(OR18-03-26) Integration of a Brief DHA Food Frequency Questionnaire in the Electronic Medical Record and Associations With Preterm Birth in a Clinical Prenatal Population

Objectives: Docosahexaenoic acid (DHA) intake during pregnancy is associated with reduced risk of preterm birth, particularly among women with low intake in early pregnancy. However, routine assessment of DHA intake in clinical care is uncommon. A brief 7-question DHA food frequency questionnaire (DHA FFQ) has been validated to estimate DHA intake and correlates with red blood cell DHA status. We integrated this questionnaire into the electronic medical record (EMR) at the University of Kansas Medical Center to evaluate associations between DHA intake and gestational age outcomes in a clinical prenatal population. The objective of this study is to examine early preterm birth (EPTB; < 34 weeks) and preterm birth (PTB; < 37 weeks) rates according to maternal DHA intake using an EMR-based dietary screening tool.

Methods: We conducted an observational cohort study of prenatal patients utilizing an electronic 7-question DHA FFQ integrated into the EMR. Data were extracted from the Healthcare Enterprise Repository for Ontological Narration (HERON) clinical data repository. After removing duplicate records and multiple gestations, 3,610 unique pregnancies were captured since the DHA FFQ implementation in July 2023. DHA intake was categorized as < 150 mg/day or ≥150 mg/day based on DHA FFQ responses. Gestational age outcomes were categorized as EPTB, PTB, and full term (≥37weeks). Associations were assessed using chi-square tests

Results: Among 3,610 pregnancies, 118 (3.27%) resulted in EPTB and 331 (12.44%) in PTB. Women reporting DHA intake < 150 mg/day had higher PTB rates compared with ≥150 mg/day (13.78% vs 10.94%, p=0.0098). EPTB rates were also higher among women with lower DHA intake (3.47% vs 3.04%; NS). Prenatal DHA supplement use alone was associated with lower PTB rates compared with no DHA supplement use (11.09% vs 14.46%; p=0.0026).

Conclusions: Integration of a brief DHA FFQ into the EMR is feasible in routine prenatal care and enables population-level monitoring of maternal DHA intake. Lower DHA intake ( < 150 mg/day) was associated with higher preterm birth rates, supporting the potential value of rapid dietary screening to identify women who may benefit from targeted nutritional interventions during pregnancy.

Funding Sources: None