Clinical question
How effective are omega‐3 long-chain polyunsaturated fatty acids, as supplements or dietary additions, during pregnancy on maternal, perinatal, and neonatal outcomes, and longer‐term outcomes for mother and child?
Bottom line
Omega‐3 LCPUFA, particularly docosahexaenoic acid, supplementation during pregnancy reduced preterm birth and early preterm birth, with low cost and little indication of harm. There was a possible reduced risk of perinatal death and of neonatal care admission, a reduced risk of low birthweight babies, and a possible small increased risk of large-for-gestational-age babies with omega‐3 LCPUFA. The effect on most child development and growth outcomes was minimal or uncertain.
Caveat
Most trials were conducted in upper‐middle or high‐income countries, and nearly half the trials included women at increased/high risk for factors that might increase the risk of adverse maternal and birth outcomes.
Context
Higher intakes of foods containing omega‐3 LCPUFA, such as fish, during pregnancy have been associated with longer gestations and improved perinatal outcomes.
Cochrane Systematic Review
Middleton P et al. Omega-3 fatty acid addition during pregnancy. Cochrane Reviews, 2018, Issue 11. Art. No.: CD003402.DOI: 10.1002/14651858. CD003402.pub3. This review contains 70 studies involving 19,927 participants.
![Barbara Fountain, editor of New Zealand Doctor Rata Aotearoa, and Paul Hutchison, GP and senior medical clinician at Tāmaki Health [Image: Simon Maude]](/sites/default/files/styles/thumbnail_cropped_100/public/2025-03/Barbara%20Fountain%2C%20editor%20of%20New%20Zealand%20Doctor%20Rata%20Aotearoa%2C%20and%20Paul%20Hutchison%2C%20GP%20and%20senior%20medical%20clinician%20at%20T%C4%81maki%20Health%20CR%20Simon%20Maude.jpg?itok=-HbQ1EYA)
![Lori Peters, NP and advanced health improvement practitioner at Mahitahi Hauora, and Jasper Nacilla, NP at The Terrace Medical Centre in Wellington [Image: Simon Maude]](/sites/default/files/styles/thumbnail_cropped_100/public/2025-03/2.%20Lori%20Peters%2C%20NP%20and%20advanced%20HIP%20at%20Mahitahi%20Hauora%2C%20and%20Jasper%20Nacilla%2C%20NP%20at%20The%20Terrace%20Medical%20Centre%20in%20Wellington%20CR%20Simon%20Maude.jpg?itok=sUfbsSF1)
![Ministry of Social Development health and disability coordinator Liz Williams, regional health advisors Mary Mojel and Larah Takarangi, and health and disability coordinators Rebecca Staunton and Myint Than Htut [Image: Simon Maude]](/sites/default/files/styles/thumbnail_cropped_100/public/2025-03/3.%20Ministry%20of%20Social%20Development%27s%20Liz%20Williams%2C%20Mary%20Mojel%2C%20Larah%20Takarangi%2C%20Rebecca%20Staunton%20and%20Myint%20Than%20Htut%20CR%20Simon%20Maude.jpg?itok=9ceOujzC)
![Locum GP Helen Fisher, with Te Kuiti Medical Centre NP Bridget Woodney [Image: Simon Maude]](/sites/default/files/styles/thumbnail_cropped_100/public/2025-03/4.%20Locum%20GP%20Helen%20Fisher%2C%20with%20Te%20Kuiti%20Medical%20Centre%20NP%20Bridget%20Woodney%20CR%20Simon%20Maude.jpg?itok=TJeODetm)
![Ruby Faulkner, GPEP2, with David Small, GPEP3 from The Doctors Greenmeadows in Napier [Image: Simon Maude]](/sites/default/files/styles/thumbnail_cropped_100/public/2025-03/5.%20Ruby%20Faulkner%2C%20GPEP2%2C%20with%20David%20Small%2C%20GPEP3%20from%20The%20Doctors%20Greenmeadows%20in%20Napier%20CR%20Simon%20Maude.jpg?itok=B0u4wsIs)
![Rochelle Langton and Libby Thomas, marketing advisors at the Medical Protection Society [Image: Simon Maude]](/sites/default/files/styles/thumbnail_cropped_100/public/2025-03/6.%20Rochelle%20Langton%20and%20Libby%20Thomas%2C%20marketing%20advisors%20at%20the%20Medical%20Protection%20Society%20CR%20Simon%20Maude.jpg?itok=r52_Cf74)
![Specialist GP Lucy Gibberd, medical advisor at MPS, and Zara Bolam, urgent-care specialist at The Nest Health Centre in Inglewood [Image: Simon Maude]](/sites/default/files/styles/thumbnail_cropped_100/public/2025-03/7.%20Specialist%20GP%20Lucy%20Gibberd%2C%20medical%20advisor%20at%20MPS%2C%20and%20Zara%20Bolam%2C%20urgent-care%20specialist%20at%20The%20Nest%20Health%20Centre%20in%20Inglewood%20CR%20Simon%20Maude.jpg?itok=z8eVoBU3)
![Olivia Blackmore and Trudee Sharp, NPs at Gore Health Centre, and Gaylene Hastie, NP at Queenstown Medical Centre [Image: Simon Maude]](/sites/default/files/styles/thumbnail_cropped_100/public/2025-03/8.%20Olivia%20Blackmore%20and%20Trudee%20Sharp%2C%20NPs%20at%20Gore%20Health%20Centre%2C%20and%20Gaylene%20Hastie%2C%20NP%20at%20Queenstown%20Medical%20Centre%20CR%20Simon%20Maude.jpg?itok=Z6u9d0XH)
![Mary Toloa, specialist GP at Porirua and Union Community Health Service in Wellington, Mara Coler, clinical pharmacist at Tū Ora Compass Health, and Bhavna Mistry, specialist GP at Porirua and Union Community Health Service [Image: Simon Maude]](/sites/default/files/styles/thumbnail_cropped_100/public/2025-03/9.%20Mary%20Toloa%2C%20Porirua%20and%20Union%20Community%20Health%20Service%20in%20Wellington%2C%20Mara%20Coler%2C%20T%C5%AB%20Ora%20Compass%20Health%2C%20and%20Bhavna%20Mistry%2C%20PUCHS%20CR%20Simon%20Maude.jpg?itok=kpChr0cc)