Effects of fish oil supplementation on pregnancy outcomes in pregnant women referred to Kosar Hospital

Document Type : Research article


1 Department of Obstetrics and Gynecology, Qazvin University of Medical Sciences,Qazvin, Iran.

2 Department of Obstetrics and Gynecology, School of Medicine, Qazvin University of Medical Science, Qazvin, Iran.

3 Department of Maternity and Child Health,Metabolic Disease Research Center,Qazvin University of Medical Sciences. Qazvin, Iran.


The hypothesis of a protective effect of fish oil supplementation in preventing some consequences of pregnancy such as gestational hypertension is put forward which has attracted increasing attention. The aim of the present study was to evaluate the effect of fish oil supplementation on outcomes of pregnancy. This study was a clinical trial performed on 339 women with singleton pregnancy aged 18-35 and gestational age of 20 weeks who visited prenatal clinic at Kosar Hospital in Qazvin during 2015-2016. Patients were randomly divided into two groups marked as intervention group which received soft gelatin capsules (each containing 1000 mg fish oil including 120 mg DHA and 180 mg EPA) on a daily basis from the 20th week to the end of pregnancy, and the women in the control group with no fish oil intake. The outcomes of pregnancy including preeclampsia, eclampsia, preterm labor, gestational diabetes, weight, height, head circumference at birth and the gestational age at delivery were evaluated in both groups. Data were analyzed using statistical tests including Mann-Whitney U test and t-test. There was significant difference in gestational age between the two study groups (P <0.05). There was no significant difference in the percentage of preterm birth, preeclampsia, eclampsia, IUGR, and GDM between the two groups (P>0.05). The results of this study showed that consumption of fish oil supplements from 20th week of gestation by 18-35 year-old pregnant women increased pregnancy age but failed to decrease the percentage of preterm birth, preeclampsia, eclampsia, IUGR, and GDM.

Graphical Abstract

Effects of fish oil supplementation on pregnancy outcomes in pregnant women referred to Kosar Hospital


  1. Bhutta ZA, Ahmed T, Black RE, Cousens S, Dewey K, Giugliani E, Haider BA, Kirkwood B, Morris SS, Sachdev HP and hekar M. What works? Interventions for maternal and child undernutrition and survival. Lancet (2008) 2: 417-40.
  2. Carlson SE, Colombo J, Gajewski BJ, Gustafson KM, Mundy D, Yeast J, Georgieff MK, Markley LA, Kerling EH and Shaddy DJ. DHA supplementation and pregnancy outcomes. J. Clin. Nutr. (2013) 97: 808-15.
  3. Koletzko B, Lien E, Agostoni C, Böhles H, Campoy C, Cetin I, Decsi T, Dudenhausen JW, Dupont C, Forsyth S and Hoesli I. World Association of Perinatal Medicine Dietary Guidelines Working Group. The roles of long-chain polyunsaturated fatty acids in pregnancy, lactation and infancy. Perinat. Med. (2008) 36: 5-14.
  4. Whitney E and Rolfes SR. Understanding Nutrition. 11th Ed, California, Thomson Wadsworth (2008) 154.
  5. ImhoffKunsch B, Stain AD, Villalpando S, Martorell R and Ramakrishnan U. Docosahexaenoic Acid Supplementation from Mid-Pregnancy to Parturition Influenced Breast Milk Fatty Acid Concentrations at 1 Month Postpartum in Mexican Women . J. Nutr. (2011) 141: 321-6.
  6. Jensen CL. Effects of n-3 fatty acids during pregnancy and lactation. J. Clin. Nutr. (2006) 83: 1452-7.
  7. Davoodabadifarahani M and Seyedzadehagdam N. Effect of docosahexaenoic acid and eicosapentaenoic acid supplementation during pregnancy on birth weight and length of pregnancy. Altern. Complement. Med. (2011) 1: 39-47
  8. Brenna T and Diau GY .The influence of dietary docosahexaenoic acid and arachidonic acid on central nervous system polyunsaturated fatty acid composition. Leukot Essent. Fatty Acids (2007) 77: 247-50.
  9. Agostoni C. Docosahexaenoic acid (DHA): From the maternal–foetal dyad to the complementary feeding period. Early Human Develop. (2010) 86: 3-6.
  10. Carlson SE. Docosahexaenoic acid supplementation in pregnancy and lactation. J. Clin. Nutr. (2009) 89: 678- 84.
  11. Innis SM and Friesen RW. Essential n-3 fatty acids in pregnant women and early visual acuity maturation in term infants. J. Clin. Nutr. (2008) 87: 548- 57.
  12. Cnossen JS, Vollebregt KC, De Vrieze N, Ter Riet G, Mol BWJ, Franx A, Khan KS and van der Post JA. Accuracy of mean arterial pressure and blood pressure measurements in predicting pre-eclampsia: systematic review and meta-analysis. BMJ (2008) 336: 1117-20.
  13. Campoy C, Escoano-Margarit V, Anjos T, Szajewska H and Uauy R. Omega 3 fatty acids on child growth, visual acuity and neurodevelopment. J. Nutr. (2012) 107: 85-106.
  14. Rahaei MA and Mosaddeq N. The effect of fish oil in reducing the incidence and severity of hypertension in pregnant women at high risk. Isfahan. Med. Sch. (2006) 24: 45-50.
  15. Fereidooni B and Jenabi E. The use of omega 3 on pregnancy outcomes: a single-center study. Pak. Med. Assoc. (2014) 64: 1363-5
  16. Olsen SF, Secher NJ, Tabor A, Weber T, Walker JJ and Gluud C. Randomized clinical trials of fish oil supplementation in high risk pregnancies. J.O.G. (2000) 107: 382- 95
  17. Onwude JL, Lilford RJ, Hjartardottir H, Staines A and Tuffnell D. A randomized double blind placebo controlled trial of fish oil in high risk pregnancy. J. Obstet. Gynaecol. (2005) 102: 95-100.
  18. Salvig JD, Olsen SF and Secher NJ. Effects of fish oil supplementation in late pregnancy on blood pressure: a randomized controlled trial. J. Obstet. Gynaecol. (2006) 103: 529-33.
  19. Olsen SF, Osterdal Ml, Salvig JD, Webr T, Tabor T and Secher NJ. Duration of pregnancy in relation to fish oil supplementation and habitual fish intake: a randomized clinical trial with fish oil. J. Clin. Nutr. (2007) 61: 976-85.
  20. Makrides M, Duley L and Olsen SF. Marine oil, and other prostaglandin precursor, supplementation for pregnancy uncomplicated by pre‐eclampsia or intrauterine growth restriction. The Cochrane Library (2006) 19: 3
  21. Szajewska H, Horvath A and Koletzko B. Effect of n-3 long-chain polyunsaturated fatty acid supplementation of women with low risk pregnancies on pregnancy outcomes and growth measures at birth: a meta-analysis of randomized controlled trials. J. Clin. Nutr. (2006) 83: 1337-44.
  22. Muthayya S, Dwarkanath P, Thomas T, Ramprakash S, Mehra R, Mhaskar A, Mhaskar R, Thomas A, Bhat S, Vaz M and Kurpad AV. The effect of fish and omega-3 LCPUFA intake on low birth weight in Indian pregnant women. J. Clin. Nutr. (2009) 63: 340-6.
  23. Krauss-Etschmann S, Shadid R, Campoy C, Hoster E, Demmelmair H, Jiménez M, Gil A, Rivero M, Veszprém B, Decsi T and Koletzko BV. Effects of fish-oil and folate supplementation of pregnant women on maternal and fetal plasma concentrations of docosahexaenoic acid and eicosapentaenoic acid: a European randomized multicenter trial. Am. J. Clin. Nutr. (2007) 85: 1392-400.
  24. Horvath A, Koletzko B and Szajewska H. Effect of supplementation of women in high risk pregnancies with long-chain polyunsaturated fatty acids on pregnancy outcomes and growth measures at birth: a metaanalysis of randomized controlled trials. J. Nutr. (2007) 98: 253-9.
  25. Morris MC, Evans DA, Bienias JL, Tangney CC, Bennett DA, Wilson RS, Aggarwal N and Schneider J. Consumption of fish and n-3 fatty acids and risk of incident Alzheimer disease. Neurol. (2003) 60: 940-6.
  26. Martin RE, Wickham JQ, Om Ae-S, Sanders J and Ceballos N. Uptake and Incorporation of Docosahexaenoic Acid (DHA) into Neuronal Cell Body and Neurite/Nerve Growth Cone Lipids: Evidence of Compartmental DHA Metabolism in Nerve Growth Factor-Differentiated PC12 Cells. Res. (2000) 25: 715-23.
  27. Gary Coningham F, Leveno K, Bloom S, Spong C, Dash JS, Hoffman BL, Casey B and Sheffield J . Williams obstetrics. 2nd ed. New York, McGraw-Hill Co. (2005) 761- 800.
  28. Eskat G and Danforth D. Danforth's obstetrics and gynecology. Translated by: Sarami A, Yazdinrzhad A. 9th ed. Tehran: Mehrmah Publication; (2008) 400-5.
  29. Ziaei S, Motlagh Bonab K and Kazemnejad A. Serum lipid levels at 28–32 weeks gestation and hypertensive disorders. Preg. (2006) 25:3-10.
  30. Williams MA, Frederick IO, Qiu C, Meryman LJ, King IB, Walsh SW and Sorensen TK. Maternal erythrocyte omega-3 and omega-6 fatty acid, and plasma lipid concentrations, are associated with habitual dietary fish consumption in early pregnancy. Biochem. (2006) 39: 1063-70.
  31. Smuts CM, Huang M, Mundy D, Plasse T, Major S and Carlson SE. A randomized trial of docosahexaenoic acid supplementation during the third trimester of pregnancy. Gynecol. (2003) 101: 469-79.
  32. Phang M and Skilton M. Marine Omega-3 Fatty Acids, Complications of Pregnancy and Maternal Risk Factors for Offspring Cardio-Metabolic Disease. Drugs )2018(16: 138.