title: Maternal fish and shellfish intake and pregnancy outcomes: a prospective cohort study in Brittany, France.
abstract: BACKGROUND
  Recommendations about risks and benefits of seafood intake during pregnancy have been published in the last decade, but the specific health effects of the different categories of seafood remain unknown. Fish and shellfish may differ according to their fatty acid content and their concentration of chemical pollutants and toxins. Not taking these particularities into account may result in underestimating of both the positive and negative effects of seafood on birth outcomes and partly explains inconsistent results on the subject.
  
  
  METHODS
  In the PELAGIE cohort study, including 2398 pregnant women from Brittany, we fit multiple linear and logistic regression models to examine associations of fish (salt-water fish only) and shellfish intake before pregnancy with length of gestation, birthweight, and risks of preterm births, low birthweight or small-for-gestational-age (SGA) babies.
  
  
  RESULTS
  When fish and shellfish consumptions were considered simultaneously, we observed a decrease in the risk of SGA birth with increasing frequency of fish intake: OR = 0.57 (95%CI: 0.31 to 1.05) for women eating fish twice a week or more compared with those eating it less than once a month. The risk of SGA birth was significantly higher among women eating shellfish twice a week or more than among those eating it less than once a month: OR = 2.14 (95%CI: 1.13 to 4.07). Each additional monthly meal including fish was significantly related to an increase in gestational length of 0.02 week (95%CI: 0.002 to 0.035). No association was observed with birthweight or preterm birth.
  
  
  CONCLUSIONS
  These results suggest that different categories of seafood may be differently associated with birth outcomes, fish consumption with increased length of gestation and shellfish consumption with decreased fetal growth.
authors.affiliation: Inserm U625, GERHM, IFR140, Campus de Beaulieu, Rennes, F-35042 France. laurence.guldner@univ-rennes1.fr
authors.forename: Laurence
authors.initials: L
authors.lastname: Guldner
authors.forename: Christine
authors.initials: C
authors.lastname: Monfort
authors.forename: Florence
authors.initials: F
authors.lastname: Rouget
authors.forename: Ronan
authors.initials: R
authors.lastname: Garlantezec
authors.forename: Sylvaine
authors.initials: S
authors.lastname: Cordier
mesh_terms: D000328:Adult; D000818:Animals; D016009:Chi-Square Distribution; D005260:Female; D005399:Fishes; D005602:France; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007234:Infant, Premature; D016014:Linear Models; D039382:Maternal Nutritional Physiological Phenomena; D008499:Medical Records; D016017:Odds Ratio; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology*; D011446:Prospective Studies; D017747:Seafood / Q000009:adverse effects* / Q000706:statistics & numerical data; D012758:Shellfish; D011795:Surveys and Questionnaires