Food and Behaviour Research

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Interaction of maternal choline levels and prenatal Marijuana's effects on the offspring

Hoffman MC, Hunter SK, D'Alessandro A, Noonan K, Wyrwa A, Freedman R (2019)  2019 July;   DOI: 10.1017/S003329171900179X Psychol Med

Web URL: Read this and related abstracts on PubMed here



This study investigated whether higher maternal choline levels mitigate effects of marijuana on fetal brain development.

Choline transported into the amniotic fluid from the mother activates α7-nicotinic acetylcholine receptors on fetal cerebro-cortical inhibitory neurons, whose development is impeded by cannabis blockade of their cannabinoid-1(CB1) receptors.


Marijuana use was assessed during pregnancy from women who later brought their newborns for study. Mothers were informed about choline and other nutrients, but not specifically for marijuana use. Maternal serum choline was measured at 16 weeks gestation.


Marijuana use for the first 10 weeks gestation or more by 15% of mothers decreased newborns' inhibition of evoked potentials to repeated sounds (d’ = 0.55, p < 0.05). This effect was ameliorated if women had higher gestational choline (rs = −0.50, p = 0.011).

At 3 months of age, children whose mothers continued marijuana use through their 10th gestational week or more had poorer self-regulation (d’ = −0.79, p < 0.05). This effect was also ameliorated if mothers had higher gestational choline (rs = 0.54, p = 0.013). Maternal choline levels correlated with the children's improved duration of attention, cuddliness, and bonding with parents.


Prenatal marijuana use adversely affects fetal brain development and subsequent behavioral self-regulation, a precursor to later, more serious problems in childhood. Stopping marijuana use before 10 weeks gestational age prevented these effects. Many mothers refuse to cease use because of familiarity with marijuana and belief in its safety. Higher maternal choline mitigates some of marijuana's adverse effects on the fetus.


This study is purely observational, so cannot demonstrate cause-and-effect relationships - either between marijuana use in pregnancy and subsequent child behaviour and learning problems, or for the apparent protective effect of higher maternal choline intakes and status against these negative child outcomes.

However, both findings are consistent with other evidence from human and animal studies. And while there is relatively little evidence yet about effects of prenatal exposure to marijjuana, there is already a huge body of existing evidence showing that a lack of choline in early life can lead to permanent impairments of brain development and function, via many different but well-documented mechanisms.

Importantly, human clinical trials - which can show cause-and-effect - have recently shown clear benefits for children's visual and cognitive development from maternal supplementation of choline during pregnancy. See:

Most striking is that these benefits for children's brain development were achieved by giving their mothers twice the current recommended daily intake of choline, while the placebo group received the recommended daily intake (480mg).

As 90% of US mothers-to be currently fail to reach even the RDA for choline - i.e. the level given to the placebo group - those clinical trial findings strongly indicated that policymakers would do well to take action to increase both dietary recommendations and dietary intakes of choline, as well as to do more to raise awareness of this neglected essential nutrient.

These latest findings only reinforce the need for public health policy to do more to promote better awareness of choline, and higher intakes for women of childbearing age in particular - whether via food or supplementation.

See the associated news article:

For more information on choline, see: