title: Seafood consumption in pregnancy and infant size at birth: results from a prospective Spanish cohort.
abstract: BACKGROUND
  Studies on maternal seafood consumption during pregnancy and the risk of small for gestational age (SGA) births have yielded inconsistent results. As few studies have examined associations with specific seafood subtypes or accounted simultaneously for exposure to persistent organic pollutants (POPs), it is uncertain to what extent intakes of seafood subtypes with variable contaminant or fatty acid content may explain these inconsistencies.
  
  
  METHODS
  A cohort of 657 women recruited during the first trimester of pregnancy from a Mediterranean area with high seafood intakes was followed through birth. Dietary intakes were estimated using a validated questionnaire. Multivariable logistic regression was used to estimate associations between SGA and intakes of fatty fish, lean fish, canned tuna, crustaceans and other shellfish, adjusting for parity, child sex, parental anthropometry, socio-economic factors and serum levels of several POPs, including several polychlorinated biphenyls (PCBs), hexachlorobenzene (HCB) and dichlorodiphenyldichloroethylene (DDE).
  
  
  RESULTS
  Overall, 7.8% of infants were SGA. Maternal consumption of crustaceans (more than once/week) and canned tuna (more than once/week was associated with a significantly increased risk of SGA. Fatty fish (more than once/week) was associated with weaker and generally non-significant increases in risk, while lean fish and other shellfish were not associated with SGA. Adjusting for contaminants did not meaningfully change results.
  
  
  CONCLUSIONS
  Higher maternal intakes of crustaceans and canned tuna, but not other types of seafood, were associated with increased risk of SGA independently of several POPs. Future studies exploring seafood subtypes and additional contaminants are needed to determine whether these associations are causal and identify mechanisms involved.
authors.affiliation: CREAL-Centre for Research in Environmental Epidemiology, Barcelona Biomedical Research Park, Dr Aiguader, 88/Barcelona, Spain 08003. mmendez@creal.cat
authors.forename: Michelle A
authors.initials: MA
authors.lastname: Mendez
authors.forename: Estel
authors.initials: E
authors.lastname: Plana
authors.forename: Mònica
authors.initials: M
authors.lastname: Guxens
authors.forename: Carles M
authors.initials: CM
authors.lastname: Foradada Morillo
authors.forename: Rosa Martorell
authors.initials: RM
authors.lastname: Albareda
authors.forename: Raquel
authors.initials: R
authors.lastname: Garcia-Esteban
authors.forename: Fernando
authors.initials: F
authors.lastname: Goñi
authors.forename: Manolis
authors.initials: M
authors.lastname: Kogevinas
authors.forename: Jordi
authors.initials: J
authors.lastname: Sunyer
mesh_terms: D000818:Animals; D001724:Birth Weight; D015331:Cohort Studies; D003445:Crustacea; D003633:Dichlorodiphenyl Dichloroethylene / Q000097:blood; D004032:Diet; D015930:Diet Records; D005260:Female; D005506:Food Contamination; D005865:Gestational Age; D006581:Hexachlorobenzene / Q000097:blood; D006801:Humans; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age; D016015:Logistic Models; D011078:Polychlorinated Biphenyls / Q000097:blood; D011247:Pregnancy; D011446:Prospective Studies; D012307:Risk Factors; D017747:Seafood / Q000009:adverse effects*; D013030:Spain / Q000453:epidemiology; D011795:Surveys and Questionnaires; D014413:Tuna; D055815:Young Adult
chemical_list: D003633:Dichlorodiphenyl Dichloroethylene; D006581:Hexachlorobenzene; D011078:Polychlorinated Biphenyls