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Seafood consumption in pregnancy and infant size at birth: results from a prospective Spanish cohort
  1. Michelle A Mendez1,2,3,
  2. Estel Plana1,2,3,
  3. Mònica Guxens1,2,3,
  4. Carles M Foradada Morillo4,
  5. Rosa Martorell Albareda5,
  6. Raquel Garcia-Esteban1,2,3,
  7. Fernando Goñi3,6,
  8. Manolis Kogevinas1,2,3,7,
  9. Jordi Sunyer1,2,3,8
  1. 1Center for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
  2. 2Municipal Institute of Medical Research (IMIM-Hospital del Mar), Barcelona, Spain
  3. 3CIBER Epidemiologia y Salud Pública (CIBERESP), Spain
  4. 4Hospital Parc Taulí, Sabadell, Spain
  5. 5Hospital de Terrassa, Terrassa, Spain
  6. 6Laboratorio de Salud Pública de Guipúzcoa, San Sebastián, Spain
  7. 7Medical School, University of Crete, Heraklion, Greece
  8. 8Universitat Pompeu Fabra, Barcelona, Spain
  1. Correspondence to Michelle A Mendez, CREAL-Centre for Research in Environmental Epidemiology, Barcelona Biomedical Research Park, Dr Aiguader, 88/Barcelona, Spain 08003; mmendez{at}


Background Studies on maternal seafood consumption during pregnancy and the risk of small for gestational age (SGA) births have yielded inconsistent results. As few studies have examined associations with specific seafood subtypes or accounted simultaneously for exposure to persistent organic pollutants (POPs), it is uncertain to what extent intakes of seafood subtypes with variable contaminant or fatty acid content may explain these inconsistencies.

Methods A cohort of 657 women recruited during the first trimester of pregnancy from a Mediterranean area with high seafood intakes was followed through birth. Dietary intakes were estimated using a validated questionnaire. Multivariable logistic regression was used to estimate associations between SGA and intakes of fatty fish, lean fish, canned tuna, crustaceans and other shellfish, adjusting for parity, child sex, parental anthropometry, socio-economic factors and serum levels of several POPs, including several polychlorinated biphenyls (PCBs), hexachlorobenzene (HCB) and dichlorodiphenyldichloroethylene (DDE).

Results Overall, 7.8% of infants were SGA. Maternal consumption of crustaceans (more than once/week) and canned tuna (more than once/week was associated with a significantly increased risk of SGA. Fatty fish (more than once/week) was associated with weaker and generally non-significant increases in risk, while lean fish and other shellfish were not associated with SGA. Adjusting for contaminants did not meaningfully change results.

Conclusions Higher maternal intakes of crustaceans and canned tuna, but not other types of seafood, were associated with increased risk of SGA independently of several POPs. Future studies exploring seafood subtypes and additional contaminants are needed to determine whether these associations are causal and identify mechanisms involved.

  • Small for gestational age
  • birth weight
  • seafood
  • pregnancy
  • organochlorine compounds
  • nutrition
  • perinatal epidemiology

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  • Funding Spanish Ministry of Health (FIS-FIS-PI041436), Instituto de Salud Carlos III (Red INMA G03/176 and CB06/02/0041), the Generalitat de Catalunya-CIRIT 1999SGR 00241, and the European Union sixth framework project EARNEST FOOD-CT-2005-007036.

  • Competing interests None.

  • Ethics approval Ethics approval was provided by the IMIM-IMAS (Instituto Municipal de Investigación Medica-Instituto Municipal de Asistencia Sanitaria) ethics review committee.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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