BRIEF RESEARCH REPORT article
Front. Nutr.
Sec. Nutritional Epidemiology
Omega-3 Supplementation in Addition to Prenatal Vitamins During Pregnancy is Associated with Lower Rates of Preterm Birth and Small for Gestational Age
Provisionally accepted
William Yakah1
David Haas2
William A Grobman3Lisa D Levine4Uma M Reddy5Robert Silver6Claire-Marie Vacher1
Ronald Wapner5
Anna A Penn1
Morgan R Firestein7,8*- 1Department of Pediatrics, Columbia University Irving Medical Center, New York, NY, United States
- 2Department of Obstetrics and Gynecology, School of Medicine, Indiana University, Indianapolis, IN, United States
- 3Department of Obstetrics and Gynecology, The Ohio State University Wexner Medical Center, Columbus, United States
- 4Maternal Fetal Medicine Division, University of Pennsylvania, Philadelphia, United States
- 5Department of Obstetrics & Gynecology, Columbia University Irving Medical Center, New York, NY, United States
- 6Department of Obstetrics and Gynecology, University of Utah, Salt Lake City, United States
- 7Child Health Institute, Rutgers Robert Wood Johnson Medical School, New Brunswick, United States
- 8Department of Pediatrics, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, United States
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Omega-3 fatty acids and prenatal vitamins support fetal growth, but most studies assess omega-3 supplementation without accounting for baseline prenatal vitamin use during pregnancy. In this secondary analysis, we obtained data from the large, prospective Nulliparous Mother-to-be (nuMoM2b) cohort study of 9,461 nulliparous individuals. Participants were enrolled through eight clinical sites across the United States. We compared adverse birth outcomes between those taking additional omega-3 supplements beyond standard prenatal vitamin intake (PNV-OM) versus prenatal vitamins alone (PNV). PNV-OM intake was associated with significantly lower rates of preterm birth (5.04% vs 8.41%, p<0.001) and SGA (2.84% vs 4.48%, p=0.004). After adjustment for demographic and clinical differences, PNV-OM use remained associated with reduced odds of preterm birth (aOR 0.64, 95% CI: 0.47-0.86, p=0.004) and SGA (aOR 0.64, 95% CI: 0.42-0.95, p=0.03). However, given substantial socioeconomic differences between groups and the potential for residual confounding, these findings should be interpreted with caution. Supplemental omega-3 intake during pregnancy may provide an additive benefit beyond prenatal vitamins alone, but randomized trials are needed to determine whether this relationship is causal.
Keywords: Pregnancy, Preterm Birth, Small for gestation age (SGA), prenatal vitamin, Omega - 3 fatty acids, DHA, EPA
Received: 28 Aug 2025; Accepted: 28 Nov 2025.
Copyright: © 2025 Yakah, Haas, Grobman, Levine, Reddy, Silver, Vacher, Wapner, Penn and Firestein. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Morgan R Firestein
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