title: Fish consumption, erythrocyte fatty acids, and preterm birth.
abstract: OBJECTIVE
  To estimate the association between fish consumption and erythrocyte omega-3 long-chain polyunsaturated fatty acids and preterm birth in a high-risk cohort.
  
  
  METHODS
  This was an ancillary study to a randomized trial of omega-3 supplementation to prevent preterm birth in women with at least one previous spontaneous preterm delivery. Dietary fish intake was assessed by questionnaire and erythrocyte fatty acids were measured at enrollment (16-21 completed weeks of gestation). The association between fish consumption and preterm delivery was modeled with linear and quadratic terms.
  
  
  RESULTS
  The probability of preterm birth was 48.6% among women eating fish less than once a month and 35.9% among women eating fish more often (P<.001). The adjusted odds ratio for preterm birth among women reporting moderately frequent fish consumption (three servings per week) was 0.60 (95% confidence interval 0.38-0.95), with no further reduction in preterm birth among women who consumed more than three servings of fish per week. Erythrocyte omega-3 levels correlated weakly but significantly with frequency of fish intake (Spearman r=0.22, P<.001); women in the lowest quartile of erythrocyte omega-3 levels were more likely to report consuming less than one fish meal per month (40.3%) than were women in the highest three quartiles (26.3%, P<.001).
  
  
  CONCLUSIONS
  Moderate fish intake (up to three meals per week) before 22 weeks of gestation was associated with a reduction in repeat preterm birth. More than moderate consumption did not confer additional benefit. These results support the recommendations of the U.S. Food and Drug Administration and the American Congress of Obstetricians and Gynecologists for fish consumption during pregnancy.
  
  
  BACKGROUND
  ClinicalTrials.gov, www.clinicaltrials.gov, NCT00135902.
authors.affiliation: *For a list of other members of the NICHD MFMU, see the Appendix online at http://links.lww.com/AOG/A235. From the Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland; The Research Institute at Nationwide Children's Hospital, Columbus, Ohio; the Departments of Obstetrics and Gynecology, at Wake Forest University Health Sciences, Winston-Salem, North Carolina; The George Washington University Biostatistics Center, Washington, DC; University of North Carolina, Chapel Hill, North Carolina; Wayne State University, Detroit, Michigan; University of Utah Health Sciences Center, Salt Lake City, Utah; Columbia University, New York, New York; University of Pittsburgh, Pittsburgh, Pennsylvania; The Ohio State University, Columbus, Ohio; Women and Infants Hospital, Brown University, Providence, Rhode Island; Northwestern University, Chicago, Illinois; Case Western Reserve University-MetroHealth Medical Center, Cleveland, Ohio; Drexel University College of Medicine, Philadelphia, Pennsylvania; University of Alabama at Birmingham, Birmingham, Alabama; University of Texas at Houston, Houston, Texas; and University of Texas Medical Branch, Galveston, Texas.
authors.forename: Mark A
authors.initials: MA
authors.lastname: Klebanoff
authors.forename: Margaret
authors.initials: M
authors.lastname: Harper
authors.forename: Yinglei
authors.initials: Y
authors.lastname: Lai
authors.forename: John
authors.initials: J
authors.lastname: Thorp
authors.forename: Yoram
authors.initials: Y
authors.lastname: Sorokin
authors.forename: Michael W
authors.initials: MW
authors.lastname: Varner
authors.forename: Ronald J
authors.initials: RJ
authors.lastname: Wapner
authors.forename: Steve N
authors.initials: SN
authors.lastname: Caritis
authors.forename: Jay D
authors.initials: JD
authors.lastname: Iams
authors.forename: Marshall W
authors.initials: MW
authors.lastname: Carpenter
authors.forename: Alan M
authors.initials: AM
authors.lastname: Peaceman
authors.forename: Brian M
authors.initials: BM
authors.lastname: Mercer
authors.forename: Anthony
authors.initials: A
authors.lastname: Sciscione
authors.forename: Dwight J
authors.initials: DJ
authors.lastname: Rouse
authors.forename: Susan M
authors.initials: SM
authors.lastname: Ramin
authors.forename: Garland D
authors.initials: GD
authors.lastname: Anderson
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D004032:Diet; D004034:Diet Surveys; D019587:Dietary Supplements; D004281:Docosahexaenoic Acids / Q000097:blood / Q000627:therapeutic use; D004311:Double-Blind Method; D015118:Eicosapentaenoic Acid / Q000097:blood / Q000627:therapeutic use; D004912:Erythrocytes / Q000378:metabolism*; D015525:Fatty Acids, Omega-3 / Q000097:blood* / Q000627:therapeutic use; D005260:Female; D006801:Humans; D016014:Linear Models; D016015:Logistic Models; D011247:Pregnancy; D047928:Premature Birth / Q000097:blood / Q000517:prevention & control*; D017747:Seafood; D055502:Secondary Prevention
chemical_list: D015415:Biomarkers; D015525:Fatty Acids, Omega-3; D004281:Docosahexaenoic Acids; D015118:Eicosapentaenoic Acid