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Am J Clin Nutr. 2014 Mar;99(3):506-16. doi: 10.3945/ajcn.113.067421. Epub 2013 Dec 11.

Fish intake during pregnancy, fetal growth, and gestational length in 19 European birth cohort studies.

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Department of Social Medicine, Faculty of Medicine, University of Crete, Heraklion, Greece (VL, TR, and LC); the Centre for Research in Environmental Epidemiology, Barcelona, Spain (DM, MC, JS, MK, and MV); the Hospital del Mar Medical Research Institute, Barcelona, Spain (DM, MC, JS, MK, and MV); the Department of Clinical Epidemiology, Predictive Medicine and Public Health and Cardiovascular Research & Development Unit, University of Porto Medical School, Porto, Portugal (HB and AO); the Public Health Institute, University of Porto, Portugal (HB and AO); the Department for Genes and Environment (ME) and Department of Chronic Diseases (HS), Division of Epidemiology, and the Division of Environmental Medicine (A-LB, MH, and HMH), Norwegian Institute of Public Health, Oslo, Norway; the Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain (MC, M Murcia, JS, MK, and MV); the Institut National de la Santé et de la Recherche Médicale (INSERM), Centre for Research in Epidemiology and Population Health, U1018, Lifelong Epidemiology of Obesity, Diabetes and Renal Disease Team, Villejuif, France (M-AC and BH); the University Paris-Sud, UMRS 1018, le Kremlin Bicêtre, France (M-AC and BH); the INSERM UMR 1085, Institut de Recherche Santé Environnement & Travail, Université de Rennes 1, Rennes Cedex, France (SC and, FP); the Public Health Service Amsterdam, Department of Epidemiology, Documentation and Health Promotion, Amsterdam, Netherlands (MvE); the Department of Epidemiology, Lazio Regional health System, Rome, Italy (FF and DP); the Institute for Risk Assessment Sciences, Utrecht University, Utrecht, Netherlands (UG); the Environmental Risk and Health, Flemish Institute for Technological Research, Mol, Belgium (EG); the Maternal Nutrition Group, Centre for Fetal Programming, Statens Serum Institut, Copenhagen, Denmark (TIH, SFO, and MS); the Faculty of Food Science and Nutrition, University of Ice



Fish is a rich source of essential nutrients for fetal development, but in contrast, it is also a well-known route of exposure to environmental pollutants.


We assessed whether fish intake during pregnancy is associated with fetal growth and the length of gestation in a panel of European birth cohort studies.


The study sample of 151,880 mother-child pairs was derived from 19 population-based European birth cohort studies. Individual data from cohorts were pooled and harmonized. Adjusted cohort-specific effect estimates were combined by using a random- and fixed-effects meta-analysis.


Women who ate fish >1 time/wk during pregnancy had lower risk of preterm birth than did women who rarely ate fish (≤ 1 time/wk); the adjusted RR of fish intake >1 but <3 times/wk was 0.87 (95% CI: 0.82, 0.92), and for intake ≥ 3 times/wk, the adjusted RR was 0.89 (95% CI: 0.84, 0.96). Women with a higher intake of fish during pregnancy gave birth to neonates with a higher birth weight by 8.9 g (95% CI: 3.3, 14.6 g) for >1 but <3 times/wk and 15.2 g (95% CI: 8.9, 21.5 g) for ≥ 3 times/wk independent of gestational age. The association was greater in smokers and in overweight or obese women. Findings were consistent across cohorts.


This large, international study indicates that moderate fish intake during pregnancy is associated with lower risk of preterm birth and a small but significant increase in birth weight.

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