Omega-3 fatty acid supply in pregnancy for risk reduction of preterm and early preterm birth
Cetin I, Carlson S, Burden C, Fonseca E, Renzo E, Hadjipanayis A, Harris W, Kumar K, Olsen S, Mader S, McAuliffe F, Muhlhausler B, Oken E, Poon L, Poston L, Ramakrishnan U, Roehr C, Savona-Ventura C, Smuts C, Sotiriadis A, Su K, Tribe R, Vannice G, Koletzko B (2024) American Journal of Obstetrics and Gyneanacology Feb;6(2):101251 doi: 10.1016/j.ajogmf.2023.101251
Web URL: Read this article on PubMed
Abstract:
This clinical practice guideline on the supply of the omega-3 docosahexaenoic acid and eicosapentaenoic acid in pregnant women for risk reduction of preterm birth and early preterm birth was developed with support from several medical-scientific organizations, and is based on a review of the available strong evidence from randomized clinical trials and a formal consensus process.We concluded the following.
- Women of childbearing age should obtain a supply of at least 250 mg/d of docosahexaenoic+eicosapentaenoic acid from diet or supplements, and in pregnancy an additional intake of ≥100 to 200 mg/d of docosahexaenoic acid.
- Pregnant women with a low docosahexaenoic acid intake and/or low docosahexaenoic acid blood levels have an increased risk of preterm birth and early preterm birth. Thus, they should receive a supply of approximately 600 to 1000 mg/d of docosahexaenoic+eicosapentaenoic acid, or docosahexaenoic acid alone, given that this dosage showed significant reduction of preterm birth and early preterm birth in randomized controlled trials. This additional supply should preferably begin in the second trimester of pregnancy (not later than approximately 20 weeks' gestation) and continue until approximately 37 weeks' gestation or until childbirth if before 37 weeks' gestation.
- Identification of women with inadequate omega-3 supply is achievable by a set of standardized questions on intake. Docosahexaenoic acid measurement from blood is another option to identify women with low status, but further standardization of laboratory methods and appropriate cutoff values is needed.
- Information on how to achieve an appropriate intake of docosahexaenoic acid or docosahexaenoic+eicosapentaenoic acid for women of childbearing age and pregnant women should be provided to women and their partners.
FAB RESEARCH COMMENT:
Increasing Omega-3 LC-PUFA Intake in pregnancy reduces preterm birth
It is already 6 years since the Cochrane systematic review provided definitive evidence that supplementation of omega-3 LC-PUFA during pregnancy significantly reduces rates of preterm birth - as shown by meta-analysie of 70 randomised, double-blind placebo-controlled clinical trials, involving almost 20,000 women. See:
Four years later, ISSFAL (The International Society for the Study of Fatty Acids and Lipids) published an independent expert consensus statement and recommendations on omega-3 supplementation in pregnancy for the prevention of pre-term birth.
This included reference to additional dose-ranging clinical trials, showing that supplementation with 1000mg/day of omega-3 DHA is needed for women with intakes of fish and seafood below current guidelines - but that providing the appropriate dose of omega-3 from week 20 of pregnancy can reduce by half rates of early pre-term birth (which is associated with the greatest risks for lifelong physical and mental disabilities). See:
How these findings can be applied in practice
With the benefits of omega-3 in pregnancy for reducing preterm birth now backed by the very highest level of scientific evidence, this latest review - from leading scientists in this field and clinical and community health organisations - summarises the evidence, and also makes very clear, simple recommendations and guidelines for applying these findings in everyday clinical practice.
Putting this first-class evidence into practice would also SAVE MONEY - even in the short-term
Studies in both Australia and the US have already shown that the benefits of omega-3 supplementation in pregnancy for reducing preterm birth - and many other birth complications - would lead to significant cost savings even in the very short-term (i.e. immediate hospital costs). See:
Preterm birth is common - affecting 1 in 10 pregnancies worldwide, 1 in 12 in the UK (where rates are rising)
It is also the leading cause of death in children under 5, and a major cause of lifelong mental and physical disabilities.
As these expert clinical guidelines explain, the highest level of scientific evidence now shows that:
- Ensuring adequate omega-3 status in pregnancy significantly reduces the harms - and huge costs - associated with preterm birth
- Screening for suboptimal omega-3 status (via a brief checklist of dietary intake) can easily identify women in need of supplementation with omega-3 DHA - and the dosage required to reduce preterm birth risks
These clinical guidelines provide all the information that governments, health policymakers and professionals should need to promote and support this safe, effective, cheap and simple intervention for all pregnant women, as part of standard prenatal care.
To receive a FREE downloadable summary for professionals, policymakers and the generakl public - with links to the key research, and further information, please see:
See also:
And for more information on this subject:
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