Summary
This global synthesis of 66 observational studies and RCTs (2004–2025) involving 33,390 pregnant women from 28 countries reveals widespread insufficiency in maternal EPA+DHA status. Only three countries (Seychelles, Norway, Ghana) achieved desirable levels (>8%), whilst most developed nations including the United States, United Kingdom, Canada, and Australia fell into the insufficient range (4–6%), and several Asian countries demonstrated critically low levels (≤4%). The study standardised heterogeneous blood measurement methodologies to enable international comparison and underscores the need for pregnancy-specific reference ranges and targeted nutritional interventions.
Regional applicability
The United Kingdom is specifically identified as demonstrating insufficient/low eO3I levels (4–6%), indicating a maternal EPA+DHA deficiency gap despite being a developed nation. These findings suggest that UK maternal nutrition policy and clinical guidance may need to prioritise omega-3 PUFA supplementation or dietary strategies during pregnancy to meet fetal neurodevelopmental requirements.
Key measures
Estimated Omega-3 Index (eO3I) in red blood cells; maternal blood EPA+DHA concentrations; country-level mean eO3I levels classified into four categories (desirable >8%, sufficient/moderate 6-8%, insufficient/low 4-6%, very low/undesirable ≤4%)
Outcomes reported
The study assessed and compared maternal blood concentrations of EPA+DHA across 28 countries by standardising data from 66 studies involving 33,390 pregnant women, classifying countries into four categories based on estimated Omega-3 Index (eO3I) levels.
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