UHPLC–MS Profiling of Maternal and Cord Blood Choline and Betaine in Relation to Birthweight Outcomes

While previous studies suggest that a mother’s levels of choline and betaine during pregnancy may influence a baby’s growth, there has not yet been much population-level evidence gathered. To explore this, researchers at Peking University examined whether levels of these nutrients in mothers and in umbilical cord blood are linked to birthweight, measuring choline and betaine in blood samples taken late in pregnancy and at birth using ultrahigh-performance liquid chromatography–mass spectrometry (UHPLC-MS) and then analyzing how these levels related to babies’ birthweights. A paper based on their research was published in the journal Nutrients.¹

What Are the Health Risks of Abnormal Birthweight, and Why is Prevention Important?

Birthweight is an important measure of how a baby grows before birth and can have a big impact on health both right after birth and later in life.² Both low birthweight (under 2500 g) and very high birthweight (over 4000 g) are associated with health risks. These can include a higher chance of complications in newborns, poor nutrition during childhood, and an increased risk of long-term health problems like diabetes and heart disease later in life.^3,4 Understanding what influences a baby’s growth before birth is important for reducing the number of babies born too small or too large. This is especially urgent because progress in lowering these cases has been slow over the past 20 years.^5,6

Do Choline and Betaine Levels During Pregnancy Affect a Baby’s Birthweight?

The study discussed here involved 988 mother-infant dyads from China’s Hebei and Shandong provinces. Choline and betaine levels were found to be lower in mothers during late pregnancy compared with levels in the baby’s cord blood at birth. The study also showed that higher betaine levels—both in late pregnancy and in cord blood—were linked to slightly lower birthweights on average. In addition, babies with higher betaine exposure were less likely to be born very large for their gestational age or to have macrosomia (excessively high birthweight). These patterns were especially noticeable in pregnancies involving maternal overweight, obesity, or gestational diabetes mellitus (GDM), although the differences were not statistically strong enough to confirm a clear interaction. No meaningful link was found between choline levels and birthweight outcomes at any stage.¹

“Higher plasma concentrations of betaine in maternal late-pregnancy and cord blood,” write the authors of the paper,¹ “were associated with lower birthweight. These findings emphasize the importance of sufficient betaine status during pregnancy, especially among mothers with obesity or GDM.”

The researchers suggest that future long-term studies should track women from early pregnancy all the way to birth to better understand how a mother’s betaine levels during pregnancy, and at delivery, affect how the baby grows over time.¹

Read More on Similar Topics
Metabolomics Analysis of Low Birth-Weight Infants Using UHPLC-MS/MS Following Lipid Emulsion

References

1. Aihemaitijiang, S.; Wen, J.; Li, K. et al. Association of Maternal and Cord Blood Choline and Betaine Concentrations with Birthweight: A Prospective Mother-Infant Cohort Study. Nutrients 2026, 18 (9), 1456. DOI: 10.3390/nu18091456
2. Lucas, A.; Fewtrell, M. S.; Cole, T. J. Fetal Origins of Adult Disease—The Hypothesis Revisited. Bmj 1999, 319 (7204), 245-249. DOI: 10.1136/bmj.319.7204.245
3. Knop, M. R.; Geng, T. T.; Gorny, A. W. et al. Birth Weight and Risk of Type 2 Diabetes Mellitus, Cardiovascular Disease, and Hypertension in Adults: A Meta‐Analysis of 7 646 267 Participants from 135 Studies. J. Am. Heart Assoc. 2018, 7 (23), e008870. DOI: 10.1161/JAHA.118.008870
4. Taal, H. R., vd Heijden, A. J., Steegers, E. A. et al. Small and Large Size for Gestational Age at Birth, Infant Growth, and Childhood Overweight. Obesity 2013, 21 (6), 1261-1268. DOI: 10.1002/oby.20116
5. Okwaraji, Y.B.; Krasevec, J.; Bradley, E. et al. National, Regional, and Global Estimates of Low Birthweight in 2020, with Trends from 2000: A Systematic Analysis. Lancet 2024, 403, 1071–1080. DOI: 10.1016/S0140-6736(23)01198-4
6. Damhuis, S.E.; Ganzevoort, W.; Gordijn, S.J. Abnormal Fetal Growth: Small for Gestational Age, Fetal Growth Restriction, Large for Gestational Age: Definitions and Epidemiology. Obstet. Gynecol. Clin. N. Am. 2021, 48, 267–279. DOI: 10.1016/j.ogc.2021.02.002