Intake of eggs, choline, lutein, zeaxanthin, and DHA during pregnancy and their relationship to fetal neurodevelopment

ABSTRACT

Background

Maternal intake of eggs and nutrients contained within eggs during pregnancy have the potential to impact fetal neurodevelopment; however, this area is understudied. The purpose of this study was to determine whether maternal egg and choline intake and nutrient interactions between choline, lutein and zeaxanthin (L/Z), and DHA predict fetal neurodevelopment in a large cohort of pregnant women (n = 202). NCT02709239

Methods

Food frequency questionnaires were used to assess egg and nutrient intake during pregnancy. Fetal neurodevelopment was measured using fetal biomagnetometry at 32 and 36wks gestation, and fetal autonomic indices (SDNN, RMSSD) and brain maturation indices (fABAS) were calculated. Generalized linear models tested the relationships between choline intake, egg intake, and nutrient interactions with fetal neurodevelopment.

Results

Maternal egg intake predicted RMSSD at 32wks and fABAS at 36wks. The interaction between choline and L/Z intake predicted fABAS at 32wks and 36wks and the interaction between choline intake, L/Z intake, and DHA predicted fABAS at 36wks. At 36wks, SDNN was predicted by L/Z intake and interactions between choline and L/Z, L/Z and DHA, and choline, L/Z, and DHA.

Conclusion

Eggs and the nutrients contained within eggs showed synergistic associations with fetal neurodevelopment, and consumption should be encouraged among pregnant women.

KEYWORDS:

• maternal diet
• egg
• choline
• DHA
• lutein
• zeaxanthin
• nutrient synergy
• fetal neurodevelopment

Acknowledgements

This study was made possible by the study personnel who managed the day-to-day aspects of the parent trial and helped organize data for the secondary analysis, especially Nicole Mathis and Alexandra Brown. We are most grateful to the participants of the parent trial who dedicated their time to helping us complete this study.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Author contributions

DNC was the principal investigator and designed the secondary analysis with input from KFG (principal investigator of the parent trial); DH and AS performed the fABAS analysis; LCH completed the statistical analysis; DNC, KFG, and LCH wrote the manuscript but all authors contributed their insights.

Institutional review board statement

The study was conducted according to the guidelines of the Declaration of Helsinki and approved by the Institutional Review Board of The University of Kanas Medical Center (STUDY00003792, Approved March 2021).

Informed consent statement

Informed consent was obtained from all research participants involved in the study.

Data availability statement

The authors will make data and materials supporting the results or analyses presented in their paper available upon reasonable request.

Additional information

Funding

This work was supported by a Human Nutrition Research Grant from the American Egg Board/Egg Nutrition Center. The parent study was supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) 1R01HD086001 (U.S. NIH Grant/Contract).

Notes on contributors

Danielle N. Christifano

Dr. Danielle Christifano is an Assistant Professor at the University of Kansas Medical Center. Dr. Christifano is a nutrition scientist whose work aims to incorporate diet and lifestyle interventions that impact maternal and infant autonomic nervous system function and development. In addition, her lab collaborates with neurocognitive scientists in order to answer questions regarding the impact of dietary interventions on infant health and cognition.

Lynn Chollet-Hinton

Dr. Lynn Chollet Hinton is an Assistant Professor in the Department of Biostatistics Data Science at the University of Kansas Medical Center and an Associate Member in the Cancer Prevention and Control program at the University of Kansas Cancer Center. Dr. Chollet Hinton’s research involves multidisciplinary data science work that combines epidemiology, statistics, and biology for a holistic approach to population health.

Dirk Hoyer

Dr. Dirk Hoyer is the Head of Research Group Systems Analysis at the Biomagnetic Center at the Jena University. He is an expert in fetal magnetocardiographic recordings and a resulting unique methodology of prenatal diagnosis with regard to the identification of fetal maturation disturbances with instantaneous prenatal consequences as well as the ‘fetal programming’ of diseases in later postnatal age, such as cardiovascular, metabolic, hyperkinetic, cognitive and behavioral problems.

Alexander Schmidt

Alexander Schmidt is a Scientific Assistant in the Hans Berger Clinic of Neurology, Biomagnetic Center, University of Jena, Germany. He works closely with Dr. Dirk Hoyer in fetal biomagnetic research.

Kathleen M. Gustafson

Dr. Kathleen Gustafson is a Research Associate Professor in the Department of Neurology at the University of Kansas Medical Center. Her research is focused on the Developmental Origins of Health and Disease (DOHaD). She is an expert in electrophysiology and her research utilizes a dedicated fetal biomagnetometer to measure naturally occurring magnetic fields that surround bioelectric currents in the maternal and fetal bodies. Development and maturation of fetal cardiac autonomic control not only gives us insight into cardiac regulation, but also brain development.