Among the nearly 11,000 women whose fish intake was assessed via food frequency questionnaire, almost 25% never consumed fish during their entire pregnancy, and among the nearly 13,000 with data on supplements, only 16.2% reported any omega-3 supplement use. Both fish intake and supplements were more common in older women and women with a higher education and income, and supplement use was the highest among women with greater fish consumption (and lowest among those not consuming fish).
This nationwide study suggests that a substantial number of women are not meeting basic recommendations issued in all existing pregnancy guidelines, and given that all cohort participants voluntarily enrolled, it may even underestimate the number of women with low omega-3 intake. For example, a recent scoping review of dietary guidelines found recommendations as low as 230g seafood per week (equivalent to 250mg EPA/DHA) from the U.S. Department of Health and Human Services to as high as 800mg/d DHA and 100mg/d EPA per day for women with low omega-3 status from the Australian Pregnancy Care Guidelines (to prevent preterm birth). Other systematic reviews have indicated neurocognitive benefits from seafood consumption, including a boost in IQ of 4.8 to 9.5 points among the children of women with the highest intake, with no drawbacks/downsides. This recent analysis suggests there are still many women and children who could benefit from greater omega-3 intake, either from seafood or supplementation.