DHA in pregnancy: may reduce the risk of preterm births

Taking the right amounts of omega-3 fatty acids, particularly DHA, during pregnancy and breastfeeding can have protective effects on maternal and infant health. Yet another confirmation comes from a study conducted in Australia that showed, in a group of pregnant women, that supplementation with DHA was associated with a 15 percent reduction in cases of preterm pregnancies. A finding that, according to the researchers, also highlights the economic benefit of supplementation use in pregnancy: decreasing preterm births means reducing costs for the health care expenses needed to treat possible complications that the baby may manifest 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 is one that 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 thus represent a huge percentage of pediatric patients. The preterm infant, in addition to small size and low weight, is at greater risk than others of having developmental defects. The most common manifestations, both short-term and long-term, are mainly problems with the nervous system, vision and hearing, growth, behavior and school skills. In addition, the risk of crib death is more common in them. 

The severity of these disorders increases the shorter the pregnancy. The more premature the delivery, the less developed the baby's organs and the greater the risk of later complications. Premature births are usually distinguished into early, if they occur before 32 weeks of gestation, or late if they occur after this time. The causes of preterm birth are not known; however, there are several established risk factors, including twin pregnancy or two pregnancies too close in time, particular health conditions of the mother, and consumption of alcohol, drugs, and cigarettes. 

The nutritional status of the mother can also contribute to the phenomenon; conditions such as overweight, excessive thinness or malnutrition can promote premature birth. In this context, an important role of omega-3 fatty acids in the proper course of pregnancy has emerged in recent years. Indeed, numerous epidemiological studies have shown that in populations that consume a lot of fish containing high percentages of omega-3, there are longer gestations and higher neonatal weights.

DHA in pregnancy: fewer premature births and less expense for treatment

While most studies on the subject have looked at fish consumption during pregnancy in relation to premature births, the one conducted by Australian researchers, led by Professor Maria Makrides, examined the direct effects of omega-3s themselves, particularly DHA. The study, named DOMINO, involved 2,399 single-pregnant women at less than 20 weeks' gestation. Each was randomly assigned DHA-rich fish oil capsules (800 mg per capsule), or vegetable oil capsules as a placebo, to be taken daily until the birth of their children. The results of statistical analysis revealed that the number of cases of early preterm births was 15 percent lower for the group that had taken DHA, compared with the control group, and that supplementation provided a 50 percent chance of avoiding an additional preterm birth. Having obtained these results, the researchers carried out an econometric analysis, calculating for all preterm pregnancies avoided, the amount of money saved in one year; premature babies do in fact need specific care and treatment, which burdens families or the national health care system. In the case of Australia, a savings to public spending was calculated as high as 51,000,000 Australian dollars, about 34,000 euros per year. These figures, compared with the small cost of DHA supplements, and the simplicity of their use, underscore the importance of encouraging supplementation during pregnancy.

The numbers could be even larger

As the authors of the research themselves pointed out, the study only takes into account the reduction in early deliveries and the costs needed for babies immediately after birth, without taking into account the long-term complications they may face. In the latter case, of course, the savings on hospital care costs would be even greater; moreover, the data analyzed were collected from public hospitals, excluding private ones and thus a large number of pregnant women.

New public health studies and interventions in the future

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 supplementation with fish oil, can generate savings for public spending. The use of supplements in pregnancy should therefore also be encouraged with health promotion strategies. It should be noted that the dosages of DHA considered in the analyses are those used in this study; further research should be conducted to determine what cost savings may result from other supplementation dosages. In addition, as the researchers themselves stated, it should be better defined whether DHA supplements should be taken separately or together with others, such as folic acid supplements, for better action from both an intervention effectiveness and cost-saving perspective. 

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.