Ground-breaking South Australian research into fish oil diet supplements for pregnant women has resulted in new Australian Pregnancy Care Guidelines (APCG) and may help to halt rising rates of premature births around the world.
The project, led by SAHMRI Deputy Director and Women and Kids Theme Leader Professor Maria Makrides, conducted a research review of almost 20,000 single baby pregnancies and found that taking omega-3 supplements reduced the overall risk of a preterm birth by 11 per cent.
It also found the supplements reduced the risk of a baby arriving before 34 weeks of pregnancy by 42 per cent.
As part of Health Translation SA’s First 1000 Days flagship program, the project team combined the evidence of the research review with the results from their clinical trial of 5000 pregnant women – the largest omega-3 supplementation study ever undertaken – to inform transformative clinical care guidelines and practices.
“Our review of the literature and clinical trials led to the APCG adding a new recommendation advising pregnant women who are low in omega-3 to take 800mg of docosahexaenoic acid (DHA) and 100mg of eicosapentaenoic acid (EPA) supplements to reduce their risk of prematurity,” said Professor Makrides.
“The results suggested that if we globally test for, and address, omega-3 levels in pregnant women we can potentially prevent many premature births and improve the lives of many children and families.”
Every year more than 15 million babies worldwide are born too early – and despite the efforts of researchers and clinicians all over the world, the number is rising.
Professor Makrides says the impacts of premature birth can be devastating.
“The resulting medical complications are the leading cause of death and disability in children under five years of age, and the emotional, social and economic costs on families and healthcare systems can be overwhelming.”
A key challenge for clinicians is identifying women with low levels of omega-3.
Omega-3 levels can only be reliably determined by a blood test, so the project worked with SA Pathology and is evaluating a trial period of embedding omega-3 screening into its existing South Australian Maternal Serum Antenatal Screening program.
Commercialisation negotiations with pathology laboratories in Australia and internationally may see South Australia providing the analytical expertise for rapid testing of omega-3 fatty acids globally.
Professor Makrides says wide consultation is important to ensure successful translation of the omega-3 research into clinical practice.
“While the work in South Australia is off to a good start, every Australian state has different pathology and antenatal care programs so there is more to be done to ensure sustainability in the processes and practices and work towards scalability nationally,” she said.
“In SA we consulted extensively with health policy decision makers, health service providers, a range of clinicians including obstetricians, GPs and neonatologists, and most importantly with consumers – the women whose future babies this important program will protect.”
As well as providing valuable input on the content, format and design of the informational materials, deep engagement with clinicians and consumers has identified important issues about attitudes to diets and sustainability that are critical to the success of the omega-3 screening program.
“Vegan and vegetarian women are over-represented in the low omega-3 status group because they do not eat fish or other animal products,” said Professor Makrides. These women have expressed a strong preference for micro-algae sources of omega-3 fatty acids that are plant-based and fully sustainable with vegan and vegetarian diets.”
GP obstetrician and director of Adelaide Mums and Babies Clinic in South Australia, Dr Rhiannon Smith, has extensive experience in supporting families through the trauma of preterm birth.
“All health professionals welcome any opportunity to reduce the health, wellbeing and economic costs of preterm births and I feel South Australian pregnant mothers are fortunate to be given the chance to have this test,” said Dr Smith.
“So far, pregnant women have embraced the omega-3 screening wholeheartedly because they are being given the chance to understand their own health better and potentially take a supplement to improve the health of their pregnancy and newborn baby.
“The current evaluation is so important because it will help health professionals tailor health information to women on an individual level.”More News