Omega-3 Fatty Acid Deficiency During Pregnancy

Omega-3 fatty acids are essential polyunsaturated fats that the body cannot produce on its own and must obtain from dietary sources. The three main omega-3 fatty acids are ALA (alpha-linolenic acid), EPA (eicosapentaenoic acid), and DHA (docosahexaenoic acid). During pregnancy, DHA is of particular importance because it is a primary structural component of the developing baby's brain and retina.

Omega-3 deficiency during pregnancy occurs when dietary intake of these essential fats is insufficient to meet the needs of both mother and baby. The developing fetus accumulates DHA at a high rate during the third trimester, drawing from the mother's stores. If maternal intake is low, the mother's own DHA levels can become depleted, potentially affecting both her health and the baby's development.

In India, omega-3 intake tends to be lower than recommended, particularly among vegetarian populations who do not consume fish, the richest source of EPA and DHA. While ALA from plant sources can be partially converted to DHA in the body, this conversion is inefficient (typically less than 5%), making direct sources of DHA especially important during pregnancy.

The primary cause of omega-3 deficiency is limited intake of fatty fish and seafood. Despite Visakhapatnam's coastal location and access to fresh fish, not all expecting mothers consume fish regularly. Concerns about mercury contamination, personal food preferences, and vegetarian dietary practices can all reduce fish consumption. Women who eat fish infrequently or only lean varieties may not obtain sufficient DHA.

Vegetarian and vegan diets, which are common across India, rely on plant-based ALA from sources like flaxseeds, walnuts, and chia seeds. However, as the conversion of ALA to the more bioactive EPA and DHA is very limited in humans, vegetarian women are at higher risk of DHA insufficiency during pregnancy. The modern Indian diet, with its increasing reliance on refined vegetable oils rich in omega-6 fatty acids, can further shift the omega-6 to omega-3 ratio unfavourably.

A diet high in processed foods, fast foods, and snacks cooked in omega-6-rich oils (sunflower, corn, soybean) can suppress the body's ability to utilise the limited omega-3 available. Women with malabsorption conditions or those who have difficulty digesting fats may also struggle to absorb omega-3 fatty acids effectively.

Omega-3 deficiency may not produce dramatic or obvious symptoms, making it an often-overlooked nutritional gap during pregnancy. Subtle signs include dry skin, dry eyes, and brittle hair or nails. Some women may notice difficulty concentrating, forgetfulness, or mood fluctuations, including symptoms of low mood or anxiety, which have been linked to low omega-3 status in clinical studies.

Joint stiffness or pain, fatigue, and increased inflammation, manifesting as swelling or skin irritation, may also indicate insufficient omega-3 intake. Because these symptoms overlap with common pregnancy experiences, they are frequently dismissed. If you notice a combination of dry skin, mood changes, and poor concentration, it may be worth evaluating your omega-3 intake with your healthcare provider.

For the mother, omega-3 fatty acids play an anti-inflammatory role and support cardiovascular health during pregnancy. Low omega-3 levels have been associated with an increased risk of preeclampsia, preterm labour, and postpartum depression. DHA, in particular, may help regulate mood and reduce the severity of pregnancy-related anxiety and depression.

For the baby, DHA is a critical building block of the brain, constituting a significant proportion of the cerebral cortex and the retina of the eye. Adequate maternal DHA intake during pregnancy has been associated with improved cognitive function, visual acuity, and attention span in children. Some research suggests that omega-3 supplementation during pregnancy may also reduce the risk of childhood allergies and asthma, though more studies are needed.

The third trimester is a period of particularly rapid brain growth, and DHA accumulation in the fetal brain accelerates during this time. Ensuring adequate omega-3 intake throughout pregnancy, and especially during the final months, provides the developing brain with the building materials it needs for optimal development.

Fatty fish is the most efficient dietary source of EPA and DHA. Fish such as salmon, sardines, mackerel, and hilsa are rich in these omega-3 fats. In Visakhapatnam, locally available varieties like bangda (mackerel) and small fish consumed whole (including bones) are affordable and nutritious options. Aim for two to three servings of low-mercury fish per week during pregnancy. Avoid high-mercury species such as king mackerel, swordfish, and shark.

Plant-based sources of ALA include flaxseeds (alsi), chia seeds, walnuts, hemp seeds, and their oils. While ALA is not as potent as DHA, regular consumption of these foods contributes to overall omega-3 status. Adding ground flaxseeds to smoothies, raita, or chutney is a simple way to increase intake. Mustard oil, traditionally used in some Indian cooking, also contains ALA.

For vegetarian women or those who do not eat fish, algal oil supplements provide a plant-based source of DHA derived from microalgae. Fish oil supplements, available in purified and deodorised forms, are another option. Look for supplements that provide at least 200-300 mg of DHA per day. Always choose supplements that are certified for purity and discuss any supplementation with your healthcare provider before starting.

Discuss your omega-3 intake with your obstetrician, especially if you follow a vegetarian diet, do not eat fish, or have a history of mood disorders. Your doctor can advise on the most appropriate supplementation strategy based on your dietary patterns and individual needs. While there is no routine blood test for omega-3 levels in standard prenatal care, specialised tests are available if clinically indicated.

If you experience symptoms of depression, persistent anxiety, or mood disturbances during pregnancy, mention these to your healthcare provider. While omega-3 supplementation alone is not a treatment for mood disorders, it may be a supportive component of a broader management plan. Your doctor in Visakhapatnam can help you balance the benefits of omega-3 supplementation with any concerns about fish oil quality, mercury exposure, or interactions with other medications.