A University of Colorado Anschutz clinical trial published in October 2026 reveals that pregnant women taking phosphatidylcholine supplements had four-year-old children with an average eight-point IQ jump and significantly lower social withdrawal rates, offering new evidence for prenatal brain development.
University of Colorado Anschutz Clinical Trial Design and Dosing
Researchers enrolled 206 pregnant women at University of Colorado-affiliated clinics between 2017 and 2021. At 16 weeks of pregnancy, participants were randomly assigned to receive either 9,000 milligrams of phosphatidylcholine daily or a placebo until delivery. The trial, registered on ClinicalTrials.gov under identifier NCT03028857 and published in the American Journal of Obstetrics and Gynecology, marks the largest randomized clinical trial of prenatal choline supplementation ever conducted.
This is the largest randomized clinical trial of prenatal choline supplementation ever conducted.
Robert Freedman, senior author and professor of psychiatry at CU Anschutz, via University of Colorado Anschutz
Study co-authors include Sharon K. Hunter, M. Camille Hoffman, Amanda J. Law, Uwe Christians, Angelo D’Alessandro, and Robert Freedman. Funding came from the National Institutes of Health, the National Institute of Child Health and Human Development, the National Center for Advancing Translational Sciences, the National Institute of Mental Health, the National Institute of Drug Abuse, the Institute for Children’s Mental Health, and The Anschutz Foundation.
Cognitive Performance and Behavioral Assessments at Age Four
Children were assessed from 18 months to 4 years of age, with preschool intelligence tests administered to 103 children at ages 3 and 4. Four-year-olds in the supplement group averaged an IQ score of 106, compared to an average of 98 for children in the placebo group. Twelve children scored above the 90th percentile on IQ testing, with ten of those twelve coming from the phosphatidylcholine group. Parents completed behavior checklists for 142 children, revealing striking differences in social withdrawal.
| Metric at Age 4 | Supplement Group | Placebo Group |
|---|---|---|
| Average IQ Score | 106 | 98 |
| Elevated Social Withdrawal | 4 percent | 24 percent |
Behavioral assessments showed that only 4% of children in the supplement group exhibited multiple or lasting withdrawal problems—such as reduced eye contact, limited interest in other people, and withdrawing from social activities—compared to 24% of children whose mothers took the placebo. Researchers also observed significantly fewer children with language difficulties and behavior profiles commonly associated with autism spectrum disorder in the supplement group, though attention problems did not show significant improvement.
Cellular Mechanisms and Dietary Limitations Identified by Researchers
Choline activates a receptor produced by the CHRNA7 gene in developing nerve cells before birth, helping them build the machinery to receive signals from other nerve cells. Natural dietary intake often falls short of what developing neurons require. Senior author Robert Freedman explained that consuming enough choline through ordinary food is nearly impossible, noting that eating ten eggs a day would still not suffice.
Choline in the baby’s circulation comes from the choline eaten by the mother which activates this receptor.
Robert Freedman, professor of psychiatry at CU Anschutz, via University of Colorado Anschutz
Based on comparisons with an earlier trial, researchers suggest a lower daily dose of 7,200 milligrams of phosphatidylcholine—or 900 milligrams of choline itself—since the higher 9,000-milligram dose did not raise blood choline levels any further. Both options are available in drug and grocery stores over the counter.
Maternal Education Levels Influence Participant Attrition
About one-third of enrolled participants did not complete follow-up through the four-year assessments. Attrition correlated heavily with maternal education: 81% of mothers with graduate degrees stayed through year four, compared to 43% of mothers who had not finished high school.
