Analysis reveals big costs savings for DHA supplements during pregnancy

Data from the "DHA to Optimize Mother and Infant Outcome" (DOMInO) trial indicated that DHA supplementation was associated with 15% lower rates of pre-term births, and this could result in significant in-patient hospital cost savings.

A regression analysis by Professor Maria Makrides’ group at Adelaide University showed that DHA supplementation may generate annual costs savings to the Australian public hospital system of AUS$15-51 million (US$11-37 million).

“There is now an ongoing debate on whether the consumption of adequate amounts of omega-3 fatty acids, especially DHA, during pregnancy and breastfeeding, is associated with improvements in maternal and infant health,”​ wrote the researchers in Prostaglandins, Leukotrienes and Essential Fatty Acids​​.

“Given that the cost of the fish oil supplement is small, if relatively simple interventions like DHA-rich fish-oil supplementation during pregnancy can generate cost savings from a public policy perspective, it may be worthwhile considering implementing programs that encourage DHA supplementation among pregnant women.”​

Analysis details​

The DOMInO trial involved 2,399 women pregnant with only one baby at less than 20 weeks gestation. The women were randomly assigned to receive DHA-rich fish oil capsules (800 mg/d of DHA) or matched vegetable oil capsules without DHA until the birth of their children.

The study found that the number of early pre-term birth cases was reduced by 15% for the DHA group compared to the control group, and that DHA supplementation provided a 50% chance of avoiding an additional premature birth.

The new econometric analysis found that DHA supplements during pregnancy may decrease in-patient hospital costs by an average of AU$92 (US$67) for singleton pregnancies. For 163,500 singleton pregnancies per year, this would extrapolate to a total potential cost savings to the Australian public hospital system of AUS$15-51 million per year (US$11-37 million per year).

Longer term benefits​

The researchers noted that they did not factor in the longer term benefits of DHA supplementation during pregnancy for healthcare or social costs.

“The study found that there was a 15% reduction in early pre-term birth through DHA supplementation during pregnancy. Given that pre-term births could have long term complications, this study may understate the actual cost effectiveness of DHA supplementation,”​ they wrote.

“Additionally, the DOMInO trial sample only included patients that attended public hospitals and therefore, as a robustness check, it would be useful to expand this study to private hospital patients as well. ​

“Lastly, although there is a general consensus that DHA contributes to improved pregnancy and birth outcomes, there is a lack of agreement on the optimal dose of DHA supplementation. The benefits observed here relate to dose used in the DOMInO trial and further studies will need to determine if similar cost savings can be achieved with other doses. ​

“Policy makers will ultimately need to quantify the cost of providing or subsidizing DHA supplements for women separately or together with other supplements, such as folic acid, relative to the savings and improved pregnancy and birth outcomes that potentially result from such supplementation.”​

The paper’s authors were affiliated with the Women’s and Children’s Health Research Institute (North Adelaide), the South Australian Health and Medical Research Institute (Adelaide), the University of Adelaide, the Women's and Children's Health Network, and Joondalup Health Campus (Perth).

Source: Prostaglandins, Leukotrienes and Essential Fatty Acids​​
Volume 102-103, Pages 5-11, doi: 10.1016/j.plefa.2015.08.002
“Analysis of hospital cost outcome of DHA-rich fish-oil supplementation in pregnancy: Evidence from a randomized controlled trial”​
Authors: S. Ahmed, et al.