Feasibility, Implementation And Early Adoption Of An Omega-3 Test-And-Treat Program To Reduce Preterm Birth

ObjectiveTo evaluate the feasibility and early adoption of the Omega-3 Test-and-Treat Program, a targeted intervention to reduce preterm birth in women with low omega-3 levels, implemented within routine antenatal care. DesignA prospective implementation study using the Quality Enhancement Research Initiative (QUERI) framework, conducted between April 19, 2021, and June 30, 2022. SettingAntenatal care settings in South Australia, leveraging the South Australia (SA) Pathology, South Australian Serum Antenatal Screening (SAMSAS) program. ParticipantsPregnant women with singleton pregnancies <20 weeks gestation undergoing antenatal screening and healthcare providers responsible for ordering and facilitating omega-3 testing. InterventionA structured program to identify women with low omega-3 levels in early pregnancy and provide evidence-based supplementation guidance to reduce the risk of preterm birth. Main Outcome MeasuresProgram feasibility (uptake and fidelity), representativeness of early adopters compared to the broader population, adherence to program criteria (singleton pregnancies <20 weeks gestation), and omega-3 status distribution. ResultsA total of 4,801 omega-3 tests were reported by SA Pathology, with consistent uptake over time. Women tested were demographically and clinically comparable to those not tested. Among early adopters, 702 (14.7%) had low, 1,638 (34.2%) moderate, and 2,442 (51.1%) sufficient omega-3 levels. Program fidelity was high across 5057 omega-3 lab samples with 4,935 (97.6%) analysed within the standard 72-hour timeframe. Adherence to testing criteria was strong, with only 33 (0.7%) samples from pregnancies >20 weeks and 58 (1.2%) from multiple pregnancies. ConclusionEarly evaluations show the Omega-3 Test-and-Treat Program is feasible and integrates effectively into routine antenatal care. This real-world approach demonstrates strong potential to reduce preterm birth rates through targeted nutritional intervention, supporting its scalability and broader implementation. SUMMARY BOXThe known: Preterm birth is a leading cause of infant morbidity and mortality. Omega-3 supplementation reduces preterm birth risk in women with low omega-3 levels, yet no standardised protocol exists for identifying and treating omega-3 levels during pregnancy. The new: The Omega-3 Test and Treat Program is feasible, integrates effectively into routine antenatal care, and has broad reach, with maternal characteristics of tested women consistent with those not tested. The implications: This scalable program has the potential to reduce preterm birth rates. Strong early adoption, high fidelity, and community engagement highlight its potential for broader implementation.