Highlighting the power of nutrition: New recommendations on preventing preterm birth through omega-3 fatty acid intake during pregnancy

Preterm birth is difficult to predict and most women who deliver preterm have no prior risk factors. Recent studies now agree that there is a promising, effective, and safe way to prevent preterm birth and especially early preterm birth. The daily intake of omega-3 fatty acids by pregnant women can reduce the risk to deliver preterm by up to 50% whilst being easy to integrate into the daily diet. Omega-3 fatty acids are found in various types of fish and can be easily supplemented. In order to provide expectant mothers and healthcare professionals with information on the optimal intake of omega-3 fatty acids, the Child Health Foundation released a new clinical practice guideline. It not only supports the search for the right nutrition for pregnant women, but also provides an outlook on possible screening approaches.

The risk factors for preterm birth (PTB) are diverse and not specific enough to determine every woman’s risk. In fact, most PTBs and early PTB occur in women without risk factors. Preventive measures during pregnancy are therefore key to reducing the risk of PTB for all mothers. A new clinical practice guideline from the Child Health Foundation has analysed the potential of omega-3 docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) supplementation to reduce the risk of PTB. With the contribution of EFCNI, a steering committee of experts from around the world developed 11 recommendations for the intake of omega-3 fatty acids.

Taking omega-3 fatty acids during pregnancy reduces the risk of PTB by up to 50%

Several studies and reviews involving hospitals across Europe and the US have investigated the effects of DHA and combined DHA+EPA intake during pregnancy. Supplementation significantly reduced the risk of PTB by 11-51% and by 35-65% for early PTB. In the light of the latest scientific evidence in the field, the new guidelines therefore recommend that every person, including women of childbearing age, should consume a minimum of 250 mg of DHA+EPA per day. This changes for pregnant women, for whom a minimum of 100-200 mg/d DHA is recommended. Pregnant women with low DHA blood levels should receive 600 to 1,000 mg/d of DHA or alternatively DHA+EPA. The intake of DHA and EPA is safe up to a consumption of 1,000 mg/d. Pregnant women should note that supplementation should begin no later than the second trimester and continue until the 37th week of pregnancy.

Admittedly, it is not easy to consume these amounts of omega-3 fatty acids on a daily basis. DHA and EPA are mainly found in fish and fish oils. Fish with particularly good sources of omega-3 fatty acids are salmon, mackerel, herring, tuna, sardines, and anchovies, whereas egg yolks, liver, and poultry contain only small amounts of DHA. However, all women who reached the recommended levels took additional supplements as an easier way to reach their dietary target.

Pregnant women need more nutritional support from healthcare professionals

The benefits of an omega-3 rich diet are great. It is considered a highly effective, safe, and comparatively affordable method of preventing PTB. However, only two countries, Australia and Poland, currently recommend the intake of DHA and EPA particularly for the prevention of PTB, but knowledge needs to be spread more widely. The guidelines have therefore been extended to include demands on healthcare professionals to support pregnant women in their diet. Screening approaches to identify women with low omega-3 fatty acid intake should be implemented by simply asking about dietary habits or, if possible, by standardized laboratory methods. Furthermore, all healthcare professionals should be knowledgable about nutrition in pregnant women and be able to provide information to them. This is the key to successfully reducing the rates of preterm birth and especially early preterm birth in the long term.

Paper available at: https://www.ajogmfm.org/article/S2589-9333(23)00393-2/abstract

Full list of authors: Irene Cetin, Susan Carlson, Christy Burden, Gretchen Vannice, Berthold Koletzko, et al.

DOI: https://doi.org/10.1016/j.ajogmf.2023.101251

Find out more about your personal nutrition status: https://www.figo.org/figo-resources/nutrition/figo-nutrition-checklist