Fish and omega-3 supplement intake found lacking in pregnant women


A recent study highlighted the disparity between dietary recommendations and actual intake of fish and omega-3 supplements among pregnant women, underscoring the need for targeted public health interventions to address this shortfall.

Fish and omega-3 supplement intake found lacking in pregnant women | Image Credit: © nadianb - © nadianb -

Fish and omega-3 supplement intake found lacking in pregnant women | Image Credit: © nadianb - © nadianb -

Fish and omega-3 (n-3) supplement consumption is uncommon in pregnant patients, according to a recent study published in Public Health Nutrition.


  1. The study highlights that both fish consumption and omega-3 (n-3) supplement intake are generally low among pregnant women, indicating a gap between recommendations and actual practice.
  2. Despite being essential for neurodevelopment in offspring and improving pregnancy outcomes, the intake of n-3 polyunsaturated fatty acids (PUFAs) through fish or supplements remains insufficient among pregnant patients.
  3. Factors such as age, education level, ethnicity, and tobacco/nicotine use influence both fish consumption and supplement intake during pregnancy, indicating a need for targeted interventions to address these disparities.
  4. While there's evidence of reduced fish and n-3 PUFA intake over recent decades, the study found that fish consumption did not vary based on the year of delivery, suggesting a consistent trend rather than significant improvement over time.
  5. The study suggests the importance of public health interventions to encourage either fish consumption or n-3 supplement intake among pregnant women, emphasizing the need for advice and resources to bridge the gap between recommendations and actual behavior.

N-3 polyunsaturated fatty acids (PUFAs) are essential nutrients, especially during pregnancy as they support neurodevelopment in offspring and improve pregnancy outcomes. N-3 PUFAs are primarily obtained through consumption of fish and other seafood.

Guidelines recommend pregnant patients consume 8 to 12 ounces of fish per week, but limited data has indicated these recommendations are met by few women. Data has also indicated a reduction in fish and n-3 PUFA intake during pregnancy within the previous few decades.

While fish consumption is considered the optimal way to meet n-3 PUFA recommendations, n-3 PUFA supplements are available for patients who cannot or choose not to eat fish. However, there is little data about the extent to which women take n-3 supplements.

To evaluate fish consumption and n-3 supplement use among pregnant women, investigators conducted a study using data from the Environmental influences on Child Health Outcomes program. Twenty-three cohorts containing data about fish consumption and 35 about supplement use were included in the analysis.

Food frequency questionnaires evaluating fish and supplement intake were identified through keyword searches. Fish intake was recorded as a 4-level categorical variable, including never or less than once per month, once per month to less than once per week, 1 to 2 times per week, and more than twice per week.

A binary variable for fish intake was also created, including never or less than once per month vs more. N-3 supplementation intake was also reported as a binary variable of any vs none. Other characteristics included race, ethnicity, age, education, pre-pregnancy body mass index (BMI), and tobacco or nicotine use during pregnancy.

There were 10,800 pregnant women included in the analysis of fish consumption, 24.6% of whom reported never consuming fish while 75.4% consumed fish during pregnancy. Consuming less than 1 serving per week was reported by 40.1%, 1 to 2 servings per week by 22.1%, and more than 2 servings per week by 13.2%.

Patients who were older, other than non-Hispanic White, had a lower BMI, and used tobacco or nicotine products were more likely to consume fish during pregnancy, with relative risks (RRs) of 1.14, 1.13, 0.97, and 1.04, respectively. Fish intake did not vary based on year of delivery.

N-3 PUFA supplement intake information was available for 12,646 pregnant women, 16.2% of whom reported any supplement use. Patients who were older and had a higher education level were more likely to report supplement intake, with RRs of 2.01 and 1.71, respectively.

Non-Hispanic Black and Hispanic patients were less likely to use supplements vs non-Hispanic White patients, with RRs of 0.61 and 0.67, respectively. An RR of 0.81 was reported for patients who used tobacco or nicotine products and 0.79 for those with a higher BMI. Increased supplement use was observed among patients with higher fish consumptions, contrasting recommendations.

These results indicated rates of fish consumption and N-3 supplement intake among pregnant women do not meet recommendations. Investigators recommended public health advice and resources to encourage fish consumption or n-3 supplement intake during pregnancy.


Oken E, Musci RJ, Westlake M, et al. Demographic and health characteristics associated with fish and n-3 fatty acid supplement intake during pregnancy: results from pregnancy cohorts in the ECHO program. Public Health Nutr. 2024. doi:10.1017/S136898002400051X

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