DefinePK

Abstract

Background: Long-chain omega-3 polyunsaturated fatty acids (PUFAs), notably docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA), support fetal neurogenesis and attenuate maternal inflammation. In South Asia, dietary omega-3 intake is low and pregnancy-related data are scarce.
Objectives: To evaluate the impact of maternal omega-3 supplementation on third-trimester inflammatory biomarkers, neonatal cranial ultrasound measures, and 12-month cognitive outcomes.
Methods: In this prospective comparative study, 40 women at 20–22 weeks’ gestation were enrolled at tertiary hospitals in Pakistan (September 2023–December 2024). Participants self-selected into two groups: supplemented (n = 20; ≥ 500 mg DHA + 120 mg EPA daily from enrollment until delivery) and control (n = 20; no supplementation). At 32–34 weeks, fasting blood samples were analyzed for interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), and C-reactive protein (CRP) via ELISA. Within 48 hours of birth, cranial ultrasound assessed head circumference, biparietal diameter, and lateral-ventricle width. At 12 months, cognitive performance was measured using the Bayley Scales of Infant Development, Third Edition (BSID-III). Statistical analyses included independent-samples t-tests, Mann–Whitney U tests, chi-square or Fisher’s exact tests, and Pearson correlation; significance was set at p < 0.05.
Results: Supplemented women exhibited lower IL-6 (3.8 ± 1.1 vs. 5.4 ± 1.3 pg/mL; p = 0.001) and CRP (2.1 ± 0.6 vs. 3.6 ± 1.0 mg/L; p = 0.0002). Their infants had larger head circumferences (34.8 ± 1.1 vs. 33.7 ± 1.3 cm; p = 0.004) and greater biparietal diameters (92.4 ± 2.6 vs. 89.5 ± 2.9 mm; p = 0.001). At 12 months, cognitive composite scores were higher in the supplemented group (109.2 ± 7.6 vs. 101.7 ± 8.4; p = 0.002). Maternal CRP inversely correlated with cognitive scores (r = –0.48; p = 0.004).
Conclusions: Maternal omega-3 supplementation during pregnancy significantly reduces systemic inflammation and enhances early neurodevelopmental outcomes. Routine prenatal omega-3 supplementation is recommended, particularly in low-intake populations.