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:
It is now 6 years since the Cochrane systematic review of clinical trials of omega-3 LC-PUFA supplementation in pregancy for the prevention of preterm birth found clear evidence of benefit from meta-analysis of 70 ransomised controlled 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 supporting the benefits of omega-3 supplementation in pregnancy for the prevention of pre-term birth. See:
With the benefits of omega-3 in pregnancy for reduction of preterm birth now backed by the very highest level of scientific evidence, this latest review - from leading individual scientists and health organisations in this field - not only summarises that evidence, but also makes very clear and simple recommendations for clinical practice.
Studies in both Australia and the US have already shown that the benefits of omega-3 supplementation in pregnancy for reducing pre-term birth - and 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 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.
See also:
And for more information on this subject:
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