Julvez
J
,
Mendez
M
,
Fernandez-Barres
S
, et al
.
Maternal consumption of seafood in pregnancy and child neuropsychological development: a longitudinal study based on a population with high consumption levels
.
Am J Epidemiol
.
2016
;
183
(
3
):
169
182
; doi:
https://doi.org/10.1093/aje/kwv195

Investigators from the Spanish Childhood and Environment Project (SCEP), a multicenter cohort study investigating associations between environmental exposures and childhood outcomes, evaluated the impact of prenatal seafood consumption on neuropsychological outcomes of children born during 2004–2008. Investigators enrolled pregnant women during first trimester prenatal visits and followed their newborns until age 5 years.

The primary exposure was prenatal seafood intake (measured in g/week) as assessed by food frequency questionnaires (FFQ) completed by participants at 10–13 weeks and 28–32 weeks of pregnancy. Investigators also assessed seafood type (classified as large fatty fish, smaller fatty fish, lean fish, shellfish, or smoked/salted fish) through FFQ and sampled cord blood for mercury and concentration of total fatty acids (TFA). The primary outcome was child neuropsychological development at 14 months old, using the Bayley Scales of Infant Development, and at 5 years old, with the McCarthy Scales of Children’s Abilities and Childhood Asperger Syndrome Test. Investigators determined the correlation between seafood type and cord-blood mercury and TFA. They also assessed the difference in neuropsychological scores (with increased scores for the Bayley and McCarthy Scales and reduced scores for the Asperger test being desirable) for each 10 g/week increase in both total seafood consumption and specific seafood type after controlling for sociodemographic characteristics and other confounders.

There were 1,892 and 1,589 participants included in analysis at the child ages of 14 months and 5 years, respectively. The average prenatal seafood consumption by mothers was 498 g/week (approximately 3 servings/week). Consumption of large fatty fish was most correlated with cord-blood mercury and TFA.

Overall, a 10 g/week increase in total seafood consumption was associated with a 0.02 increase in Bayley Scale scores at 14 months (95% CI, 0 to 0.05), with lean fish having the most positive association (.03; 95% CI, 0 to 0.07). A similar association was observed between total seafood consumption and McCarthy Scale scores at 5 years of age (.02; 95% CI, 0 to 0.05), with large fatty fish having the most positive association (.06; 95% CI; 0 to 0.13). Total seafood consumption was associated with reduced scores on the Childhood Asperger Syndrome Test at 5 years (−0.01; 95% CI, −0.01 to 0), with large fatty fish associated with the largest score reduction (−0.02; 95% CI, −0.04 to 0).

The authors conclude that there is moderate improvement in child neuropsychological outcomes with increased prenatal seafood consumption.

Dr Wagner has disclosed no financial relationship relevant to this commentary. This commentary does not contain a discussion of an unapproved/investigative use of a commercial product/device.

The impact of environmental exposures during fetal life and childhood on neurodevelopmental outcomes remains a heavily investigated field within pediatrics. Although the benefit of prenatal seafood consumption has...

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