DHA in Pregnancy: May Reduce the Risk of Premature Births

Taking the right amounts of omega-3 fatty acids, particularly DHA, during pregnancy and breastfeeding can have protective effects for maternal and infant health. The latest confirmation comes from a study conducted in Australia that demonstrated, in a group of pregnant women, that DHA supplementation is associated with a 15% reduction in preterm pregnancies. According to the researchers, this also highlights the economic advantage of supplement use during pregnancy: reducing premature births means lowering healthcare costs required to treat possible complications that the child may develop even in the long term.

The results of the study, conducted at the University of Adelaide, were published in the journal Prostaglandins, Leukotrienes and Essential Fatty Acids.

Premature Babies: What Are the Risks

A premature, or preterm, birth occurs before the 37th week of gestation. Each year in Europe about 500,000 babies, one in ten, are born prematurely; in Italy about 40,000. Preterm infants therefore represent a huge percentage of pediatric patients. Besides their small size and low weight, premature newborns are at higher risk than others of developmental defects. The most common manifestations, both short- and long-term, mainly affect the nervous system, vision and hearing, growth, behavior, and school abilities. Additionally, the risk of sudden infant death syndrome is more frequent in them. 

The severity of these disorders increases the shorter the pregnancy. The earlier the birth, the less developed the child’s organs and the higher the risk of subsequent complications. Preterm births are usually classified as early if they occur before the 32nd week of gestation, or late if after this period. The causes of preterm birth are unknown; however, several risk factors have been identified, including twin pregnancy or two pregnancies too close in time, particular maternal health conditions, and the use of alcohol, drugs, and cigarettes. 

The mother’s nutritional status can also contribute to the phenomenon; conditions such as overweight, excessive thinness, or malnutrition may favor premature birth. In this context, an important role of omega-3 fatty acids in the proper course of pregnancy has emerged in recent years. Numerous epidemiological studies have shown that populations consuming a lot of fish containing high percentages of omega-3 report longer pregnancies and higher birth weights. 

DHA in Pregnancy: Fewer Premature Births and Lower Healthcare Costs

While most studies on the topic have considered fish consumption during pregnancy in relation to premature births, the study conducted by Australian researchers, led by Professor Maria Makrides, examined the direct effects of omega-3 themselves, particularly DHA. The study, named DOMINO, involved 2,399 women with singleton pregnancies, less than 20 weeks gestation. Each woman was randomly assigned to receive either fish oil capsules rich in DHA (800 mg per capsule) or vegetable oil capsules as placebo, to be taken daily until the birth of their children. Statistical analysis revealed that the number of early preterm births was 15% lower in the DHA group compared to the control group, and that supplementation provided a 50% chance to avoid an additional premature birth. Having obtained these results, researchers performed an econometric analysis, calculating the amount saved in one year for all avoided preterm pregnancies; premature babies need specific care and treatments that burden families or the national health system. In Australia, the public expenditure savings reached up to 51 million Australian dollars, about 34,000 euros per year. These figures, compared to the low cost of DHA supplements and their ease of use, underline the importance of promoting supplementation during pregnancy.

The Numbers Could Be Even Bigger

As the authors themselves pointed out, the study only considers the reduction of early births and the costs necessary for babies immediately after birth, without taking into account long-term complications these babies may face. In the latter case, obviously, the savings on hospital care costs would be even greater. Also, the data analyzed were collected from public hospitals, excluding private ones and therefore a large number of pregnant women.

Future Studies and Public Health Interventions

The data from this research confirm the beneficial role of DHA in the proper course of pregnancy and fetal development and highlight how a simple intervention such as fish oil supplementation can generate savings for public expenditure. The use of supplements during pregnancy should therefore be encouraged, including through health promotion strategies. It should be noted that the DHA dosages considered in the analyses are those used in the study; further research should be conducted to determine what savings on costs may result from other supplementation dosages. Moreover, as the researchers themselves stated, it will be necessary to better define whether DHA-based supplements should be taken separately or together with others, such as folic acid supplements, for better efficacy both from the intervention’s effectiveness and cost-saving perspectives. 

Source: S. Ahmed, et al. “Analysis of hospital cost outcome of DHA-rich fish-oil supplementation in pregnancy: Evidence from a randomized controlled trial”. Volume 102-103, Pages 5-11, Prostaglandins, Leukotrienes and Essential Fatty Acids.