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Omega-3 fatty acid supply in pregnancy for risk reduction of preterm and early preterm birth.

  • Cetin, Irene1
  • Carlson, Susan E2
  • Burden, Christy3
  • da Fonseca, Eduardo B4
  • di Renzo, Gian Carlo5
  • Hadjipanayis, Adamos6
  • Harris, William S7
  • Kumar, Kishore R8
  • Olsen, Sjurdur Frodi9
  • Mader, Silke10
  • McAuliffe, Fionnuala M11
  • Muhlhausler, Beverly12
  • Oken, Emily13
  • Poon, Liona C14
  • Poston, Lucilla15
  • Ramakrishnan, Usha16
  • Roehr, Charles C17
  • Savona-Ventura, Charles18
  • Smuts, Cornelius M19
  • Sotiriadis, Alexandros20
  • And 4 more
  • 1 Fondazione IRCCS, Ospedale Maggiore Policlinico, University of Milan, Milan, Italy (Dr Cetin). , (Italy)
  • 2 Department of Dietetics and Nutrition, University of Kansas Medical Center, Kansas City, KS (Dr Carlson).
  • 3 Academic Women's Health Unit, Bristol Medical School: Translational Health Sciences, University of Bristol, Bristol, United Kingdom (Dr Burden). , (United Kingdom)
  • 4 Department of Obstetrics and Gynaecology, Federal University of Paraíba, João Pessoa, Brazil (Dr da Fonseca). , (Brazil)
  • 5 Centre of Perinatal and Reproductive Medicine, University of Perugia, Perugia, Italy (Dr di Renzo); PREIS School, Florence, Italy (Dr di Renzo). , (Italy)
  • 6 School of Medicine, European University Cyprus, Nicosia, Cyprus (Dr Hadjipanayis); European Academy of Paediatrics, Brussels, Belgium (Dr Hadjipanayis). , (Belgium)
  • 7 Fatty Acid Research Institute, Sioux Falls, SD (Dr Harris); Department of Internal Medicine, Sanford School of Medicine, University of South Dakota, Sioux Falls, SD (Dr Harris).
  • 8 Cloudnine Hospitals, Bangalore, India (Dr Kumar); University of Notre Dame Australia, Perth, Australia (Dr Kumar). , (Australia)
  • 9 Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark (Dr Olsen); Department of Public Health, University of Copenhagen, Copenhagen, Denmark (Dr Olsen); Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA (Dr Olsen). , (Denmark)
  • 10 European Foundation for the Care of Newborn Infants, Munich, Germany (Ms Mader). , (Germany)
  • 11 UCD Perinatal Research Centre, National Maternity Hospital, University College Dublin, Dublin, Ireland (Dr McAuliffe). , (Ireland)
  • 12 Health and Biosecurity, Commonwealth Scientific and Industrial Research Organisation, Canberra, Australia (Dr Muhlhausler); School of Agriculture, Food and Wine, University of Adelaide, Adelaide, Australia (Dr Muhlhausler); South Australian Health and Medical Research Institute, Adelaide, Australia (Dr Muhlhausler). , (Australia)
  • 13 Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA (Dr Oken).
  • 14 Maternal Medicine, Department of Obstetrics and Gynaecology, The Chinese University of Hong Kong, Hong Kong, China (Dr Poon); Department of Women and Children's Health, King's College London, London, United Kingdom (Dr Poon). , (China)
  • 15 School of Life Course and Population Sciences, King's College London, London, United Kingdom (Dr Poston); International Society for Developmental Origins of Health and Disease (Dr Poston). , (United Kingdom)
  • 16 Hubert Department of Global Health, Emory University, Atlanta, GA (Dr Ramakrishnan); Doctoral Program in Nutrition and Health Sciences, Laney Graduate School, Emory University, Atlanta, GA (Dr Ramakrishnan).
  • 17 National Perinatal Epidemiology Unit, Clinical Trials Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom (Dr Roehr); Faculty of Health Sciences, University of Bristol, Bristol, United Kingdom (Dr Roehr); Newborn Care, Women and Children's Division, Southmead Hospital, Bristol, United Kingdom (Dr Roehr); European Society for Paediatric Research, Satigny, Switzerland (Dr Roehr). , (Switzerland)
  • 18 Department of Obstetrics & Gynaecology, Mater Dei Hospital, University of Malta Medical School, Msida, Malta (Dr Savona-Ventura); Centre for Traditional Chinese Medicine & Culture, University of Malta, Msida, Malta (Dr Savona-Ventura). , (Malta)
  • 19 Centre of Excellence for Nutrition, North-West University, Potchefstroom, South Africa (Dr Smuts). , (South Africa)
  • 20 Second Department of Obstetrics and Gynecology, Faculty of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece (Dr Sotiriadis). , (Greece)
  • 21 Mind-Body Interface Research Center (MBI-Lab), China Medical University Hospital, Taichung, Taiwan (Dr Su); An-Nan Hospital, China Medical University, Tainan, Taiwan (Dr Su); College of Medicine, China Medical University, Taichung, Taiwan (Dr Su). , (China)
  • 22 Department of Women and Children's Health, School of Life Course and Population Sciences, King's College London, St Thomas' Hospital, London, United Kingdom (Dr Tribe). , (United Kingdom)
  • 23 Applied Nutrition Consulting, Santa Cruz, CA (Ms Vannice).
  • 24 Dr. von Hauner Children's Hospital, Ludwig Maximilian University of Munich Hospital, Munich, Germany (Dr Koletzko); Child Health Foundation (Stiftung Kindergesundheit), Munich, Germany (Dr Koletzko); European Academy of Paediatrics, Brussels, Belgium (Dr Koletzko). Electronic address: [email protected]. , (Belgium)
Published Article
American journal of obstetrics & gynecology MFM
Publication Date
Feb 01, 2024
DOI: 10.1016/j.ajogmf.2023.101251
PMID: 38070679


This clinical practice guideline on the supply of the omega-3 docosahexaenoic acid and eicosapentaenoic acid in pregnant women for risk reduction of preterm birth and early preterm birth was developed with support from several medical-scientific organizations, and is based on a review of the available strong evidence from randomized clinical trials and a formal consensus process. We concluded the following. Women of childbearing age should obtain a supply of at least 250 mg/d of docosahexaenoic+eicosapentaenoic acid from diet or supplements, and in pregnancy an additional intake of ≥100 to 200 mg/d of docosahexaenoic acid. Pregnant women with a low docosahexaenoic acid intake and/or low docosahexaenoic acid blood levels have an increased risk of preterm birth and early preterm birth. Thus, they should receive a supply of approximately 600 to 1000 mg/d of docosahexaenoic+eicosapentaenoic acid, or docosahexaenoic acid alone, given that this dosage showed significant reduction of preterm birth and early preterm birth in randomized controlled trials. This additional supply should preferably begin in the second trimester of pregnancy (not later than approximately 20 weeks' gestation) and continue until approximately 37 weeks' gestation or until childbirth if before 37 weeks' gestation. Identification of women with inadequate omega-3 supply is achievable by a set of standardized questions on intake. Docosahexaenoic acid measurement from blood is another option to identify women with low status, but further standardization of laboratory methods and appropriate cutoff values is needed. Information on how to achieve an appropriate intake of docosahexaenoic acid or docosahexaenoic+eicosapentaenoic acid for women of childbearing age and pregnant women should be provided to women and their partners. Copyright © 2023. Published by Elsevier Inc.

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