expert opinion

DHA supplementation during pregnancy benefits pregnant women primarily through the prevention of premature birth

October 15, 2015


Professor Maria Makrides, Adelaide University, Australia

A new analysis of data by Professor Makrides’ group at Adelaide University (1) in Australia has shown that in-patient hospital costs could decrease by 92 Australian Dollars (AUD) on average per pregnancy (single) when DHA supplements were consumed during pregnancy. The total potential financial impact of the cost savings to the Australian public hospital system was estimated at being between 15 and 51 million AUD per year (on the basis of 163,519 singleton pregnancies per year). The study calculated that the DHA supplementation provided a 50% chance of avoiding an additional premature birth.

This study used data collected from the “DHA to Optimize Mother and Infant Outcomes” trial (DOMInO) conducted with 2,399 pregnant women supplemented with 800mg DHA per day (in the form of fish oil capsules) recruited from 2005 and 2008 in Australia.

In 2010, the original DOMInO randomized controlled trial conducted by Professor Makrides indicated that supplementation of DHA during pregnancy could reduce the incidence of premature birth, i.e., less than 34 weeks gestation (2).

In a review article (3), Professor Makrides noted that the pregnant women have an increased need of DHA during pregnancy because of the demands of the developing fetus to accrue neural tissue. She also noted that generally in Westernized countries dietary intake was low, and that there was a lack of evidence that DHA could be provided by precursor fatty acids. As such, the investigation of the efficacy of DHA supplementation during pregnancy was justified because of the potential health benefits to both mother and child. At the time of the review, there was conflicting evidence as to the benefit of prenatal DHA supplementation in terms of improved visual acuity and growth in term infants, but this could be explained by the small size of the studies. However, the fact that even large dose interventions of DHA had been used in those trials with no ill effects, provided an incentive for much larger trials to be carried out.

In 2008, her group found that requirement for DHA for optimum visual acuity in premature babies was higher than expected, at 1% of fatty acids, rather than the recommended 0.3% in Australia (4).

In summary, Professor Makrides has shown that prenatal supplementation of pregnant women with DHA reduces the risk of premature birth. This has considerable health benefits for the individuals and cost benefits for the state. She has also shown that supplemental DHA in the formula of premature babies can improve their visual development.


  1. Ahmed S, Makrides M, Sim N, McPhee A, Quinlivan J, Gibson R, Umberger W; “Analysis of hospital cost outcome of DHA-rich fish-oil supplementation in pregnancy: Evidence from a randomized controlled trial”; Prostaglandins Leukot Essent Fatty Acids. 2015 Sep 3 pii: S0952-3278(15)00153-2. doi: 10.1016/j.plefa.2015.08.002.
  2. Makrides M, Gibson AR, McPhee JA, Yelland L, Quinlivan J & Ryan P; “Effect of DHA supplementation during pregnancy on maternal depression and neurodevelopment of young children”; JAMA 2010; 304 (15): 1675–1683.
  3. Makrides M; “Is there a dietary requirement for DHA in pregnancy?”; Prostaglandins Leukot Essent Fatty Acids 2009; 81: 171–174.
  4. Smithers LG, Gibson, RA, McPhee A. & Makrides, M.: “Higher dose of docosahexaenoic acid in the neonatal period improves visual acuity of preterm infants: results of a randomized controlled trial.”; Am. J. Clin. Nutr 2008: 88: 1049–56.