Every year, approximately 15 million babies are born preterm, before 37 weeks of gestation, the World Health Organization (WHO) reports. Preterm complications are the leading cause of death among children under five years old and are responsible for about 1 million deaths in 2015.
Researchers have been working to find ways to prevent preterm births and reduce the likelihood of infants dying at a young age. Scientists now suggest that supplementing with more docosahexaenoic acid (DHA) may lead to a reduction in the risk of preterm birth.
In the study published in the journal EClinical Medicine, a dose of 1000 mg of DHA may reduce early preterm births significantly compared to 200 mg as found in some prenatal supplements.
What is Docosahexaenoic acid (DHA)?
Docosahexaenoic acid (DHA) is a type of omega-3 fat, similar to the eicosapentaenoic acid (EPA). DHA is mainly found in oily fish, such as anchovies and salmon. The body can only produce a small amount of DHA from other fatty acids. Hence, supplementation is essential to maintain enough DHA levels.
DHA is essential for brain development during pregnancy and early childhood. It has also been linked to improved heart health, better vision, and reduced inflammatory response.
During pregnancy, women are advised to take prenatal supplements containing 200 mg to 300 mg of DHA. Past studies have found that DHA supplementation during pregnancy may promote neurological development in infants. It can also reduce the risk of neurological conditions such as autism and attention deficit hyperactivity disorder (ADHD).
Further, DHA supplementation in the last trimester of pregnancy may reduce the risk of preterm labor.
Increased DHA supplementation
To arrive at the study findings, the researchers conducted a trial of women recruited at one of three large academic medical centers in the United States. Pregnant women who are between 12 to 20 weeks gestation were eligible to participate.
The team enrolled about 1,100 participants between June 8, 2016, and March 13, 2020, with the last birth on September 5, 2020.
The participants were divided into two, 576 women who received the higher dose of 1,000 mg and 524 women who received the 200 mg DHA supplement at enrollment. They found that the higher-dose group had fewer preterm births, with 2 percent compared to 4.1 percent from the latter group.
For the women who started the study with high DHA levels, many of whom were already on DHA supplements, the rate of early preterm birth was 1.3 percent, and there was no benefit of the higher 1,000 mg dose.
Also, the higher dose resulted in fewer maternal and neonatal adverse severe effects.
"Clinicians could consider prescribing 1000 mg DHA daily during pregnancy to reduce EPB in women with low DHA status if they are able to screen for DHA," the researchers noted in the study.
The team also said that this is the first study to compare the 1,000 mg DHA to the 200 mg DHA.
"This study is a potential game-changer for obstetricians and their patients," Dr. Carl P. Weiner, professor of obstetrics and gynecology and professor of integrative and molecular physiology at the University of Kansas School of Medicine, explained.
"The dramatic decrease in early preterm birth with DHA supplementation will improve short- and long-term outcomes for children, families, and society in a cost-effective fashion," he added.
The study results add to the evidence from the 2018 Cochrane Review and secondary outcomes from the ORIP trial in 2020, leading to a review of the current dietary standards for pregnant women.
To explain DHA and preterm birth, biomarkers assessed before 20 weeks gestation suggest spontaneous preterm labor with stressors associated with inflammation. DHA can help resolve inflammation.
Preventing preterm labor is crucial, particularly in North America and Africa. However, the burden of preterm birth in numbers disproportionately occurs in Asia and Africa, where many countries have low DHA intake and status.