(Press-News.org) In two recent articles published in Schizophrenia Bulletin, Sharon Hunter, PhD, an associate professor in the University of Colorado School of Medicine Department of Psychiatry, and M. Camille Hoffman, MD, MSc, an associate professor in the University of Colorado School of Medicine Department of Obstetrics and Gynecology, along with their research group, have uncovered a potential link between choline deficiency in Black pregnant women in the United States and increased risk of developmental and behavioral issues that can evolve into mental illness later in their children's lives.
The first article, published in November 2020, is a study, titled, "Black American Maternal Prenatal Choline, Offspring Gestational Age at Birth, and Developmental Predisposition to Mental Illness." The second, published last month and titled "Targeting Treatments to Health Disparities," is a follow-up article delving more deeply into known healthcare disparities highlighted by the study results.
The studies are the result of more than 20 years of research by the group, which began with a general goal of understanding in utero risk factors of schizophrenia.
"At that time, there was a lot of discussion around the idea that mental illnesses like schizophrenia were tied to prenatal neurodevelopment," Hunter says.
Early choline clinical trial
Choline is an essential nutrient that can be found in foods such as milk, red meats, and eggs. Based on previous studies of choline showing that it is vital for fetal neurodevelopment, including the development of inhibitory neurocircuits in the brain that are abnormal in individuals with schizophrenia and many of their family members, the group launched its first clinical trial in 2004. During the trial, they supplemented pregnant women with a specific form of choline called phosphatidylcholine, then monitored their children until the age of four. Phosphatidylcholine is less likely to cause side effects, such as stomach upset, associated with pure choline. The results of the trial showed that those inhibitory neurocircuits were functioning properly in more children from supplemented moms than in children whose mothers didn't receive the supplement.
"It showed that mothers who had lower choline levels during the second trimester of pregnancy gave birth to babies who were more likely to have worse neurodevelopmental scores, which can be a marker for later mental illness or behavioral problems," Hoffman says.
The ultimate goal was to uncover whether supplementing with choline could help prevent schizophrenia, but since the condition isn't typically diagnosed until a patient is in their 20s, the group instead monitored for the some of the disease's early indicators.
"We couldn't follow these children for 20 years, but we could test them as children to see if they had problems with attention or withdrawal or aggression, which can be indicators not just of schizophrenia but of other mental issues as well," Hunter explains.
Uncovering a racial health care disparity
After the first choline trial, the group conducted a follow-up study in which they measured choline levels in 183 pregnant women. Although the women were told about choline and the researchers suggested that they try to get more choline in their diets, they did not administer any choline supplements to the participants. It was during this study that the group noticed a demographic disparity: overall, choline levels were markedly lower in Black women than any other group.
"When we found these differences in choline levels, we started to wonder whether this also translated to differences in outcomes," Hunter says. "And preliminary data suggests that it does."
This disparity in choline levels prompted the researchers to look back at the results of the first clinical trial. When they did, they found that the gestational age at delivery in Black mothers who had been supplemented with choline was extended by an average of three weeks compared to Black mothers who didn't receive supplementation.
"As an Ob/Gyn, preterm birth is one of the main adverse pregnancy outcomes that we're always working towards preventing," Hoffman says. "And there are known disparities in both birth weight and risk of preterm birth between Black women and their children and almost every other group."
Since preterm birth can have adverse effects on the development of cognition and behavior throughout childhood -- including mental health -- the results of the clinical trial and the subsequent observational study seem to point to two potential benefits of choline supplementation for pregnant women, and, in particular, Black women: enhanced prenatal development of inhibitory neuro-circuits in the brain and older gestational age at delivery.
How systemic racism in the U.S. may play a role in stress and pregnancy
Now the researchers were faced with the question of why Black mothers' choline levels were so much lower than those of other women? They compared the choline levels of the Black pregnant women in the American study to blood samples from a cohort of pregnant women in Uganda and found that the choline levels of the Ugandan women were much higher than their American counterparts.
"Of course, we know that not all Black women in America are African American or of African heritage, Hunter says. "But still, it seemed like there was something else going on that might account for the racial differences we were seeing."
So, they turned their attention to a potential culprit and differentiator: stress.
"Part of my contribution to the research group early on was looking at ways to capture and measure stress in relation to two primary pregnancy outcomes," Hoffman says. "One was gestational age at birth and the other was birth weight, because both of those are markers for either long-term wellness or potential impairments."
One of the group's hypotheses was that the more stressed a mother is, the more her liver may sequester choline for itself, meaning that the fetus may not receive an adequate amount for neurodevelopment and is more at risk for preterm birth.
The team used Hoffman's methods to collect measures of maternal stress in the observational study participants. And while the Black women didn't report feeling more stress, their hair cortisol levels, a biomarker of stress exposure, were higher than those of participants of other races.
"Even though they don't report it, their bodies looked more stressed," Hunter says. "Our question now is whether there are stressors that Black women experience but that our questionnaires do not capture, or are cortisol levels reflecting accumulated exposure to low-level, background stressors, perhaps stemming from decades or lifetimes or even generations of institutional racism in this country. We don't have the data to answer those questions yet, but we wanted to get this study out there to say, 'this is something we should be paying attention to.'"
Could choline be the next folic acid?
The Food and Drug Administration (FDA) currently recommends that pregnant women get 550 milligrams of choline a day, but Hunter says that about 90% of pregnant women don't meet that goal.
"That's hard to do," she says. "It's not that it can't be done, but it would be difficult. There have also studies that tried to raise choline levels in women by bringing them into a laboratory and providing them with high-choline foods, but they were not very successful."
"The same was true for folic acid studies 20 years ago," says Hoffman. "We recommend folic acid for pregnant women because it has a major impact on reducing neural tube defects. But the same story played out back in the early days of folic acid research, where the risk was significantly reduced when folate was included in a supplement versus trying to get people achieve adequate dietary intake. Dietary changes are hard to make, but we know you're going to get higher choline levels when you supplement."
Hunter says the group hopes to do another clinical trial in the future where they supplement one cohort of Black women at the FDA-recommended choline level, plus another group at about two to three times the recommended amount to see if there is any additional benefit to supplementing at a higher level.
"If we're telling women that they need 550 milligrams of choline per day, but some other factor limits how much choline can get to the fetus, that level of intake may not adequately meet the needs of the developing fetus. We need to understand this," she says.
Unfortunately, the supplements can be expensive: usually $600-$800 over the course of a pregnancy, and up to about $1,200 for some of the more expensive supplements.
Both Hoffman and Hunter hope to continue to raise awareness around this issue and the health disparity when it comes to Black women.
"For over 50 years, maternal fetal medicine has been trying to figure out ways that we can reduce preterm birth, and then we find a promising contender in the choline data set," Hoffman says. "It's especially exciting because a major push in obstetrics right now is trying to close these known gaps in outcomes that exist for Black women and their children. The choline and cortisol connection gives us objective, physiologic measures to sort out what changes we need to make in terms of addressing health disparities"
Studies explore links between stress, choline deficiency, preterm births, and mental health
CU researchers say the data points to a health care disparity when it comes to caring for Black mothers and their children in the U.S.
2021-07-07
ELSE PRESS RELEASES FROM THIS DATE:
Quantum laser turns energy loss into gain?
2021-07-07
Scientists at KAIST have fabricated a laser system that generates highly interactive quantum particles at room temperature. Their findings, published in the journal Nature Photonics, could lead to a single microcavity laser system that requires lower threshold energy as its energy loss increases.
The system, developed by KAIST physicist Yong-Hoon Cho and colleagues, involves shining light through a single hexagonal-shaped microcavity treated with a loss-modulated silicon nitride substrate. The system design leads to the generation of a polariton laser at room temperature, which is exciting because this usually requires cryogenic temperatures.
The researchers found another unique and counter-intuitive feature of this design. Normally, energy is lost during laser operation. ...
Study reveals how our immune system reacts to COVID-19 variants
2021-07-07
Australian scientists researching how our immune system responds to COVID-19 have revealed that those infected by early variants in 2020 produced sustained antibodies, however, these antibodies are not as effective against contemporary variants of the virus.
The research is one of the world's most comprehensive studies of the immune response against COVID-19 infection. It suggests vaccination is more effective than the body's natural immune response following infection and shows the need to invest in new vaccine designs to keep pace with emerging COVID variants.
Published today in PLOS ...
New composites with magnetolectrical properties will help treat neurodegenerative diseases
2021-07-07
Polymer composite materials that combine magnetic and electrical properties are the subjects of particular attention for modern-day researchers. Their basic property is the ability to convert electric polarization into a magnetic field and vice versa. Although some materials exhibit a much better magnetoelectric effect, polymer-based composites are easier not only to produce but also to modify.
Such composites have great potential in a variety of different fields. For example, using them as a basis, scientists can develop surfaces that help cultivate various cells. In this case, polymer composites serve as a substrate through which it is possible to affect the culture using a non-contact and controlled electric charge and morphological properties ...
Aging-related conditions increase treatment burden in older cancer patients
2021-07-07
DANVILLE, Pa. - Having multiple chronic health conditions and living in a rural area were the top two factors affecting increased healthcare system contact among older patients with bladder cancer, a research team has found.
The Geisinger-led team evaluated 73,395 Medicare beneficiaries age 66 and older who had been diagnosed with non-muscle-invasive bladder cancer to assess their treatment burden, defined as the number of days the patients had contact with a health system in the year following diagnosis.
Nearly two-thirds of the patients had multiple co-existing chronic conditions at the time of bladder cancer diagnosis, as well as other aging-related conditions, including a history of falls, ...
Study explores opioid prescribing preferences and practices among residents and faculty
2021-07-07
Opioid prescribing preferences and practices among surgical residents and faculty differ, according to a new study published in the journal Surgery.
The study, titled "Evaluation of opioid prescribing preferences among surgical residents and faculty," was based on a survey of 56 residents and 57 faculty within the University of Colorado School of Medicine Department of Surgery. In the survey, participants were asked how many oxycodone tablets they would prescribe for 14 common surgical procedures.
Answers were compared between residents and faculty, as well as against the Opioid Prescribing Engagement Network (OPEN) guidelines and actual opioids ...
New approach will help identify drugs that can 'glue' proteins together
2021-07-07
A new screening method that can test the effectiveness of therapeutic molecules designed to 'glue' proteins together in the body has been developed by researchers at the University of Birmingham and the University of Leicester.
The research paves the way for drug developers to screen large numbers of potential new drug compounds to discover new treatments for diseases such as breast cancer and Parkinson's disease.
The ways in which proteins interact with each other are fundamental to all cell functions. These interactions underpin every function of a healthy body, with any slight change in these interactions resulting in disease.
A handful ...
Rare genetic variants confer largest increase in type 2 diabetes risk seen to date
2021-07-07
Scientists at the University of Cambridge have identified rare genetic variants - carried by one in 3,000 people - that have a larger impact on the risk of developing type 2 diabetes than any previously identified genetic effect.
Type 2 diabetes is thought to be driven in part by inherited genetic factors, but many of these genes are yet unknown. Previous large-scale studies have depended on efficient 'array genotyping' methods to measure genetic variations across the whole genome. This approach typically does a good job at capturing the common genetic differences between people, though individually these each confer only small increases in diabetes ...
Viruses are the most common cause of myocarditis in children, experts offer guidance
2021-07-07
DALLAS, July 7, 2021 -- Myocarditis in children is a rare yet challenging condition to treat. Diagnosis and treatment includes multiple options, and many cases of myocarditis resolve on their own, according to a new scientific statement from the American Heart Association, "Diagnosis and Management of Myocarditis in Children," published today in Circulation, the Association's flagship journal. The scientific statement writing group reviewed the latest research to develop guidance in diagnosis and treatment for myocarditis in children.
Myocarditis is inflammation of the middle layer of the wall of the heart muscle, the myocardium, and it ...
New method lets researchers rapidly monitor snow leopard stress levels in the wild
2021-07-07
The newly developed method lets researchers rapidly and accurately measure stress hormones in snow leopards without the need for bulky equipment or specialised knowledge. It uses widely available equipment that can be carried into the field, allowing hormone extraction from faecal samples and analysis to be done on site.
This differs from existing approaches to hormone monitoring in wild animals, where faecal samples must be taken to laboratories for hormone extraction and analysis. These approaches are particularly limiting in remote locations, such as the Himalayas.
"Because conventional hormone monitoring methods require frozen and refrigerated chemical reagents, and laboratory equipment, it is almost impossible to use them on-site." explained ...
Could a longer reproductive period put women at greater risk for Alzheimer disease?
2021-07-07
CLEVELAND, Ohio (July 7, 2021)--Estrogen has been thought to play a role in a woman's risk of developing Alzheimer disease (AD). A new study has taken a different approach to identifying risk factors for AD by examining the association between a woman's reproductive life span as an indicator of endogenous estrogen exposure and levels of cerebrospinal fluid biomarkers. Study results are published online in Menopause, the journal of The North American Menopause Society (NAMS).
Alzheimer disease represents 60% to 70% of all dementia diagnoses, making it the most common form of dementia. Approximately ...
LAST 30 PRESS RELEASES:
Reality check: making indoor smartphone-based augmented reality work
Overthinking what you said? It’s your ‘lizard brain’ talking to newer, advanced parts of your brain
Black men — including transit workers — are targets for aggression on public transportation, study shows
Troubling spike in severe pregnancy-related complications for all ages in Illinois
Alcohol use identified by UTHealth Houston researchers as most common predictor of escalated cannabis vaping among youths in Texas
Need a landing pad for helicopter parenting? Frame tasks as learning
New MUSC Hollings Cancer Center research shows how Golgi stress affects T-cells' tumor-fighting ability
#16to365: New resources for year-round activism to end gender-based violence and strengthen bodily autonomy for all
Earliest fish-trapping facility in Central America discovered in Maya lowlands
São Paulo to host School on Disordered Systems
New insights into sleep uncover key mechanisms related to cognitive function
USC announces strategic collaboration with Autobahn Labs to accelerate drug discovery
Detroit health professionals urge the community to act and address the dangers of antimicrobial resistance
3D-printing advance mitigates three defects simultaneously for failure-free metal parts
Ancient hot water on Mars points to habitable past: Curtin study
In Patagonia, more snow could protect glaciers from melt — but only if we curb greenhouse gas emissions soon
Simplicity is key to understanding and achieving goals
Caste differentiation in ants
Nutrition that aligns with guidelines during pregnancy may be associated with better infant growth outcomes, NIH study finds
New technology points to unexpected uses for snoRNA
Racial and ethnic variation in survival in early-onset colorectal cancer
Disparities by race and urbanicity in online health care facility reviews
Exploring factors affecting workers' acquisition of exercise habits using machine learning approaches
Nano-patterned copper oxide sensor for ultra-low hydrogen detection
Maintaining bridge safer; Digital sensing-based monitoring system
A novel approach for the composition design of high-entropy fluorite oxides with low thermal conductivity
A groundbreaking new approach to treating chronic abdominal pain
ECOG-ACRIN appoints seven researchers to scientific committee leadership positions
New model of neuronal circuit provides insight on eye movement
Cooking up a breakthrough: Penn engineers refine lipid nanoparticles for better mRNA therapies
[Press-News.org] Studies explore links between stress, choline deficiency, preterm births, and mental healthCU researchers say the data points to a health care disparity when it comes to caring for Black mothers and their children in the U.S.