Seafood consumption in pregnancy, from policy to plate

The possible combinations of matters related to fish consumption are many, but few, if any, fish consumption patterns optimize all domains.  In this talk, I will summarize the issue of fish consumption choice, with a focus on pregnancy and early childhood.  

I will also present results from an observational analysis of fish consumption during pregnancy and childhood cognition.  1999-2002 we enrolled pregnant women into a prospective cohort, and followed their children since.  At 24-28 weeks gestation we estimated maternal fish intake using a semiquantitative food frequency questionnaire and collected blood. We assayed stored erythrocytes for total Hg and plasma for fatty acids including n-3 docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA). In mid-childhood we administered the Kauffman Brief Intelligence Test (KBIT) to children.  We performed multivariable linear regression analyses adjusting for maternal and child characteristics including home environment and maternal IQ. 

Finally, I will discuss results from a pilot randomized trial, in which we recruited 51 women in the greater Boston, MA area at 12–22 weeks gestation who consumed <=2 fish servings/month. We randomized participants to 3 arms: Advice to consume low-mercury/high-DHA fish (n=18); Advice + grocery store gift cards (GC) to purchase fish (n=17); or Control messages (n=20). At baseline and 12-week follow-up we estimated intake of fish, DHA and mercury using a 1-month fish intake food frequency questionnaire, and measured plasma DHA and blood and hair total mercury.  We found that the educational intervention successfully increased consumption of fish and DHA but not mercury.