Despite strong recommendations in favor of consuming omega-3 fatty acids to support pregnancy outcomes and offspring health, one in four women either rarely or never eat fish during pregnancy, and even fewer women take omega-3 supplements, according to a new study by a team at the Harvard Pilgrim Health Care Institute.
 
The findings, published in Public Health Nutrition, come ahead of plans by both the World Health Organization and U.S. National Academies to issue reports on the risks and benefits of fish consumption in pregnancy later this year.
 
“Omega-3 fatty acids are essential nutrients for supporting positive health outcomes. Getting enough of these nutrients during pregnancy is vital for preventing preterm birth and promoting optimal child health and neurodevelopment,” said the study’s lead author Emily Oken, MD, MPH, Harvard Medical School professor and chair of the Department of Population Medicine at the Harvard Pilgrim Health Care Institute.
 
The study team assessed fish consumption in 10,800 pregnant women, and supplement intake information from 12,646 pregnant women from cohorts across the U.S. that participated in the Environmental Influences on Child Health Outcomes (ECHO) program.
 
Prior research on demographic characteristics associated with fish and supplement intake during pregnancy has been limited, involving relatively small groups of participants and older data that might not be representative of today’s population.
 
Nearly 25% of participants reported not eating fish or eating it less than once per month, and only 16% of the cohort took supplements. Supplement use was less common among those who consumed less fish, putting that group at an even higher risk for insufficient omega-3 fatty acid intake.
 
Older participants with higher incomes and education were more likely to consume more fish and take more supplements. Fish consumption was higher in those with racial/ethnic identities other than non-Hispanic White, and in those who used tobacco or other nicotine products. The highest likelihood of supplement intake was among those who were older, had a higher education and income, and were non-Hispanic White or Asian. Supplement use was less common among those at higher risk for adverse pregnancy outcomes as a function of using tobacco or nicotine products, or having a higher BMI.
 
“Current evidence shows that the benefits of maternal consumption of low-mercury fish, or in its place, omega-3 supplements, outweigh any potential  risks,” said Oken. “Our study provides updated information to inform much needed public health advice and resources to support clinical conversations to encourage consumption of low-mercury fish during pregnancy and intake of omega-3 supplements among those who do not consume fish.”