Pregnancy is a transformative and critical phase in a woman's life, marked by profound changes in her body and the development of her baby. During this extraordinary journey, proper nutrition plays an indispensable role in not only safeguarding the mother's health but also nurturing the growth and development of the unborn child. It is during pregnancy and breastfeeding that the mother's nutrients are directly transferred to the fetus or infant through the umbilical cord and placenta. One group of nutrients that emerges as particularly crucial in this context is the long-chain Omega-3 fatty acids, including DHA (Docosahexaenoic Acid) and EPA (Eicosapentaenoic Acid). These essential fatty acids serve structural and regulatory functions in various physiological and metabolic processes [1].

The Necessity of DHA and EPA Supplementation during Pregnancy

Nutrient supply to the developing fetus is entirely reliant on the mother during pregnancy, making it essential for the mother to maintain adequate nutrient levels. This underscores the importance of assessing the mother's nutrient intake before conception. Deficiencies in crucial nutrients can potentially lead to abnormal or deficient fetal development.

In this context, it is imperative to analyze the levels of different fatty acids in the erythrocyte membrane of plasma, a minimally invasive diagnostic technique known as the "Erythrocyte Fatty Acid Profile." This analytical tool is instrumental in detecting deficiencies or excesses in specific fatty acids, as well as evaluating the ratio between different fatty acids and families. Moreover, it allows for personalized supplementation dosages and continuous monitoring throughout gestation.

Omega-3 DHA and EPA Deficiencies in Our Diet

Fatty acids are fundamental components of cell membranes throughout the body. However, due to various nutritional and genetic factors, specific Omega-3s such as DHA and EPA, and even some Omega-6s, are frequently lacking in our diet.

Natural sources of biologically relevant DHA and EPA, crucial for our cells, are found in cold-water, wild-caught fish like sardines, mackerel, salmon, herring, and anchovies. Despite the recommendation of a minimum weekly intake of two servings of wild-caught fish, this guideline often goes unheeded due to the risk of contamination from high mercury concentrations. Thus, during pregnancy, it becomes vital to supplement with high-concentration DHA and EPA to ensure adequate bioavailability.

The Crucial Functions of DHA and EPA during Pregnancy

DHA, in particular, plays a pivotal role in the development of the brain and vision, especially during the third trimester. This period witnesses rapid and intense brain development, demanding a substantial supply of DHA. Approximately 50% of the fatty acids comprising neuronal cell membranes are DHA. In the brain, DHA serves a structural function, providing membrane fluidity necessary for dynamic processes that facilitate neurotransmission and the establishment of appropriate synaptic contacts during brain development. Multiple scientific studies underscore the significance of DHA and EPA intake during pregnancy for central nervous system development. Low DHA levels increase the risk of children developing conditions such as autism and attention deficit hyperactivity disorder (ADHD) [5].

Additionally, the development of the retina and eyes during pregnancy necessitates an ample supply of DHA for the formation of the external disks of cone and rod cell membranes in the retina [7].

Preventing Allergies and Childhood Asthma through EPA and DHA Supplementation

The rising incidence of allergies and respiratory diseases like asthma has been linked to Omega-3 nutritional deficiencies during pregnancy. Several scientific studies have concluded that adequate intake of EPA and DHA during pregnancy correlates with a reduced prevalence of skin diseases, allergies, and asthma. In these cases, an excessively high Omega-6/Omega-3 ratio promotes the synthesis of pro-inflammatory molecules, leading to inflammatory skin conditions such as allergies, eczema, and atopic dermatitis [10].

A randomized clinical trial involving 145 pregnant women at risk of bearing allergic children revealed that supplementation with 1.6g of EPA and 1.1g of DHA increased the levels of these fatty acids in the mother's and fetus's membrane phospholipids. This was directly associated with the risk of IgE-mediated allergies in the child during the first year of life [11].

Additional Benefits of Omega-3 Supplementation during Pregnancy

Omega-3 DHA and EPA supplementation during pregnancy not only reduces the risk of postpartum depression but also minimizes the likelihood of premature birth and preeclampsia. Furthermore, a study published in the "Functional Food" journal by researchers from the University of Granada and King's College London found that maternal DHA supplementation during gestation enhances the expression of genes that regulate iron transport through the placenta. This contributes to improved fetal iron metabolism, preventing fetal anemia [12].

Recommended Dosages of DHA and EPA during Pregnancy

According to the European Food Safety Authority (EFSA) health claims for adults, DHA contributes to the normal functioning of the brain and vision, with a beneficial effect achieved with a daily intake of 250 mg of DHA and EPA combined. However, this minimal daily dose is insufficient during pregnancy, as the naturally synthesized DHA falls short of fetal requirements. It is generally assumed that, in addition to the basic EFSA recommendations, 200 mg of additional DHA should be included to meet the fetus's nutritional needs, provided there are no pre-existing deficiencies or multiple pregnancies.

These dosage recommendations are, however, approximate minimum values, subject to various individual genetic and dietary factors. DHA and EPA can be synthesized from the essential Omega-3 alpha-linolenic acid (ALA) found in terrestrial plant seeds. However, in practice, the conversion of ALA to DHA and EPA is limited, with an estimated average of only 1% of ALA being transformed into DHA. Thus, supplementation with DHA and EPA during pregnancy is deemed essential.