So you’ve taken a Prenatal DHA Test and now you want to understand what your results mean. In this blog, we’ll take you through some of the most commons questions people have after taking a test. If you haven’t taken one yet and you are pregnant, perhaps you will learn something from this blog that motivates you to measure your levels, so that you can make sure you are getting enough DHA to benefit you and your growing baby.
First, what does the Prenatal DHA Test measure? The Prenatal DHA Test measures the omega-3 fatty acid known as docosahexaenoic acid (DHA) in your blood during pregnancy.
Omega-3s have been associated with several important health outcomes for mom and baby. But recent evidence shows that higher levels of the omega-3 DHA during pregnancy are strongly associated with a lower risk of premature birth. In fact, recent studies show that having a certain amount of DHA in the blood lowers the risk of early preterm (before 34 weeks) and preterm birth (before 37 weeks) by 42% and 11%, respectively. More on that below.
The Prenatal DHA Test is based in large part on a research paper authored by OmegaQuant’s Dr. Kristina Harris Jackson, in which she focused on two main studies — one looking at blood levels of women who had a full term pregnancy or those who had early preterm birth (giving birth before 34 weeks) and another, a meta-analysis of 70 studies where groups of women were given fish oil or placebo.
In the former study, researchers found that those who had higher omega-3s in their blood had a lower risk of being an early preterm birth case. At around 5% DHA in the blood was where they started to see that risk decrease and continue to lessen with an increase in blood DHA level. On the other hand, below 5%, Dr. Harris contends, there was an extremely steep risk curve for early preterm birth. For example, those with a 3% DHA level were 10x more likely to have a preterm birth than those above 5%. So being 5% and above, she wrote in her paper, should be the main goal during pregnancy.
Another important study Dr. Harris focused on in establishing the rationale for the Prenatal DHA Test was a meta-analysis of 70 studies in pregnancy where one group was given fish oil during pregnancy and the other a placebo.
The 70 randomized controlled trials (RCTs) analyzed in this updated Cochrane Review involved nearly 20,000 women and asked the same question as the original review, which was published in 2006: Does taking long-chain omega-3s during pregnancy from supplements or food improve pregnancy outcomes and other health outcomes of the babies and their mothers?
The answer: There is strong evidence to suggest that when women take omega-3s during their pregnancy, they can reduce the risk of preterm (before 37 weeks) and early preterm (before 34 weeks) birth by 11% and 42%, respectively. Further, omega-3s can reduce the risk of low birthweight by 10%, as well as perinatal death by 25%.
Both of these studies together supported the need for having a simple, safe blood test for measuring DHA. This way women could know what that level is and adjust their omega-3 DHA intake safely as needed to lower their risk for preterm birth.
INFOGRAPHIC: The Risks of Preterm Birth
How can you raise your omega-3 DHA level easily and safely during pregnancy?
It’s easy and safe to raise your omega-3 DHA level during pregnancy. We know that eating fish during pregnancy is a tricky topic, but there is a lot of research showing that the benefits outweigh the risks. However, it is important to be careful and to understand what kinds of fish are high in EPA and DHA but also low in mercury and other toxins.
The other option is to take supplements, which are safe and non-toxic — and you’ll also know with more certainty how much DHA you are actually taking. If you want to make sure you are getting at least 200 mg of DHA a day, then a supplement is a good option.
The general recommendation for DHA during pregnancy is 200 mg per day on top of your current diet, which some estimate delivers about 100 mg DHA per day – for a total of 300 mg per day. While the American Academy Obstetricians & Gynecologists does not have an official recommendation, organizations like the March of dimes support the 200 mg a day, along with many other medical and scientific bodies across the world. Whether or not 200 mg a day is enough is the big question.
To us at OmegaQuant, it comes down to the blood level. One side of the equation is that most women are not getting to 100 mg per day, much less getting 200 or 300 mg per day during pregnancy. According to the most recent research, most women of childbearing age are getting about 60 mg of DHA a day and less than 1 in 10 takes an omega-3 supplement. In that case, we would not expect their level to be above 5%. So if most women are not meeting even the bare minimum recommendations we have, it is hard to know whether or not we need to increase the recommendation to 600 mg a day vs. making sure women get to the 200 mg or 300 mg recommendation.
The other important piece of the puzzle is personalization, which is where DHA testing plays a very important role in optimizing intake. If someone has a DHA level less than 5%, then we would recommend they take more than someone who is above 5%.
So, for example, if you are below 3%, then we would recommend 900 mg DHA per day throughout pregnancy. If you are between 3-5% — which is the majority of US women — then we would recommend 600 mg DHA per day. If you are above 5%, then it makes sense to maintain 200 mg DHA per day. These recommendation are well within doses that have been studied and shown to be safe for mom and baby. If you make any changes, make sure to re-test in 2-3 months to see how your DHA level has improved.
Is fish the only way to increase your omega-3 DHA during pregnancy?
There is plenty of evidence to show that eating fish is a healthy way to get your omega-3s during pregnancy. However, for some of you there is no amount of data that is going to change your mind when it comes to your comfort level about the risks of eating fish. And also, you just might not have a taste for it.
In that case, it is strongly recommended that you take an omega-3 supplement like fish or algal oil and make sure that it has at least 200 mg of DHA. Whether or not this will increase your blood level is hard to know without testing, so we recommend, if possible, that women who are pregnant or looking to become pregnant take a prenatal DHA test before they get pregnant and then again during the first, second and third trimesters.
Are there vegan options for raising my omega-3 DHA level?
If you are vegetarian and you don’t want to eat fish or take fish oil, DHA that comes from algae might be a good option for you. This is one of the only plant-based options that is vegan, non-toxic and will raise your blood and breast milk DHA levels.
There are other plant-based omega-3 sources like flax, walnuts and chia but they contain an omega-3 called alpha linolenic acid (ALA), which is healthy but it won’t raise your omega-3 DHA levels in blood and breast milk. So during pregnancy and postpartum it is important to take preformed DHA in an algal supplement if you are vegetarian.
What are some tips for picking an omega-3 supplement?
TIP #1 – MAKE SURE YOUR SUPPLEMENT CONTAINS “DHA” OR “DOCOSAHEXAENOIC ACID”
When you are looking for a supplement, look at the “Supplement Facts” panel on the back of the bottle to check the amount of DHA. Make a note of the serving size, which is located at the top of the Supplement Facts panel. Look specifically for either “DHA” or “docosahexaenoic acid” to see how much, based on serving size you are getting for your supplement.
For example, if it says a serving size is two capsules and you are getting 200 mg, then you would need 2 pills per day to reach 200 mg. There are hundreds of omega-3 supplements out there, but the key is making sure you choose the ones that have the long-chain omega-3s, EPA and DHA. If DHA is not listed on the label, then you are not getting this omega-3 in your supplement.
You can also choose a traditional omega-3 fish oil supplement, which contains both EPA and DHA as long as you are able to meet the need of 200 mg per day DHA. DHA can also come from algae, which is what the fish eat to make it themselves. Suffice it to say that you can choose either a pure algal DHA supplement or a fish oil supplement that contains EPA and DHA. But again, make sure you are getting at least 200 mg per day.
TIP #2 – ALWAYS TAKE YOUR OMEGA-3 OR DHA SUPPLEMENT WITH A MEAL
Make sure you take your omega-3 supplement with a meal. DHA is a fat and you want your body to be ready to absorb it because it is a very special kind of fat. If you don’t take it with a meal, then you won’t be able to fully absorb the DHA and as a result your blood level might not change. It is also important to test your level to make sure the supplement you’ve chosen is working for you.
TIP #3 – RESEARCH THE DIFFERENT TYPES OF FORMULATIONS
There are so many different kinds of omega-3 supplement formulations — triglycerides, emulsions, ethyl esters, phospholipids. And all of these play a role in how bioavailable the fat is to YOUR body. One way to make sure the omega-3 fat you are taking is bioavailable to your body is to eat a meal with fat, so that the omega-3 fats you are taking in your supplement can be absorbed. We don’t have an opinion on the different formulations. There are some small differences in the way these types of formulations are absorbed. But at the end of the day, the amount of DHA you are taking in is by far the most important aspect of how much your DHA blood level will go up. And only a Prenatal DHA Test will tell you if what you are taking is delivering a protective amount of DHA.
How often should you take a Prenatal DHA Test?
When you do change your diet based on your test results, it is important to re-test to make sure the changes you made actually impacted your blood level. We recommend re-testing every 2-3 months during pregnancy. For our regular Omega-3 Index test-takers we advise testing every 4-6 months.
In many of the studies we’ve seen where women only started supplementing in their second trimester, it was still enough to have an impact on gestational length and preterm birth. So even if you didn’t take DHA in the first trimester, it’s not too late to start taking it even into the third trimester. It all counts!
What will your Prenatal DHA Test results look like?
When you get your prenatal DHA results report your level will be marked by the blue arrow. If you are below 5%, you will be in the yellow or red zone. If you are 5% or above, then you will land in the green or “desirable” zone, which is ideally where you want to be.
The goal is to know where you are and then re-test after a few months to see if the changes you’ve made have impacted your DHA level, especially if you are below 5%.
How long is omega-3 DHA important for your baby?
Another reason it is so important to take DHA during the last trimester is because this is the time when most of the fat transfer to the baby happens. This is when the baby’s brain really starts to grow and develop. In fact, the baby’s brain and eyes will continue their development well up to 2 years of age and DHA will play a crucial role.
And even after that, omega-3s will continue to be important through your child’s life. So maintaining a diet rich in these nutrients is just as important as making sure they are getting the right vitamins.
How does omega-3 DHA impact breast milk?
Another good reason to take DHA during pregnancy is that your breast milk DHA levels will continue to increase, even postpartum. DHA levels will drop off to meet whatever dietary intake is, but for about 4-6 weeks DHA will transfer to breast milk from women who take fish oil and have higher DHA levels during pregnancy. Breast milk DHA levels can also be measured using our Mother’s Milk DHA test.
How can you make sure your omega-3 DHA levels remain optimal after birth?
You can measure DHA in your breast milk by using our Mother’s Milk DHA Test. DHA levels are known to go down in the blood after pregnancy because of the recovery from birth and pregnancy, as well as the fact that DHA goes into your breast milk.
DHA is important postpartum to restore your blood levels and also to make sure that you are delivering an optimal amount through your breast milk to your growing baby.
Who can you talk to about DHA testing?
If you ordered a test online on your own you should share this with your doctor, especially if you plan to make any dietary changes or take supplements during your pregnancy. Fish is a very low risk intervention as are supplements, however, it is always important to check with your doctor so they are aware what changes you are making. And who knows, you just might teach them something about DHA and pregnancy.