From awareness to action: dsm-firmenich spotlights urgent need for DHA in maternal nutrition

06 Mar 2024 --- Research continues to shine a light on the critical role of docosahexaenoic acid (DHA) supplementation in supporting full-term pregnancies and its potential to prevent preterm births. 

On the occasion of Women’s History Month, Nutrition Insight looks at the latest global clinical guidelines recommending minimum DHA intake for women before and during pregnancy to significantly reduce the risk of preterm and early preterm births, with Dr. Kristen Finn, the science translation and advocacy segment lead for early life nutrition at dsm-firmenich.

Finn sheds light on the global challenge of preterm births, the lifelong implications for children born preterm and emphasizes the importance of awareness and access to adequate omega-3 supplementation among healthcare professionals and expectant mothers. Finn also spotlights dsm-firmenich’s #EveryDayCounts campaign and the company’s efforts to raise awareness of the critical need for DHA during pregnancy.

Can you tell us about the role of adequate DHA supplementation in preventing preterm births?
Finn: The importance of DHA intake to support full-term pregnancies has been known for some time. A Cochrane review and meta-analysis found with high certainty that omega-3 addition during pregnancy reduced the risk of preterm births — less than 37 weeks gestation — by 11% and early preterm births — less than 34 weeks gestation — by 42%.Dr. Kristen Finn, the science translation and advocacy segment lead for early life nutrition at dsm-firmenich.

Thus, it is now recognized that women who have low omega-3 intakes and/or status early in pregnancy are at an increased risk of having a baby born preterm — less than 37 weeks gestation — compared to their counterparts with adequate omega-3 intake. However, what has been missing are concrete recommendations on dose. How much DHA should a woman who is pregnant, or considering pregnancy, consume to support a full-term pregnancy?

The first ever global expert clinical practice guideline focused on omega-3 fatty acids to reduce the risk of preterm births was published in February 2024 in the American College of Obstetrics and Gynecology — Maternal & Fetal Medicine Journal, and has now been endorsed by the European Board and College of Obstetrics and Gynecology. This guideline recommends that all women of childbearing age consume at least 250 mg of DHA plus eicosapentaenoic acid (EPA) per day prior to pregnancy.

This intake can be met with DHA alone. During pregnancy, all women need at least an additional 100-200 mg of DHA — a total of 350-450 mg of DHA or DHA plus EPA — per day. However, for women who enter pregnancy with a low omega-3 intake and/or status as indicated by a blood test or food frequency questionnaire, the evidence shows that even higher doses of 600-1000 mg of DHA plus EPA or DHA alone per day can help reduce the risk of preterm or early preterm — less than 34 weeks gestation — births.

How significant is the challenge of preterm births globally?
Finn: Globally, one in ten babies are born preterm, with rates ranging from 4-16% across countries, according to the World Health Organization. Although preterm births remain a significant problem in developing countries, rates are rising also in many developed areas. For example, in the US, the preterm birth rate has increased consistently since 2014 and was at 10.38 in 2022. There are also racial disparities, with rates among Black women 1.5 times higher than all others. It is unclear what is driving the increase in preterm birth rates, but low omega-3 intakes are likely one important factor. 

According to the National Health and Nutrition Examination Survey, 100% of the pregnant women surveyed consumed less than the recommended 8 oz of seafood per week and the mean dietary intake of DHA and EPA was only approximately 79 mg per day — far less than the recommended levels ranging from 350-1000 mg per day for pregnant women.dsm-firmenich kicked off the #EveryDayCounts advocacy campaign in Washington, DC, US, in 2023.

What are the potential lifelong implications for children born preterm?
Finn: Children who are born preterm, and especially those born early preterm, face a myriad of potentially lifelong health issues, including vision and hearing problems, learning difficulties and, in severe cases, intracranial hemorrhage, respiratory distress syndrome, necrotizing enterocolitis and cerebral palsy. A recent health economic study found that early preterm births in the US result in a five-fold increase in lifetime healthcare costs compared to a full-term birth. 

Additionally, it is estimated that the total population costs of preterm births in the US totaled over US$34 billion in 2021. If all pregnant women had access to an efficacious dose of high-quality, algal DHA at 1000 mg per day, it could lead to a 25% reduction of these annual costs. But more importantly, it could prevent an estimated 40,000 preterm births annually, with approximately two-thirds of them being the more detrimental early preterm births No cost can be assigned to the lives saved and lifelong health burdens relieved.

Can you elaborate on the recent expert recommendations regarding DHA intake during pregnancy and how dsm-firmenich’s products can align with these guidelines for customers and consumers?
Finn: Clinical recommendations and consumer acceptance of multivitamins, prenatal supplements and iron are quite well established among pregnant women. However, when it comes to DHA, awareness of its importance throughout the motherhood journey is much lower for both healthcare professionals (HCPs) and consumers. Until now, DHA has been primarily known to promote fetal neural and cognitive development, assuming a daily intake of 200 mg per day, which is far below the recently published expert clinical practice guidelines.

Adequate DHA intake can prove to be a challenge for pregnant women considering the size of traditional DHA capsules, number of capsules and flavor of fishy off-notes, resulting in low adherence to dietary recommendations and possibly obscuring its full potential in positively influencing the incidence of preterm birth. dsm-firmenich has been leading sustainable omega-3 innovation with life’sDHA and life’sOMEGA  lipids – which offer maternal brand owners a variety of high-potency DHA levels delivering recommended daily intakes in minimal serving sizes and with superior sensory properties notable both in traditional soft gel capsules as well as alternative formats such as soft chews and gummies.DHA can significantly reduce the risks of preterm and early preterm births.

The algal-based life’s portfolio presents the perfect solution to assist moms-to-be in fostering a healthy future, not just for themselves and their babies but also the planet. These solutions are derived from natural, non-GMO algae via a proprietary indoor process — guaranteeing high-quality ingredients independent of the delicate marine environment.

With the campaign #EveryDayCounts, how is dsm-firmenich working to raise awareness about the critical need for DHA during pregnancy among healthcare professionals and expectant mothers and why is that important?
Finn: dsm-firmenich kicked off the #EveryDayCounts advocacy campaign at a maternal health event in Washington, DC, in 2023. During this event, leading scientists and advocates, including a representative from the March of Dimes, shared the latest scientific findings with members of the US Congress to raise awareness that omega-3 fatty acids can address the issue of preterm births, and that there is a need to increase access for all women of childbearing age. This was followed by events at the American Society for Nutrition, where dsm-firmenich hosted a symposium to raise awareness of this issue and the need for updated prenatal nutrition recommendations among nutrition professionals and policymakers.

At last year’s International Federation of Gynecology and Obstetrics World Congress, dsm-firmenich hosted another symposium where the new global expert clinical guidelines were first launched. In May, we plan to host a session to introduce the clinical guidelines to an American audience at the annual American College of Obstetrics and Gynecology meeting taking place in San Francisco. 

We continue to collaborate with key experts and clinicians to raise awareness and hopefully increase access to adequate omega-3 supplementation for all women of childbearing age.

By William Bradford Nichols