ArticlesMaternal seafood consumption in pregnancy and neurodevelopmental outcomes in childhood (ALSPAC study): an observational cohort study
Introduction
Optimum fetal neurodevelopment is dependent on specific nutrients derived solely from dietary sources, including docosahexaenoic acid (DHA), an omega-3 essential fatty acid, of which seafood is a major source.1 Low seafood intake during pregnancy could lead to fetal deficiency in essential long-chain omega-3 fatty acids such as DHA and eicosapentaenoic acid, (EPA) resulting in adverse effects on neurodevelopment.2 DHA deficiency leads to reduced dendritic arborisation3 and impaired gene expression for regulation of neurogenesis, neurotransmission, and connectivity.4 In severe conditions of DHA deprivation, such as Zellweger disease and peroxisomal disorders, mental retardation is common, yet restoration of dietary DHA intake improves clinical outcomes and neuronal myelination.5, 6, 7
In 2004, advice8 was issued jointly by two US Federal Government agencies for pregnant women or women likely to become pregnant to restrict their overall consumption of seafood to 340 g per week,8 to avoid fetal exposure to trace amounts of neurotoxins. However, such control of seafood consumption could cause intake of long-chain omega-3 fatty acids to fall below quantities adequate for best fetal neurodevelopment.9, 10 We analysed an observational cohort study, the Avon Longitudinal Study of Parents and Children (ALSPAC), to assess whether the advice is successful in providing protection from adverse neurodevelopmental outcomes.
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Methods
ALSPAC was designed to assess environmental factors (including diet) during and after pregnancy that might affect the development, health, or wellbeing of the child. All pregnant women living in Bristol, UK, and surrounding areas, with an expected delivery date between April 1, 1991 and Dec 31, 1992 were eligible for inclusion.11 Of 14 541 pregnancies, 13 988 children survived for at least 12 months. About 85% of eligible expectant mothers participated; recruitment, dropout, and other
Results
Maternal seafood consumption ranged from 0 to 3268 g per week (mean 235 g per week, SD 202), resulting in estimated intakes of omega-3 fatty acids from seafood ranging from 0 to 15·6 g per week, (mean 1·06 g per week, SD 1·05). In total 12% of women were eating no fish during pregnancy, 65% 1–340 g per week, and 23% more than 340 g per week.
As shown in table 1, low seafood consumption by mothers was more likely in homes with evidence of social disadvantage (high level of family adversity,
Discussion
The information obtained in ALSPAC shows no evidence that consumption of more than three portions of seafood a week during pregnancy has an adverse effect on the behaviour or development of the child. By contrast, maternal consumption of more than 340 g seafood a week was beneficial for the child's neurodevelopment. These results were unexpected since the 2004 advisory8 was formulated on the basis of an assessment of development in the verbal domain, the Boston naming test.29 The relevant
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