Omega-3 and DHA Supplementation in Pregnancy: A Systematic Review of Its Role in Preventing Preeclampsia and Gestational Diabetes
Keywords:
DHA supplementation, GDM, Omega-3, PreeclampsiaAbstract
Background: Omega-3 fatty acids, such as docosahexaenoic acid (DHA), plays a crucial role in fetal development and pregnancy maintenance, potentially reducing the risk of complications like gestational diabetes mellitus (GDM) and preeclampsia. Supplementation of these fatty acids may improve pregnancy outcomes by promoting fetal growth, prolonging gestational age, and positively influencing neonatal birth weight. However, the clinical evidence supporting the role of omega-3 supplementation in preventing preeclampsia and GDM remains inconclusive. Methods: A preliminary database search identified over 100 relevant studies. Following a rigorous three-stage screening process, eight studies meeting the predefined inclusion criteria were selected for in-depth analysis. Each underwent a comprehensive critical assessment to examine the impact of Omega-3 and DHA supplementation on preventing preeclampsia and gestational diabetes. This systematic approach ensured that the analysis was based on high-quality data, aligned with the study’s objectives, and provided meaningful insights. Result: The final selection comprised eight studies that met the inclusion criteria. A thorough evaluation of these studies allowed for an in-depth investigation of Omega-3 and DHA supplementation's role in preventing preeclampsia and gestational diabetes. This structured analysis reinforced the study’s reliability, ensuring that conclusions were drawn from robust and credible evidence. Conclusion: DHA supplementation plays a crucial role in pregnancy, supporting placental function and maternal metabolic health. However, its preventive role in preventing preeclampsia and GDM remains uncertain. Future research should explore potential benefits and evidence-based guidelines.
References
Colombo, J., Shaddy, D. J., Gustafson, K., Gajewski, B. J., Thodosoff, J. M., Kerling, E., & Carlson, S. E. (2019). The Kansas University DHA Outcomes Study (KUDOS) clinical trial: long-term behavioral follow-up of the effects of prenatal DHA supplementation. The American journal of clinical nutrition, 109(5), 1380–1392. https://doi.org/10.1093/ajcn/nqz018
Harris, M. A., Reece, M. S., McGregor, J. A., Wilson, J. W., Burke, S. M., Wheeler, M., Anderson, J. E., Auld, G. W., French, J. I., & Allen, K. G. (2015). The Effect of Omega-3 Docosahexaenoic Acid Supplementation on Gestational Length: Randomized Trial of Supplementation Compared to Nutrition Education for Increasing n-3 Intake from Foods. BioMed research international, 2015, 123078. https://doi.org/10.1155/2015/123078
Comitini, F., Peila, C., Fanos, V., & Coscia, A. (2020). The Docosahexanoic Acid: From the Maternal-Fetal Dyad to Early Life Toward Metabolomics. Frontiers in pediatrics, 8, 538. https://doi.org/10.3389/fped.2020.00538
Campoy, C., Escolano-Margarit, M. V., Anjos, T., Szajewska, H., & Uauy, R. (2012). Omega 3 fatty acids on child growth, visual acuity and neurodevelopment. The British journal of nutrition, 107 Suppl 2, S85–S106. https://doi.org/10.1017/S0007114512001493
Carlson, S. E., Colombo, J., Gajewski, B. J., Gustafson, K. M., Mundy, D., Yeast, J., Georgieff, M. K., Markley, L. A., Kerling, E. H., & Shaddy, D. J. (2013). DHA supplementation and pregnancy outcomes. The American journal of clinical nutrition, 97(4), 808–815. https://doi.org/10.3945/ajcn.112.050021
Fereidooni, B., & Jenabi, E. (2014). The use of omega 3 on pregnancy outcomes: a single-center study. JPMA. The Journal of the Pakistan Medical Association, 64(12), 1363–1365.
Chen, B., Ji, X., Zhang, L., Hou, Z., Li, C., & Tong, Y. (2015). Fish Oil Supplementation does not Reduce Risks of Gestational Diabetes Mellitus, Pregnancy-Induced Hypertension, or Pre-Eclampsia: A Meta-Analysis of Randomized Controlled Trials. Medical science monitor : international medical journal of experimental and clinical research, 21, 2322–2330. https://doi.org/10.12659/MSM.894033
Horvath, A., Koletzko, B., & Szajewska, H. (2007). Effect of supplementation of women in high-risk pregnancies with long-chain polyunsaturated fatty acids on pregnancy outcomes and growth measures at birth: a meta-analysis of randomized controlled trials. The British journal of nutrition, 98(2), 253–259. https://doi.org/10.1017/S0007114507709078
Krauss-Etschmann, S., Shadid, R., Campoy, C., Hoster, E., Demmelmair, H., Jiménez, M., Gil, A., Rivero, M., Veszprémi, B., Decsi, T., Koletzko, B. V., & Nutrition and Health Lifestyle (NUHEAL) Study Group (2007). Effects of fish-oil and folate supplementation of pregnant women on maternal and fetal plasma concentrations of docosahexaenoic acid and eicosapentaenoic acid: a European randomized multicenter trial. The American journal of clinical nutrition, 85(5), 1392–1400. https://doi.org/10.1093/ajcn/85.5.1392
Williams, M. A., Frederick, I. O., Qiu, C., Meryman, L. J., King, I. B., Walsh, S. W., & Sorensen, T. K. (2006). Maternal erythrocyte omega-3 and omega-6 fatty acids, and plasma lipid concentrations, are associated with habitual dietary fish consumption in early pregnancy. Clinical biochemistry, 39(11), 1063–1070. https://doi.org/10.1016/j.clinbiochem.2006.09.008
Burchakov, D. I., Kuznetsova, I. V., & Uspenskaya, Y. B. (2017). Omega-3 Long-Chain Polyunsaturated Fatty Acids and Preeclampsia: Trials Say "No," but Is It the Final Word?. Nutrients, 9(12), 1364. https://doi.org/10.3390/nu9121364
Hubinont, C., & Savoye, T. (2017). Maternal and fetal benefits of DHA supplementation during pregnancy. Journal of Pregnancy and Reproduction, 1(1). https://doi.org/10.15761/jpr.1000103
Devarshi, P. P., Grant, R. W., Ikonte, C. J., & Hazels Mitmesser, S. (2019). Maternal Omega-3 Nutrition, Placental Transfer and Fetal Brain Development in Gestational Diabetes and Preeclampsia. Nutrients, 11(5), 1107. https://doi.org/10.3390/nu11051107
Gholami, N., Abotorabi, S., Lalooha, F., & Oveisi, S. (2020). Effects of Fish Oil Supplementation on Pregnancy Outcomes in Pregnant Women Referred to Kosar Hospital. Iranian journal of pharmaceutical research : IJPR, 19(3), 241–247. https://doi.org/10.22037/ijpr.2019.13976.12041
Serra, R., Peñailillo, R., Monteiro, L. J., Monckeberg, M., Peña, M., Moyano, L., Brunner, C., Vega, G., Choolani, M., & Illanes, S. E. (2021). Supplementation of Omega 3 during Pregnancy and the Risk of Preterm Birth: A Systematic Review and Meta-Analysis. Nutrients, 13(5), 1704. https://doi.org/10.3390/nu13051704
Jiang, Y., Chen, Y., Wei, L., Zhang, H., Zhang, J., Zhou, X., Zhu, S., Du, Y., Su, R., Fang, C., Ding, W., & Feng, L. (2023). DHA supplementation and pregnancy complications. Journal of translational medicine, 21(1), 394. https://doi.org/10.1186/s12967-023-04239-8
Amza, M., Haj Hamoud, B., Sima, R. M., Dinu, M. D., Gorecki, G. P., Popescu, M., Gică, N., Poenaru, M. O., & Pleș, L. (2024). Docosahexaenoic Acid (DHA) and Eicosapentaenoic Acid (EPA)-Should They Be Mandatory Supplements in Pregnancy?. Biomedicines, 12(7), 1471. https://doi.org/10.3390/biomedicines12071471
Cetin, I., Carlson, S. E., Burden, C., da Fonseca, E. B., di Renzo, G. C., Hadjipanayis, A., Harris, W. S., Kumar, K. R., Olsen, S. F., Mader, S., McAuliffe, F. M., Muhlhausler, B., Oken, E., Poon, L. C., Poston, L., Ramakrishnan, U., Roehr, C. C., Savona-Ventura, C., Smuts, C. M., Sotiriadis, A., … Clinical Practice Guideline on behalf of Asia Pacific Health Association (Pediatric-Neonatology Branch), Child Health Foundation (Stiftung Kindergesundheit), European Academy of Paediatrics, European Board & College of Obstetrics and Gynaecology, European Foundation for the Care of Newborn Infants, European Society for Paediatric Research, and International Society for Developmental Origins of Health and Disease (2024). Omega-3 fatty acid supply in pregnancy for risk reduction of preterm and early preterm birth. American journal of obstetrics & gynecology MFM, 6(2), 101251. https://doi.org/10.1016/j.ajogmf.2023.101251
Hypertension in pregnancy. Report of the American College of Obstetricians and Gynecologists’ Task Force on Hypertension in Pregnancy. (2013). Obstetrics and gynecology, 122(5), 1122–1131. https://doi.org/10.1097/01.AOG.0000437382.03963.88
Zhou, S. J., Yelland, L., McPhee, A. J., Quinlivan, J., Gibson, R. A., & Makrides, M. (2012). Fish-oil supplementation in pregnancy does not reduce the risk of gestational diabetes or preeclampsia. The American journal of clinical nutrition, 95(6), 1378–1384. https://doi.org/10.3945/ajcn.111.033217
Johnsen, G. M., Basak, S., Weedon-Fekjær, M. S., Staff, A. C., & Duttaroy, A. K. (2011). Docosahexaenoic acid stimulates tube formation in first trimester trophoblast cells, HTR8/SVneo. Placenta, 32(9), 626–632. https://doi.org/10.1016/j.placenta.2011.06.009
Rani, A., Wadhwani, N., Chavan-Gautam, P., & Joshi, S. (2016). Altered development and function of the placental regions in preeclampsia and its association with long-chain polyunsaturated fatty acids. Wiley interdisciplinary reviews. Developmental biology, 5(5), 582–597. https://doi.org/10.1002/wdev.238
Bakouei, F., Delavar, M. A., Mashayekh-Amiri, S., Esmailzadeh, S., & Taheri, Z. (2020). Efficacy of n-3 fatty acids supplementation on the prevention of pregnancy induced-hypertension or preeclampsia: A systematic review and meta-analysis. Taiwanese journal of obstetrics & gynecology, 59(1), 8–15. https://doi.org/10.1016/j.tjog.2019.11.002
Zornoza-Moreno, M., Fuentes-Hernández, S., Carrión, V., Alcántara-López, M. V., Madrid, J. A., López-Soler, C., Sánchez-Solís, M., & Larqué, E. (2014). Is low docosahexaenoic acid associated with disturbed rhythms and neurodevelopment in offsprings of diabetic mothers?. European journal of clinical nutrition, 68(8), 931–937. https://doi.org/10.1038/ejcn.2014.104
Min, Y., Djahanbakhch, O., Hutchinson, J., Eram, S., Bhullar, A. S., Namugere, I., & Ghebremeskel, K. (2016). Efficacy of docosahexaenoic acid-enriched formula to enhance maternal and fetal blood docosahexaenoic acid levels: Randomized double-blinded placebo-controlled trial of pregnant women with gestational diabetes mellitus. Clinical nutrition (Edinburgh, Scotland), 35(3), 608–614. https://doi.org/10.1016/j.clnu.2015.05.020
Gázquez, A., Giménez-Bañón, M. J., Prieto-Sánchez, M. T., Martínez-Graciá, C., Suárez, C., Santaella-Pascual, M., Galdo-Castiñeira, L., Ballesteros-Meseguer, C., Vioque, J., Martínez-Villanueva, M., Avilés-Plaza, F., Noguera-Velasco, J. A., Morales, E., García-Marcos, L., Larqué, E., & On Behalf Of The Nela Study Group (2021). Self-Reported DHA Supplementation during Pregnancy and Its Association with Obesity or Gestational Diabetes in Relation to DHA Concentration in Cord and Maternal Plasma: Results from NELA, a Prospective Mother-Offspring Cohort. Nutrients, 13(3), 843. https://doi.org/10.3390/nu13030843
García-López, S., Villanueva Arriaga, R. E., Nájera Medina, O., Rodríguez López, C. P., Figueroa-Valverde, L., Cervera, E. G., Muñozcano Skidmore, O., & Rosas-Nexticapa, M. (2016). One month of omega-3 fatty acid supplementation improves lipid profiles, glucose levels and blood pressure in overweight schoolchildren with metabolic syndrome. Journal of pediatric endocrinology & metabolism : JPEM, 29(10), 1143–1150. https://doi.org/10.1515/jpem-2015-0324
Pellonperä, O., Vahlberg, T., Mokkala, K., Houttu, N., Koivuniemi, E., Tertti, K., Rönnemaa, T., & Laitinen, K. (2021). Weight gain and body composition during pregnancy: a randomised pilot trial with probiotics and/or fish oil. The British journal of nutrition, 126(4), 541–551. https://doi.org/10.1017/S0007114520004407
Yang, S., Lin, R., Si, L., Li, Z., Jian, W., Yu, Q., & Jia, Y. (2019). Cod-Liver Oil Improves Metabolic Indices and hs-CRP Levels in Gestational Diabetes Mellitus Patients: A Double-Blind Randomized Controlled Trial. Journal of diabetes research, 2019, 7074042. https://doi.org/10.1155/2019/7074042
Jamilian, M., Samimi, M., Ebrahimi, F. A., Hashemi, T., Taghizadeh, M., Razavi, M., Sanami, M., & Asemi, Z. (2017). The effects of vitamin D and omega-3 fatty acid co-supplementation on glycemic control and lipid concentrations in patients with gestational diabetes. Journal of clinical lipidology, 11(2), 459–468. https://doi.org/10.1016/j.jacl.2017.01.011
Downloads
Published
Issue
Section
License
Copyright (c) 2025 Deni Wirhana, Bayu Setyo Nugroho, Tuswandi Ahmad Waly (Author)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Authors publishing here keep copyright but grant the journal first publication rights, under a Creative Commons Attribution-NonCommercial 4.0 License. They can distribute their work non-exclusively elsewhere with an acknowledgment of its first publication in this journal. Posting the work online before and during submission for earlier and greater citation is encouraged, reflecting Open Access benefits.
