Thursday, December 10, 2015

Prenatal Choline Supplements May Decrease Later Attention, Social Problems in Children

Children born to mothers who take a high-dose choline supplement during pregnancy may be less likely to experience attention and social problems later in life, according to a study published Monday in AJP in Advance.

“The main significance of our findings is that we’ve shown that it is potentially possible to intervene prenatally to improve brain development in a safe way that is reflected in behavior that predicts increased resilience and decreased psychiatric illness later in life,” lead author Randal Ross, M.D., a professor of psychiatry at the University of Colorado School of Medicine, told Psychiatric News. “The earlier in development you intervene, the greater the potential benefits and lower the costs.”

Past studies suggest that children who later develop psychiatric disorders with an attentional component (such as attention-deficit/hyperactivity disorder, autism spectrum disorder, and schizophrenia) display developmental deficits from an early age. For instance, diminished auditory response inhibition in newborns has been found to be associated with their parent’s psychosis, the greatest risk factor for future psychotic illness.

In a previous study, Ross and colleagues found that newborns born to healthy mothers who had taken prenatal phosphatidylcholine supplements (3,600 mg each morning and 2,700 mg each evening) were more likely to display healthy adult levels of auditory inhibition than those whose mothers had taken a placebo throughout pregnancy. As a follow-up to this study, the researchers asked the parents to rate the behavioral development of their children at age 40 months.

Of the 100 pregnant women enrolled in the initial trial, 86 delivered children from whom researchers recorded auditory evoked potentials at 1 month. The parents of 49 of these children later completed the Child Behavior Checklist, where they rated their 3-year-olds on measures of attention, aggression, withdrawal, and more.

Parent ratings on the Child Behavior Checklist attention and withdrawn subscale were significantly lower in those children who had been treated with choline compared with those who had been treated with placebo. The 40-month Child Behavior Checklist ratings were also related to newborn auditory response inhibition, with significant effects on scores for both the withdrawn subscale and total problems.

“The outcome of the fetal stage of brain development has lifelong consequences for mental function, and there is little prospect of reversing these developmental problems later in life when mental illnesses appear,” Ross and colleagues wrote. “Thus, perinatal intervention, even before individuals at risk for mental illness can be identified, is the only opportunity for potentially reversing this initial major aspect of the pathogenesis of mental illness. A primary, low-cost, low-risk intervention during fetal development will not prevent all cases of mental illness, but even a partial decrease in their incidence or severity would have substantial global value.”

(Image: pio3/Shutterstock)

PQRS Penalty Correction

Information that was published in this week’s Psychiatric News Update regarding the deadline to avoid a penalty related to the reporting of Physician Quality Reporting System (PQRS) measures was incorrect. Based on your practice’s Medicare patient volume, it may not be possible to take action to avoid a penalty at this time. For more information about PQRS, click here.