Assessing Omega-3 Fatty Acid Supplementation During Pregnancy and Lactation to Optimize Maternal Mental Health and Childhood Cognitive Development

Chelsea M Klemens; Kataneh Salari; Ellen L Mozurkewich


Clin Lipidology. 2012;7(1):93-109. 

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Although there is strong biological plausibility for a beneficial role for omega-3 fatty acids in maternal mental health and child development, a beneficial role for dietary supplementation of mothers during pregnancy and lactation, or for fortification of infant formula, has not yet been established. Despite promising early open-label reports of omega-3 fatty acid supplementation treatment for perinatal depression, current evidence does not support the benefits of these supplements for the prevention or treatment of maternal depression, and use of omega-3 fatty acids for this indication remains investigational. Negative results from available trials may reflect a true lack of benefit or may have resulted from investigators' choices of fatty acid preparations to study. Limited evidence in nonpregnant individuals suggests that EPA may be the more active long-chain PUFA in the treatment of mood disorders.

Observational data suggest that maternal fish ingestion during pregnancy may be associated with reduced risk for suboptimum cognitive development of the child.[14] However, results of intervention studies of omega-3 fatty acid supplementation have been inconsistent, with many showing no overall meaningful benefit.[6] Nevertheless, available evidence from two large randomized controlled trials suggests that supplementation may reduce risk for the greatest degrees of adverse developmental outcome.[44,87] In a large supplementation study of low-risk women, DHA supplementation was associated with a lower risk for developmental quotient <85 than placebo supplementation, although cognitive development overall did not differ between groups.[44] Similarly, in another randomized study by the same investigators evaluating postnatal supplementation of preterm infants, DHA supplementation was also associated with reduced risk for significant mental delay (MDI <70), as well as a reduced risk for both mild (MDI <85) and significant mental delay (MDI <70) among girls.[87] In summary, findings of the supplementation trials have been inconsistent and inconclusive. At present, the optimal dose of omega-3 fatty acids, composition and ratio of EPA:DHA to optimize child development is not established.


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