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July 13, 2023

Prepping for pregnancy: reducing the risk of premature birth with DHA

Premature birth is a significant problem affecting over 15 million babies each year, leading to serious complications such as long-term negative neurodevelopmental effects

Pregnancy Preconception New Science

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  • Premature birth is a significant problem affecting over 15 million babies each year, leading to serious complications such as long-term negative neurodevelopmental effects. It is also the biggest cause of infant mortality worldwide.
  • Today, maternal health experts are increasingly emphasizing the importance of diet and nutrition – from preconception to birth and beyond – on the health of mothers and babies
  • dsm-firmenich’s new whitepaper explores the important role that omega-3 docosahexaenoic acid (DHA) – an essential fatty acid – plays in in the motherhood journey to help reduce the risk of negative birth outcomes. Read on for the latest insights.

Globally, premature birth is the leading cause of death among children.1 Any birth before 37 weeks is considered preterm, but the earlier the gestational age the greater the risk of morbidity and mortality.2,3 Even in premature babies who survive, there can be significant risk of illness or long-term negative neurodevelopmental sequela.4

Premature births remain a problem in the developed world, however, they are especially burdensome in low- and middle-income countries.1,2 According to data from across 184 countries, rates of premature birth range from 4% in Belarus to 18% in Malawi, with a worldwide average of 11%.1,2,5 With more than 15 million premature births occurring each year and approximately one million children dying due to the complications associated with this, several efforts are underway to curb rates.1,2,5,6,7 dsm-firmenich’s latest whitepaper demonstrates the importance of nutrition in preparing women for a healthy conception and pregnancy. Read on to discover one way in which we can support women and reduce the risk of preterm birth with the omega-3 docosahexaenoic acid (DHA).

DHA: Setting the stage for a healthy, full-term birth

Many observational studies have shown a positive association between fish intake and gestational length which has been attributed to the omega-3 fatty acid DHA. Spontaneous preterm birth is hypothesized to be linked to inflammation and DHA is known for its anti-inflammatory properties. However, it is estimated that 96% of the population does not have adequate dietary DHA intake.8 This is especially concerning for women of childbearing age because those who become pregnant with poor DHA status have a higher risk of preterm birth.9,10 As such, women of childbearing age, especially those who are trying to conceive, should consider supplementing with DHA at the recommended intake levels of 250-600 mg/day.

The proof is in the science

The benefits of DHA supplementation have been demonstrated in a recent Cochrane systematic review and meta-analysis.11 The evaluation included data from across 26 randomized controlled trials and more than 10,000 women. It determined that omega-3 supplementation during pregnancy reduced the risk of preterm birth (<37 weeks) and early preterm birth (<34 weeks) compared to placebo. The findings were largely powered by trials using doses of >500 mg and studies utilizing DHA only or DHA predominant oil blends were most effective for lowering the risk of preterm birth. Based on these conclusions, pregnant women should consider supplementing with 450-600 mg of DHA daily to reduce their risk for premature birth.

More recent clinical trials have shown that the risk reduction is even more substantial in pregnant women with low DHA intake and/or status compared to women with adequate DHA intake.12,13,14 Consequently, pregnant women with low DHA intake or status should consider supplementing with even higher doses of DHA (1000 mg) – which has been shown to be superior to lower doses for reducing the risk of preterm birth in this population.

The benefits of DHA don’t stop at the early stages of pregnancy though. During the last trimester of pregnancy, the placenta transfers DHA to the fetus – highlighting the nutrient’s critical importance in fetal development.15 Research suggests that DHA is critical for optimal brain and nervous system development in the unborn child.16

To support a healthy pregnancy and infant outcomes, women should first ensure their DHA intake is sufficient prior to conceiving. Following that, it’s important for women to maintain DHA intake (or supplementation if needed) throughout their pregnancy. DHA is usually sourced from fish. But to suit the different lifestyles of today’s mothers-to-be and support environmental sustainability, there are now high-quality, algal-sourced DHA products available on the market that cater to vegetarian or vegan preferences. 

Learn more

Read our new whitepaper to explore the latest science and solutions designed to meet varying nutritional needs throughout the motherhood journey.

References

  1.  Walani. Global burden of preterm birth. International Journal of Obstetrics and Gynecology, vol. 150, no. 1, 31-33, 2020.
  2. Shapiro-Mendoza & Lackritz. Epidemiology of late and modern preterm birth. Semin Fetal Neonatal Med., vol. 17, no. 3, 120-125, 2012.
  3. Saigal & Doyle. An overview of mortality and sequelae of preterm birth from infancy to adulthood. Lancet, vol. 371, no. 9608, 261-269, 2008.
  4. Mendoza et al. CDC grand rounds: public health strategies to prevent preterm birth. MMWR Morb Mortal Wkly Rep., vol. 65, no. 32, 826-830, 2016.
  5. WHO 2012. 
  6. United Nations 2019.
  7. Blencowe et al. National, regional, and worldwide estimates of preterm birth rates in the year 2010 with time trends since 1990 for selected countries: a systematic analysis and implications. Lancet, vol. 379, no. 9832, 2162-2172, 2012.
  8. Colombo et al., Projected declines in global DHA availability for human consumption as a result of global warming. Ambio. 49: 865–880, 2020.
  9. Carlson et al, Higher dose docosahexaenoic acid supplementation during pregnancy and early preterm birth: A randomised, double-blind, adaptive-design superiority trial. EClinicalMedicine. 2021 May 17;36:100905.
  10.  Simmonds et al, Omega-3 fatty acid supplementation in pregnancy-baseline omega-3 status and early preterm birth: exploratory analysis of a randomised controlled trial. BJOG. 2020 Jul;127(8):975-981.  
  11. Middleton et al. Omega-3 fatty acid addition during pregnancy. Cochrane Database of Systematic Reviews, 2018.
  12. Olsen et al. Examining the Effect of Fish Oil Supplementation in Chinese Pregnant Women on Gestation Duration and Risk of Preterm Delivery, The Journal of nutrition, vol. 149, no. 11, pp. 1942–1951, 2019.
  13. Carlson et al. Higher dose docosahexaenoic acid supplementation during pregnancy and early preterm birth: A randomised, double-blind, adaptive-design superiority trial, EClinicalMedicine, vol. 36, no. 100905, 2021.
  14. Simmonds et al. Omega-3 fatty acid supplementation in pregnancy-baseline omega-3 status and early preterm birth: exploratory analysis of a randomised controlled trial, BJOG : an international journal of obstetrics and gynaecology, vol. 127, no. 8, pp. 975–981, 2020.
  15. [Chen et al. Association between serum vitamin D level during pregnancy and recurrent spontaneous abortion: A systematic review and meta-analysis, Am J Reprod Immunol., vol. 88, no. 3, e13582, 2022.
  16. Zeisel. The fetal origins of memory: the role of dietary choline in optimal brain development, J Pediatr., vol. 149, no. 5 Suppl, S131-136, 2006.
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