Inadequate dietary α-linolenic acid intake among Indonesian pregnant women is associated with lower newborn weights in urban Jakarta.

Key Findings:

Studies on maternal dietary intake of omega-3 fatty acids in developing countries have been limited. Women living in urban areas in developing countries, including Indonesia, may have poor food patterns. Low intake of meat, fish, and eggs has been observed among pregnant women in urban areas. This food pattern may predispose pregnant women to the development of crucial nutrient deficiencies such as omega-3 FAs. The present study revealed that low ALA intake among Indonesian pregnant women was significantly associated with lower weight in newborns after adjustment for maternal energy intake, gestational age, MUAC, height, Hb level, and delivery mode. A  limitation existed regarding infant birth length data, which relied on assessment by midwives. The findings suggest that insufficient dietary intake of omega-3 FAs, particularly ALA, by Indonesian pregnant women during the third trimester is associated with lower birth weight in newborns. Further investigation on the effect of omega-3 FAs on birth size is required.

ABSTRACT

BACKGROUND:  Omega-3 fatty acid intake during pregnancy has been confirmed to affect newborn birth outcomes in the developed world. However, the association between maternal omega-3 fatty acid intake and birth size is unknown in developing countries. OBJECTIVE: To examine the association of maternal omega-3 fatty acid intake with newborn birth size. METHODS AND STUDY DESIGN: A cross-sectional study was conducted, involving 282 pregnant women aged 19-40 years who had a gestational age of >32 weeks and received antenatal care at 10 health centres and one referral hospital in East Jakarta, Indonesia. Maternal habitual intake of omega-3 fatty acids, including α-linolenic acid, docosahexaenoic acid, and eicosapentaenoic acid, was assessed using a semiquantitative food frequency questionnaire. Birth weight and head circumference were measured using a paediatric weighing scale and tape, respectively, and birth length was obtained from medical records. Multiple linear regression analysis was performed to provide adjusted associations. RESULTS:  The median total intake of omega-3 fatty acids, docosahexaenoic acid, eicosapentaenoic acid, and α-linolenic acid was lower than the recommended dietary intake. The newborns of mothers with an α-linolenic acid intake lower than 0.82 g/d had a significantly lower (β=114, 95% confidence interval=-216, -13.5; p=0.014) weight compared with those of mothers with high α-linolenic acid intake, after adjustment for confounding factors. CONCLUSION:  Inadequate maternal intake of α-linolenic acid, but not omega-3 fatty acids, docosahexaenoic acid, or eicosapentaenoic acid, was associated with lower birth weight. Enhanced promotion of consumption of foods rich in essential fatty acids during pregnancy may facilitate attaining optimal infant weight in urban areas.