Research published in the Journal of Perinatology adds to the body of evidence supporting the establishment of an appropriate omega-3 DHA level for pregnant women. This prospective cohort study, conducted between February and August 2016 at the Obstetrics and Gynecology Department of Citadelle Regional Hospital Center in Liège, Belgium, investigated 108 healthy women with singleton pregnancies. The study collected data on gestational duration, birth anthropometric measurements, pregnancy-associated complications, and participants' red blood cell omega-3 levels, specifically the Omega-3 Index.
The research team noted that interest in the role of omega-3 fatty acids on pregnancy outcomes began in the early 1980s, with observations of longer gestations, higher birth weights, and fewer preterm births in the fish-consuming community of the Faroe Islands compared to Denmark. It has been increasingly recognized that nutrient availability before and during the early stages of pregnancy influences fetal development, affecting the offspring's health over their lifetime.
Preterm birth and fetal growth restriction remain significant obstetric health challenges, contributing to perinatal morbidity, mortality, and long-term disability. Despite improvements in perinatal and neonatal care, the researchers argue that prevention strategies hold the potential for a significant impact on pregnancy complication rates, warranting further exploration as a high priority in modern healthcare.
This study aimed to contribute to the evidence base for primary prevention by examining the association of higher DHA levels and the omega-3 index with longer gestational lengths, higher birth weights, and larger head circumferences. Conversely, a higher omega-6/omega-3 ratio was associated with shorter gestational lengths and lower birth weights.
DHA, in particular, has garnered attention over the last decade for preventing spontaneous preterm birth, leading some researchers to propose a target prenatal DHA level.
The authors believe personalized nutrition could offer new opportunities, especially in dietary management for those needing specific nutritional support, such as pregnant women. Helping women establish and meet an optimal DHA level of 5% could guide appropriate DHA intake and potentially improve pregnancy outcomes, such as preterm birth.
As dietary lipid quality has undergone significant changes over the past 50 years, the study concludes that prenatal counseling should raise awareness of the importance of omega-3 during pregnancy.
The ORIP study – Encouraging a targeted approach for DHA supplementation
The ORIP Trial, published in the New England Journal of Medicine, suggested that individuals with the lowest omega-3 DHA levels might benefit most from supplementation in reducing the risk of early preterm birth. This largest clinical study of omega-3 supplementation during pregnancy involved ~5400 Australian women, examining if taking fish oil rich in the omega-3 fat DHA could help prevent very early preterm birth.
The study found that DHA supplementation did not affect early preterm birth, especially for those already consuming a significant amount of DHA in their diet or through supplements. Dr. Jackson noted the baseline DHA levels in the ORIP study were about 20% higher than observed in the KUDOS study, where a significantly lower frequency of early preterm birth was observed with omega-3 supplementation than with placebo.
Furthermore, the ORIP study included women with multiple fetuses, a factor known to influence gestational duration. Dr. Jackson highlighted that further studies are needed to determine if there might be benefits for women with low omega-3 levels.
The importance of tailoring DHA intake
The Prenatal DHA Test was launched as a way for pregnant women and their doctors to guide proper DHA intake before and during pregnancy, measuring the amount of DHA in the blood with a target of 5% as the most protective level. These objective measurements of DHA status can help women and their healthcare providers assess, modify, and monitor their status to ensure adequate consumption of this critical nutrient from pregnancy through breastfeeding and into the postpartum period.
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