for congenital heart defects?\",\"answer\":\"Higher intakes of several choline forms were associated with reduced risks of total CHD and specific defects such as ventricular septal defects and atrial septal defects.\"}]","Dietary Choline Intake During Pregnancy and Congenital Heart Defects in a Chinese Population | PDF",1790773000,33]