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Seafood Choices: Balancing Benefits and Risks
Part I: Benefits to Women, Infants, and Young Children Associated with Omega-3 Fatty Acids
BENEFITS TO WOMEN DURING AND AFTER PREGNANCY
An array of studies based on supplemental intake of EPA/DHA or biochemical indicators of EPA/DHA levels has been carried out to determine whether there is an association between increased intake or blood levels of EPA/DHA and decreased incidence of or risk for preeclampsia (Olsen and Secher, 1990; Schiff et al., 1993; Williams et al., 1995; Velzing-Aarts et al., 1999; Clausen et al., 2001). Because these and other studies, including randomized clinical trials (Bultra-Ramakers et al., 1995; Onwude et al., 1995; Salvig et al., 1996) or reviews of trials (Sibai, 1998) did not show clear evidence of a beneficial effect of a broad range of intake (or biochemical indicators) of EPA/DHA levels, it does not appear likely that increased seafood intake or fish-oil supplementation will reduce the incidence of preeclampsia among US women (see Appendix Table B-1a).
During pregnancy and lactation there is a correspondent transfer of DHA from the mother to the fetus or infant (Holman et al., 1991; Al et al., 1995). Following pregnancy and lactation, maternal DHA blood levels may require many months for recovery to pre-pregnancy levels (Otto et al., 2001). Although prior depressive illness is the best predictor of higher risk for postpartum depression, it has been proposed that low DHA levels in the brain in late pregnancy and early postpartum period may contribute to the emergence of postpartum depression (Hibbeln and Salem, 1995). Further, it has been hypothesized that increased EPA/DHA intake during pregnancy could reduce the risk for postpartum depression. To date, however, there have been no randomized controlled trials or controlled clinical studies testing whether increased omega-3 fatty acid intake by pregnant women could reduce the risk for postpartum depression.
Hibbeln (2002) conducted a cross-cultural review of 41 studies and concluded that there is an association between increased seafood consumption and higher maternal milk DHA levels (p<0.006) and that this was associated with a lower prevalence of postpartum depression (p<0.0001). Timonen et