Omega-3s: The Key to Reducing the Risk of Preterm Birth?

NEW SCIENCE 11/19/2018

2min read

Talking Nutrition Editors

The impact of prematurity

  • Premature birth is a widespread issue and can have a significant emotional and economic impact on the families of preterm babies.
  • Evidence suggests there is a link between babies who are born before 37 weeks and poor health outcomes later in life.
  • A newly published Cochrane review indicates that long chain omega-3 supplementation during pregnancy could lower the risk of having a preterm or low birth weight baby. Authors of the publication recommend a daily dose of 500 – 1,000 mg of EPA and DHA, with at least 500 mg as DHA, which is associated with these benefits.

A bank of new, promising scientific evidence

Preterm birth occurs when babies are born before 37 weeks gestation. It is a global issue – with15 million babies born prematurely every year. In 2016, preterm birth affected about one in six infants born in the United States.A recent Cochrane systematic review highlights the positive effect of the long-chain omega-3 fatty acids, docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA), when supplemented during pregnancy.2 This publication is timely, with World Prematurity Day being celebrated on 17 November. Cochrane Reviews are internationally recognized as the ‘gold standard’ for the analysis of scientific evidence. 
The potential health problems associated with premature birth have been widely documented in scientific studies over the years. According to this research, prematurity is directly responsible for more than 85% of all complications in early life, as well as being the leading cause of death in children under five years of age.3,4  
Growing scientific evidence suggests that babies born before 34 weeks’ gestation – defined as early preterm delivery – often require extended periods in hospital intensive care, potentially developing problems with respiratory, digestive and immune system function. These health issues can continue to impact premature infants throughout life, affecting behavior and communication.  

Early omega-3 supplementation is key

The Cochrane review, published in the Cochrane Database of Systematic Reviews, examines the effect of nutritional interventions – specifically long chain omega-3 supplementation – during pregnancy on both maternal and infant health outcomes , including  reduced  risk of premature birth.5 The systematic review looked at 70 randomized controlled trials (RCTs), including a total of 19,927 women and was primarily conducted in high-income countries such as the US, the UK, the Netherlands, Australia and Denmark.  Based on the findings of the Cochrane review, the authors recommend that supplementationwith long chain omega-3 fatty acids DHA and EPA during pregnancy reduces the risk of having a premature or small baby (<37 weeks by 11% and <34 weeks by 42%), especially among women expecting a single baby. The data suggests that the most effective dose is between 500 and 1,000 mg of DHA and EPA per day, where at least 500 mg is from DHA. For optimum benefit, the study recommends that supplementation should begin at the start of the second trimester, which is earlier than previous studies have indicated.

Spreading the word

A detailed cost benefit analysis was conducted in the USA and published prior to the Cochrane Review. In the USA, estimated savings of up to US$6 billion in healthcare costs could be achieved if women were supplemented with 600 mg algal DHA per day during the last two trimesters of pregnancy.7 Despite the weight of scientific evidence, awareness of the importance of long chain omega-3s during pregnancy and their ability to reduce the risk of preterm birth is low.  Until this publication, there have been no official recommendations related to supplement use as part of healthcare strategies to prevent prematurity. Currently, available prenatal vitamin and mineral supplements contain approximately 200-300 mg of DHA; a dose which is considerably lower than that recommended in the most recent Cochrane Review. 

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References
  1. World Health Organization (WHO), ‘Preterm birth’, 2018, http://www.who.int/news-room/fact-sheets/detail/preterm-birth, (accessed 11 October 2018). 

  2. Middleton P. et al., ‘Omega-3 fatty acid addition during pregnancy’, Cochrane Database of Systematic Reviews, 2018. 

  3. Thornton S. et al., ‘Preterm birth: causes, consequences and prevention’, The Obstetrician and Gynecologist, vol. 10, no.4, pg. 280, 2008.   

  4. L. Liu et al., ‘Global, regional and national causes of under-5 mortality in 2000-15: an updated systematic analysis with implications for the Sustainable Development Goals’, The Lancet, vol. 388, no. 10063, 2016, p.3027-3035. 

  5. Middleton P. et al., ‘Omega-3 fatty acid addition during pregnancy’, Cochrane Database of Systematic Reviews, 2018. 

  6. SAHMRI Research - Information for HealthCare Professionals

  7. Shireman et al., ‘Docosahexaenoic acid supplementation (DHA) and the return on investment for pregnancy outcomes.’, PubMed, Prostaglandins Leukot Essent Fatty Acids, 2016 Aug;111:8-10. doi: 10.1016/j.plefa.2016.05.008. Epub 2016 May 13.

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