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Comment & Response
January 14, 2019

Fish Consumption During Pregnancy

Author Affiliations
  • 1Department of Public Health, University of Southern Denmark, Odense, Denmark
  • 2Department of Environmental Health, Harvard School of Public Health, Boston, Massachusetts
  • 3Institute of Human Nutrition, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York
  • 4Department of Environmental Health and Engineering, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
JAMA Pediatr. 2019;173(3):292. doi:10.1001/jamapediatrics.2018.4920

To the Editor Bramante et al1 encourage greatly increased fish consumption by pregnant women, stressing the neurodevelopmental benefits of nutrients in fish. We agree that a pregnant woman’s fish choices can benefit the developing brain and that health professionals should provide advice on healthy seafood intake.

The authors dismiss concerns about methylmercury (MeHg) exposure from eating fish as “unjustified fears.”1 However, adverse effects of MeHg on brain development are well established and can occur in children whose mothers eat ordinary amounts of fish (see Groth2 for a review of that literature). Since 2005, more than a dozen epidemiologic studies have associated adverse effects as large as or larger than beneficial effects of fish nutrients with greater-than-average MeHg exposure from fish consumption.

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