Pregnancy is associated with a reduction in maternal serum docosahexaenoic acid (DHA, 22:6 n-3) percentage and its possible depletion in the maternal store. Since the synthesis of long chain polyunsaturated fatty acids (LCPUFA) in the fetus and placenta is low, both the maternal LCPUFA status and placental function are critical for their supply to the fetus. Maternal supplementation with DHA up to 1 g/d or 2·7 g n-3 LCPUFA did not have any harmful effect. DHA supplementation in large studies slightly the enhanced length of gestation (by about 2 days), which may increase the birth weight by about 50 g at delivery. However no advice can be given on their general using to avoid preterm deliveries in low or high risk pregnancies. Several studies, but not all, reported improvements of the offspring in some neurodevelopmental tests as a result of DHA supplementation during gestation, or, at least, positive relationships between maternal or cord serum DHA percentages and cognitive skills in young children. The effect seems more evident in children with low DHA proportions, which raises the question of how to identify those mothers who might have a poor DHA status and who could benefit from such supplementation. Most studies on the effects of n-3 LCPUFA supplementation during pregnancy on maternal depression were judged to be of low-to-moderate quality, mainly due to small sample sizes and failure to adhere to Consolidated Standards of Reporting Trials guidelines. In contrast, the effects of n-3 LCPUFA supplementation on reducing allergic diseases in offspring are promising.

The condition of low birth weight is compared in twins and in singletons in terms of birth weight distributions and with respect to factors such as the incidence of sillbirths, length of gestation, maternal age, parity, and legitimacy. In the light of demographic, biological, and developmental considerations, it is concluded that low birth weight in twins is a different condition from low birth weight in singletons and should be dealt with independently, especially in view of the different implications for child growth and survival.

Birthweight was measured on 188 monochorionic monozygotic, 54 dichorionic monozygotic, 102 like-sexed dizygotic, and 94 unlike-sexed dizygotic liveborn twin pairs. Overall, males were found to be significantly heavier than females. These differences were not significant, however, when birthweights were compared within zygosity/chorion-type categories. Males were also characterized by a slightly greater overall total variance. Comparisons of intrapair variation of monochorionic and dichorionic monozygotic twins revealed significant differences between monochorionic pairs and dichorionic separate pairs and no significant differences between monochorionic pairs and dichorionic fused pairs. The results of this study suggest that placental proximity may have as important an influence on variation in birthweight as does the presence or absence of vascular anastomoses.