Fish Intake in Pregnancy and Child Growth: A Pooled Analysis of 15 European and US Birth Cohorts | Child Development | JAMA Pediatrics | JAMA Network
[Skip to Navigation]
Access to paid content on this site is currently suspended due to excessive activity being detected from your IP address 34.204.186.91. Please contact the publisher to request reinstatement.
1.
Symonds  ME, Sebert  SP, Hyatt  MA, Budge  H.  Nutritional programming of the metabolic syndrome.  Nat Rev Endocrinol. 2009;5(11):604-610.PubMedGoogle ScholarCrossref
2.
Ailhaud  G, Guesnet  P, Cunnane  SC.  An emerging risk factor for obesity: does disequilibrium of polyunsaturated fatty acid metabolism contribute to excessive adipose tissue development?  Br J Nutr. 2008;100(3):461-470.PubMedGoogle ScholarCrossref
3.
Casals-Casas  C, Desvergne  B.  Endocrine disruptors: from endocrine to metabolic disruption.  Annu Rev Physiol. 2011;73:135-162.PubMedGoogle ScholarCrossref
4.
Grün  F, Blumberg  B.  Endocrine disrupters as obesogens.  Mol Cell Endocrinol. 2009;304(1-2):19-29.PubMedGoogle ScholarCrossref
5.
Fish: what pregnant women and parents should know: draft updated advice by FDA and EPA. June 2014. http://www.fda.gov/Food/FoodborneIllnessContaminants/Metals/ucm393070.htm. Accessed August 4, 2015.
6.
Leventakou  V, Roumeliotaki  T, Martinez  D,  et al.  Fish intake during pregnancy, fetal growth, and gestational length in 19 European birth cohort studies.  Am J Clin Nutr. 2014;99(3):506-516.PubMedGoogle ScholarCrossref
7.
Donahue  SMA, Rifas-Shiman  SL, Gold  DR, Jouni  ZE, Gillman  MW, Oken  E.  Prenatal fatty acid status and child adiposity at age 3 y: results from a US pregnancy cohort.  Am J Clin Nutr. 2011;93(4):780-788.PubMedGoogle ScholarCrossref
8.
van den Berg  SW, Wijga  AH, van Rossem  L,  et al.  Maternal fish consumption during pregnancy and BMI in children from birth up to age 14 years: the PIAMA cohort study [published online April 18, 2015].  Eur J Nutr. 2015.doi:10.1007/s00394-015-0901-6. PubMedGoogle Scholar
9.
Stratakis  N, Gielen  M, Chatzi  L, Zeegers  MP.  Effect of maternal n-3 long-chain polyunsaturated fatty acid supplementation during pregnancy and/or lactation on adiposity in childhood: a systematic review and meta-analysis of randomized controlled trials.  Eur J Clin Nutr. 2014;68(12):1277-1287.PubMedGoogle ScholarCrossref
10.
World Health Organization Multicentre Growth Reference Study Group.  WHO Child Growth Standards: Length/Height-for-Age, Weight-for-Age, Weight-for-Length, Weight-for-Height and Body Mass Index-for-Age: Methods and Development. Geneva, Switzerland: World Health Organization; 2006.
11.
de Onis  M, Onyango  AW, Borghi  E, Siyam  A, Nishida  C, Siekmann  J.  Development of a WHO growth reference for school-aged children and adolescents.  Bull World Health Organ. 2007;85(9):660-667.PubMedGoogle ScholarCrossref
12.
Monteiro  PO, Victora  CG.  Rapid growth in infancy and childhood and obesity in later life—a systematic review.  Obes Rev. 2005;6(2):143-154.PubMedGoogle ScholarCrossref
13.
Karaolis-Danckert  N, Buyken  AE, Bolzenius  K, Perim de Faria  C, Lentze  MJ, Kroke  A.  Rapid growth among term children whose birth weight was appropriate for gestational age has a longer lasting effect on body fat percentage than on body mass index.  Am J Clin Nutr. 2006;84(6):1449-1455.PubMedGoogle Scholar
14.
Barlow  SE; Expert Committee.  Expert committee recommendations regarding the prevention, assessment, and treatment of child and adolescent overweight and obesity: summary report.  Pediatrics. 2007;120(suppl 4):S164-S192.PubMedGoogle ScholarCrossref
15.
Howards  PP, Schisterman  EF, Poole  C, Kaufman  JS, Weinberg  CR.  “Toward a clearer definition of confounding” revisited with directed acyclic graphs.  Am J Epidemiol. 2012;176(6):506-511.PubMedGoogle ScholarCrossref
16.
Textor  J, Hardt  J, Knüppel  S.  DAGitty: a graphical tool for analyzing causal diagrams.  Epidemiology. 2011;22(5):745.PubMedGoogle ScholarCrossref
17.
Higgins  JP, Thompson  SG.  Quantifying heterogeneity in a meta-analysis.  Stat Med. 2002;21(11):1539-1558.PubMedGoogle ScholarCrossref
18.
Gluckman  P, Nishtar  S, Armstrong  T.  Ending childhood obesity: a multidimensional challenge.  Lancet. 2015;385(9973):1048-1050.PubMedGoogle ScholarCrossref
19.
Stettler  N.  Nature and strength of epidemiological evidence for origins of childhood and adulthood obesity in the first year of life.  Int J Obes (Lond). 2007;31(7):1035-1043.PubMedGoogle ScholarCrossref
20.
Massiera  F, Saint-Marc  P, Seydoux  J,  et al.  Arachidonic acid and prostacyclin signaling promote adipose tissue development: a human health concern?  J Lipid Res. 2003;44(2):271-279.PubMedGoogle ScholarCrossref
21.
Gonzalez-Casanova  I, Stein  AD, Hao  W,  et al.  Prenatal supplementation with docosahexaenoic acid has no effect on growth through 60 months of age.  J Nutr. 2015;145(6):1330-1334.PubMedGoogle ScholarCrossref
22.
Moon  RJ, Harvey  NC, Robinson  SM,  et al; SWS Study Group.  Maternal plasma polyunsaturated fatty acid status in late pregnancy is associated with offspring body composition in childhood.  J Clin Endocrinol Metab. 2013;98(1):299-307.PubMedGoogle ScholarCrossref
23.
Rytter  D, Bech  BH, Halldorsson  T,  et al.  No association between the intake of marine n-3 PUFA during the second trimester of pregnancy and factors associated with cardiometabolic risk in the 20-year-old offspring.  Br J Nutr. 2013;110(11):2037-2046.PubMedGoogle ScholarCrossref
24.
Standl  M, Thiering  E, Demmelmair  H, Koletzko  B, Heinrich  J.  Age-dependent effects of cord blood long-chain PUFA composition on BMI during the first 10 years of life.  Br J Nutr. 2014;13:1-8.PubMedGoogle ScholarCrossref
25.
de Vries  PS, Gielen  M, Rizopoulos  D,  et al.  Association between polyunsaturated fatty acid concentrations in maternal plasma phospholipids during pregnancy and offspring adiposity at age 7: the MEFAB cohort.  Prostaglandins Leukot Essent Fatty Acids. 2014;91(3):81-85.PubMedGoogle ScholarCrossref
26.
Turyk  ME, Bhavsar  SP, Bowerman  W,  et al.  Risks and benefits of consumption of Great Lakes fish.  Environ Health Perspect. 2012;120(1):11-18.PubMedGoogle ScholarCrossref
27.
Mozaffarian  D, Rimm  EB.  Fish intake, contaminants, and human health: evaluating the risks and the benefits.  JAMA. 2006;296(15):1885-1899.PubMedGoogle ScholarCrossref
28.
Ibrahim  MM, Fjære  E, Lock  EJ,  et al.  Chronic consumption of farmed salmon containing persistent organic pollutants causes insulin resistance and obesity in mice.  PLoS One. 2011;6(9):e25170.PubMedGoogle ScholarCrossref
29.
Sood  R, Zehnder  JL, Druzin  ML, Brown  PO.  Gene expression patterns in human placenta.  Proc Natl Acad Sci U S A. 2006;103(14):5478-5483.PubMedGoogle ScholarCrossref
30.
Gabory  A, Ferry  L, Fajardy  I,  et al.  Maternal diets trigger sex-specific divergent trajectories of gene expression and epigenetic systems in mouse placenta.  PLoS One. 2012;7(11):e47986.PubMedGoogle ScholarCrossref
31.
Tarrade  A, Panchenko  P, Junien  C, Gabory  A.  Placental contribution to nutritional programming of health and diseases: epigenetics and sexual dimorphism.  J Exp Biol. 2015;218(Pt 1):50-58.PubMedGoogle ScholarCrossref
32.
Streuling  I, Beyerlein  A, Rosenfeld  E, Schukat  B, von Kries  R.  Weight gain and dietary intake during pregnancy in industrialized countries–a systematic review of observational studies.  J Perinat Med. 2011;39(2):123-129.PubMedGoogle ScholarCrossref
33.
Stuebe  AM, Oken  E, Gillman  MW.  Associations of diet and physical activity during pregnancy with risk for excessive gestational weight gain.  Am J Obstet Gynecol. 2009;201(1):58.e1-58.e8.PubMedGoogle ScholarCrossref
34.
Boeke  CE, Oken  E, Kleinman  KP, Rifas-Shiman  SL, Taveras  EM, Gillman  MW.  Correlations among adiposity measures in school-aged children.  BMC Pediatr. 2013;13:99.PubMedGoogle ScholarCrossref
Original Investigation
April 2016

Fish Intake in Pregnancy and Child Growth: A Pooled Analysis of 15 European and US Birth Cohorts

Author Affiliations
  • 1Department of Social Medicine, Faculty of Medicine, University of Crete, Heraklion, Greece
  • 2Section of Complex Genetics, Department of Genetics and Cell Biology, NUTRIM School of Nutrition and Translational Research in Metabolism, Faculty of Health, Medicine and Life Sciences, Maastricht University Medical Centre+, Maastricht, Netherlands
  • 3Obesity Prevention Program, Harvard Pilgrim Health Care Institute, Department of Population Medicine, Harvard Medical School, Boston, Massachusetts
  • 4Department of Clinical Epidemiology, Predictive Medicine and Public Health, University of Porto Medical School, Porto, Portugal
  • 5Epidemology Research Unit, Institute of Public Health, University of Porto, Porto, Portugal
  • 6Public Health Division of Gipuzkoa, Basque Government; Health Research Institute, Biodonostia, San Sebastián, Spain
  • 7Centros de Investigación Biomédica en Red Epidemiología y Salud Pública, Spain
  • 8Centre for Research in Epidemiology and Biostatistics Paris Sorbonne Cité, Institut National de la Santé et de la Recherche Médicale, Early Origin of the Child Development and Health Team, Villejuif, France
  • 9Université Paris Descartes, Villejuif, France
  • 10Norwegian Institute of Public Health, Oslo, Norway
  • 11Department of Epidemiology, Lazio Regional Health System, Rome, Italy
  • 12Generation R Study Group, Department of Epidemiology, Erasmus University Medical Centre, Rotterdam, Netherlands
  • 13Institute for Risk Assessment Sciences, Utrecht University, Utrecht, Netherlands
  • 14Environmental Risk and Health, Flemish Institute for Technological Research, Mol, Belgium
  • 15Department of Environmental Epidemiology, Nofer Institute of Occupational Medicine, Lodz, Poland
  • 16School of Public Health, Physiotherapy, and Population Science, University College Dublin, Dublin, Ireland
  • 17Department of Epidemiology, CAPHRI School for Public Health and Primary Care, Faculty of Health, Medicine and Life Sciences, Maastricht University Medical Centre+, Maastricht, Netherlands
  • 18Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana–Universitat Jaume I, Universitat de València Joint Research Unit of Epidemiology and Environmental Health, Valencia, Spain
  • 19Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin and Reference Centre for Epidemiology and Cancer Prevention in Piemonte, Turin, Italy
  • 20Environmental Risk and Health, Flemish Institute for Technological Research, Mol, Belgium
  • 21University of Antwerp, Antwerp, Belgium; University of Southern Denmark, Odense, Denmark
  • 22Centre for Research in Environmental Epidemiology, Barcelona, Spain
  • 23Pompeu Fabra University, Barcelona, Spain
  • 24Department of Experimental and Health Sciences, Pompeu Fabra University, Barcelona, Spain
  • 25Department of Public Health, Academic Medical Centre, University of Amsterdam, Amsterdam, Netherlands
  • 26Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Bilthoven, Netherlands
  • 27CAPHRI School for Public Health and Primary Care, Faculty of Health, Medicine and Life Sciences, Maastricht University Medical Centre+, Maastricht, Netherlands
  • 28Centre for Research in Environmental Epidemiology, Barcelona, Spain
  • 29Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain
  • 30National School of Public Health, Athens, Greece
JAMA Pediatr. 2016;170(4):381-390. doi:10.1001/jamapediatrics.2015.4430
Abstract

Importance  Maternal fish intake in pregnancy has been shown to influence fetal growth. The extent to which fish intake affects childhood growth and obesity remains unclear.

Objective  To examine whether fish intake in pregnancy is associated with offspring growth and the risk of childhood overweight and obesity.

Design, Setting, and Participants  Multicenter, population-based birth cohort study of singleton deliveries from 1996 to 2011 in Belgium, France, Greece, Ireland, Italy, the Netherlands, Norway, Poland, Portugal, Spain, and Massachusetts. A total of 26 184 pregnant women and their children were followed up at 2-year intervals until the age of 6 years.

Exposures  Consumption of fish during pregnancy.

Main Outcomes and Measures  We estimated offspring body mass index percentile trajectories from 3 months after birth to 6 years of age. We defined rapid infant growth as a weight gain z score greater than 0.67 from birth to 2 years and childhood overweight/obesity at 4 and 6 years as body mass index in the 85th percentile or higher for age and sex. We calculated cohort-specific effect estimates and combined them by random-effects meta-analysis.

Results  This multicenter, population-based birth cohort study included the 26 184 pregnant women and their children. The median fish intake during pregnancy ranged from 0.5 times/week in Belgium to 4.45 times/week in Spain. Women who ate fish more than 3 times/week during pregnancy gave birth to offspring with higher body mass index values from infancy through middle childhood compared with women with lower fish intake (3 times/week or less). High fish intake during pregnancy (>3 times/week) was associated with increased risk of rapid infant growth, with an adjusted odds ratio (aOR) of 1.22 (95% CI, 1.05-1.42) and increased risk of offspring overweight/obesity at 4 years (aOR, 1.14 [95% CI, 0.99-1.32]) and 6 years (aOR, 1.22 [95% CI, 1.01-1.47]) compared with an intake of once per week or less. Interaction analysis showed that the effect of high fish intake during pregnancy on rapid infant growth was greater among girls (aOR, 1.31 [95% CI, 1.08-1.59]) than among boys (aOR, 1.11 [95% CI, 0.92-1.34]; P = .02 for interaction).

Conclusions and Relevance  High maternal fish intake during pregnancy was associated with increased risk of rapid growth in infancy and childhood obesity. Our findings are in line with the fish intake limit proposed by the US Food and Drug Administration and Environmental Protection Agency.

×