Supplements During Pregnancy: Too Many Women Are Not Getting DHA

A European-wide survey reveals that many women are unaware of the benefits of DHA during pregnancy and do not take fish oil supplements—its primary source. The issue also affects Italy, where only 60% of pregnant women are aware of its advantages for fetal health.

Despite the importance of Omega-3 DHA during pregnancy, too many women still fail to take supplements to meet their increased needs; unfortunately, many are not even aware of the potential benefits of consuming this valuable polyunsaturated fat during this particular life stage.

This is revealed by a study published in the European Journal of Nutrition by an international team of researchers, including four experts from the Crea Research Centre for Food and Nutrition (Council for Agricultural Research and Agricultural Economics Analysis): Romana Roccaldo, Laura Censi, Pasquale Buonocore, and Stefania Ruggeri.

Fortunately, the study also brings good news. In their conclusions, the authors emphasize that "women who use fish oil supplements"—a rich source of Omega-3—"receive the amount of DHA recommended by expert consensus."

DHA During Pregnancy

Consuming adequate amounts of DHA during pregnancy is important for both fetal health and the health of the expectant mother.

The fetus needs it for development; specifically, DHA is essential for proper brain and vision development. The European Food Safety Authority (EFSA) authorizes nutritional claims stating that this Omega-3, taken by the mother in appropriate doses, contributes to the normal formation of the fetus's eyes and brain.

This necessity stems from DHA's role as a structural component of nerve cells, where it makes up 10–15% of total fatty acids.

Additionally, numerous studies suggest Omega-3 benefits for a healthy pregnancy. Adequate intake has been linked to a lower risk of adverse events such as pre-eclampsia and preterm birth.

According to the Reference Intake Levels of Nutrients and Energy for the Italian Population (LARN) by the Italian Society of Human Nutrition (SINU), pregnant women must ensure an additional daily intake of 100–200 mg of DHA on top of the 250 mg of DHA + EPA (the other biologically active Omega-3) recommended for all adults.

DHA Supplements During Pregnancy: A Missed Opportunity?

Given this increased need, the amount of DHA a woman’s body can produce from its precursor (alpha-linolenic acid—ALA—obtainable from walnuts and flaxseeds) is far from sufficient. Therefore, it’s crucial for pregnant women to consume adequate amounts of preformed DHA.

Practically, this means eating plenty of fatty fish (such as tuna and salmon), the primary dietary source of biologically active Omega-3. Unfortunately, this is easier said than done.

As the study authors noted, "it has been proposed that during pregnancy, a daily intake of 200 mg of DHA is necessary, achievable through fish or fish oil supplements."

However, fish on our tables may be contaminated with substances particularly dangerous during pregnancy, such as methylmercury. This severely limits both the types of fatty fish safely included in a pregnant woman’s diet (leading to a preference for smaller species like anchovies, which accumulate less mercury) and the quantity (which should not exceed 150 g per week).

Moreover, cases where fish consumption during pregnancy falls short of healthy, balanced dietary recommendations are not uncommon, regardless of contamination concerns.

In this context, high-quality DHA supplements (free from potential fish contaminants) are a viable option to meet these needs. "These dietary supplements are commercially available," the researchers explain, "and there are no recommendations against their use during pregnancy." 

Despite this, only 49% of pregnant women in the study reported taking fish oil supplements. Furthermore, many women are unaware of its benefits for fetal development, and some associate it with side effects it does not actually have.

Fish Oil Supplement Use in Italy

The study included 1,780 pregnant women recruited via social media in four countries: Italy, Finland, Poland, and the UK. The average DHA intake was 220 mg per day, with significant variations between countries.

Polish women were the highest users of fish oil, followed by Italians. However, only slightly over 58% of Italian participants reported taking fish oil, with an average DHA intake of 200 mg per day, plus an average of 40 mg of EPA daily.

Data from Italy also revealed that only 60% of pregnant women are aware that fish oil supplements benefit fetal brain development, while 37% said they were unsure.

Even fewer Italian participants knew these supplements contribute to fetal vision development (only 36%, compared to 59% who were uncertain).

Unfortunately, many Italian participants were also confused about potential side effects of fish oil: 7% believed it increases the risk of bleeding during childbirth, 75% were unsure, and only 18% correctly recognized this warning as a myth. 

Expert Commentary

"In our study," the researchers noted, "Poland showed the highest DHA supplement intake and the highest percentage of participants using fish oil supplements among the included countries. This makes sense, as Poland is the only country with a recommendation for DHA supplementation during pregnancy (200 mg daily for all women and 1,000 mg daily for those at risk)."

"Awareness of prevailing recommendations varied across countries (...). Therefore, medical visits should include nutritional advice to ensure sufficient DHA intake, which is crucial for fetal development."

Nutritional counseling is also important to provide clear instructions on supplement use, preventing misuse (observed, the authors note, with other products like magnesium, folic acid, and iron supplements).

Additionally, experts highlighted that "studies, including a scientific opinion from EFSA, have shown that fish oil intake up to 2.7 grams daily during pregnancy is safe." 

These amounts are sufficient to meet the DHA needs of both mother and baby, especially when relying on highly concentrated and absorbable supplements like VitaDHA® Materna.

What If You Can’t Take Fish Oil?

For those who cannot take fish oil due to allergies or dietary choices (such as vegetarians and vegans), there is a fully plant-based alternative: DHA derived from microalgae.

Among microalgae-based products, some are certified for purity and vegan compatibility. Discover all the features and benefits of Omegor® Veg!

References:

European Commission. Food and Feed Information Portal Database. Last accessed: 19/05/25

Jaakkola K, Koivuniemi E, Hart K, Mazanowska N, Roccaldo R, Censi L, Egan B, Mattila L, Buonocore P, Löyttyniemi E, Raats M, Ruggeri S, Wielgos M, Laitinen K. Fish oil and probiotic food supplements: consumptions and attitudes of pregnant women in four European countries. Eur J Nutr. 2025 Apr 5;64(4):146. doi: 10.1007/s00394-025-03654-5

Saldeen P and Saldeen T. Women and omega-3 Fatty acids. Obstet Gynecol Surv. 2004 Oct;59(10):722-30; quiz 745-6. doi: 10.1097/01.ogx.0000140038.70473.96

Italian Society of Human Nutrition-SINU, 2014. LARN – Reference Intake Levels for the Italian Population: LIPIDS