Supplements in pregnancy: too many women do not take DHA

According to a Europe-wide survey, there are many women who are unaware of the benefits of DHA in pregnancy and do not take fish oil supplements-its main source. The problem also affects Italy, where only 60 percent of pregnant women are aware of their fetal health benefits.

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

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

Fortunately, some good news also emerges from the study. In fact, in their conclusions the authors point out that "women who use fish oil supplements," a source rich in Omega 3, "receive the amount of DHA recommended by the researchers' consensus."

DHA in pregnancy

Taking adequate amounts of DHA during pregnancy is important for both the health of the fetus and the pregnant woman.

In fact, the fetus needs it for its development; in particular, DHA is necessary for proper brain and vision development, so much so that the European Food Safety Authority (Efsa) authorizes the use of nutrition claims that this Omega 3, taken by the mother-to-be in appropriate doses, contributes to the normal formation of the fetus' eyes and brain.

Underlying this need is the importance of DHA as a structural component of nerve cells, in which it accounts for between 10 and 15 percent of total fatty acids.

In addition, numerous research studies suggest the benefits of Omega 3 for a healthy pregnancy. In particular, adequate intake has been associated with a lower risk of undesirable phenomena such as pre-eclampsia and preterm delivery.

According to the Reference Intake Levels of Nutrients and Energy for the Italian Population (Larn) from Sinu (the Italian Society of Human Nutrition), pregnant women should secure 100 to 200 mg more DHA each day in addition to the 250 mg of DHA + EPA (the other biologically active Omega 3) recommended for all adults.

DHA supplements in pregnancy: a missed opportunity?

Taking this increased requirement into consideration, the amount of DHA that the female body can produce from its precursor (alpha-linolenic acid-ALA-obtainable from walnuts and flaxseeds) is by no means sufficient. Therefore, it is important for pregnant women to take adequate doses of preformed DHA.

From a practical point of view, this means that during pregnancy one should eat good amounts of fatty fish (such as tuna and salmon), the main dietary source of biologically active Omega 3. Unfortunately, doing this is harder than saying it.

In fact, as noted by the study authors, "it has been proposed that 200 mg of DHA per day is needed during pregnancy, which can be achieved by consuming fish or fish oil supplements."

However, the fish that arrive on our tables are at risk of being contaminated with particularly dangerous substances during pregnancy, such as methylmercury. This severely limits both the type of fatty fish that can safely be included in a pregnant woman's diet (leading to a preference for smaller species that accumulate less mercury, such as anchovies) and its quantity (which should not exceed 150 g per week).

What's more, cases are not uncommon where, regardless of concerns about possible contaminants, fish consumption during pregnancy does not meet the recommendations for a healthy, balanced diet.

In this context, high-quality DHA supplements (thus free of possible fish contaminants) are a viable option for meeting requirements for this fat. "These dietary supplements are commercially available," the researchers explain, "and there are no recommendations against their use in pregnancy." 

Nevertheless, only 49% of pregnant women included in the study reported taking a fish oil supplement. What's more, many women are unaware of its benefits for fetal development and some associate it with side effects that, in fact, it does not have.

The use of fish oil supplements in Italy

The study included a total of 1780 pregnant women recruited through social media in four countries-Italy, Finland, Poland and the United Kingdom. The average intake of DHA was 220 mg per day, but with significant differences between countries.

The main users of fish oil were found to be Poles, followed by Italians. However, only slightly more than 58 percent of the women recruited in Italy reported taking fish oil, with an average intake of DHA of 200 mg per day, plus an average of 40 mg of EPA per day.

Data collected in Italy also showed that in our country only 60 percent of pregnant women are aware that the use of fish oil supplements is beneficial for the development of the baby's brain, while 37 percent said they were not sure.

Even fewer Italian participants said they knew that these supplements contribute to the development of her eyesight (only 36 percent, compared with 59 percent of women who said they were unsure).

Unfortunately, there was also much confusion among the Italian participants about possible side effects of fish oil: 7 percent said they believed it increased the risk of bleeding during childbirth and 75 percent said they were unsure, while only 18 percent correctly recognized the warning as a hoax. 

Expert commentary

"In our study," the research authors commented, "Poland [showed] the highest intake of DHA in supplement form and the highest percentage of participants using fish oil supplements among the included countries. This makes sense in light of the fact that Poland is the only country where there is a recommendation to the intake of DHA in supplement form during pregnancy (200 mg per day for all and 1000 mg per day for those at risk)."

"Knowledge of the prevailing recommendations was found to vary across countries (...). Thus, it is necessary for medical visits to include nutritional advice so that sufficient intake of DHA, which is important for fetal development, is achieved."

Nutritional counseling is also important to give women precise instructions on how to take them, to avoid misuse of dietary supplements (found, the authors point out, in the case of other products, such as those containing magnesium, folic acid and iron).

In addition, the experts pointed out that "studies, including a scientific opinion from Efsa, have shown that during pregnancy, fish oil intake of up to 2.7 grams per day is safe." 

These amounts are sufficient to ensure the necessary DHA intake to meet the needs of mother and baby, especially when relying on highly concentrated and assimilable supplements, such as VitaDHA® Materna.

What to do if you cannot take fish oil?

In case you cannot take fish oil because of an allergy or if, by choice, you do not include fish products in your diet (as is the case for some vegetarian women and those who adhere to a vegan lifestyle), it is good to know that there is a totally plant-based alternative: DHA obtained from microalgae.

Among microalgae products, there are also some that are certified both for purity and for their compatibility with the vegan choice. Discover all the features and benefits of Omegor® Veg!

Bibliographic references:

European Commission. Food and Feed Information Portal Database. Last viewed: 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