Fish and seafood consumption during pregnancy and the risk of asthma and allergic rhinitis in childhood: a pooled analysis of 18 European and US birth cohorts.
It has been suggested that prenatal exposure to n-3 long-chain fatty acids protects against asthma and other allergy-related diseases later in childhood. The extent to which fish intake in pregnancy protects against child asthma and rhinitis symptoms remains unclear. We aimed to assess whether fish and seafood consumption in pregnancy is associated with childhood wheeze, asthma and allergic rhinitis.



We pooled individual data from 60 774 mother-child pairs participating in 18 European and US birth cohort studies. Information on wheeze, asthma and allergic rhinitis prevalence was collected using validated questionnaires. The time periods of interest were: infancy (0-2 years), preschool age (3-4 years), and school age (5-8 years). We used multivariable generalized models to assess associations of fish and seafood (other than fish) consumption during pregnancy with child respiratory outcomes in cohort-specific analyses, with subsequent random-effects meta-analyses.



The median fish consumption during pregnancy ranged from 0.44 times/week in The Netherlands to 4.46 times/week in Spain. Maternal fish intake during pregnancy was not associated with offspring wheeze symptoms in any age group nor with the risk of child asthma [adjusted meta-analysis relative risk (RR) per 1-time/week = 1.01, 95% confidence interval 0.97-1.05)] and allergic rhinitis at school age (RR = 1.01, 0.99-1.03). These results were consistently found in further analyses by type of fish and seafood consumption and in sensitivity analyses.



We found no evidence supporting a protective association of fish and seafood consumption during pregnancy with offspring symptoms of wheeze, asthma and allergic rhinitis from infancy to mid childhood.
Department of Social Medicine, University of Crete, Heraklion, Greece.|NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands.
Nikos
N
Stratakis
Department of Social Medicine, University of Crete, Heraklion, Greece.
Theano
T
Roumeliotaki
Obesity Prevention Program, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA.
Emily
E
Oken
Spanish Consortium for Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain.|FISABIO-Universitat Jaume I-Universitat de València Joint Research Unit of Epidemiology and Environmental Health, Valencia, Spain.
Ferran
F
Ballester
Department of Clinical Epidemiology, University of Porto Medical School, Porto, Portugal.|EPIUnit - Institute of Public Health, University of Porto, Porto, Portugal.
Henrique
H
Barros
Spanish Consortium for Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain.|Public Health Division of Gipuzkoa, Basque Government, San Sebastián, Spain.
Mikel
M
Basterrechea
Epidemiological Research in Environment, Reproduction and Child Development, University of Rennes I, Rennes, France.
Sylvaine
S
Cordier
NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands.|Welten Institute, Open University of the Netherlands, Heerlen, The Netherlands.
Renate
R
de Groot
Generation R Study Group, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands.|Department of Pediatrics, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands.
Herman T
HT
den Dekker
Generation R Study Group, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands.|Department of Pediatrics, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands.
Liesbeth
L
Duijts
Norwegian Institute of Public Health, Oslo, Norway.
Merete
M
Eggesbø
Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, Bologna, Italy.
Maria Pia
MP
Fantini
Department of Epidemiology, Lazio Regional Health System, Rome, Italy.
Francesco
F
Forastiere
Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands.
Ulrike
U
Gehring
NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands.
Marij
M
Gielen
Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, Bologna, Italy.
Davide
D
Gori
Environmental Risk and Health, Flemish Institute for Technological Research (VITO), Mol, Belgium.
Eva
E
Govarts
Medical Research Council (MRC) Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK.
Hazel M
HM
Inskip
Norwegian Institute of Public Health, Oslo, Norway.
Nina
N
Iszatt
CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands.|Academic Collaborative Center for Public Health Limburg, Public Health Services, Geleen, The Netherlands.
Maria
M
Jansen
Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland.
Cecily
C
Kelleher
Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland.
John
J
Mehegan
CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands.
Carolina
C
Moltó-Puigmartí
CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands.
Monique
M
Mommers
Department of Clinical Epidemiology, University of Porto Medical School, Porto, Portugal.|EPIUnit - Institute of Public Health, University of Porto, Porto, Portugal.
Andreia
A
Oliveira
Centre for Fetal Programming, Statens Serum Institut, Copenhagen, Denmark.|Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
Sjurdur F
SF
Olsen
Epidemiological Research in Environment, Reproduction and Child Development, University of Rennes I, Rennes, France.
Fabienne
F
Pelé
Cancer Epidemiology Unit, University of Turin and CPO-Piemonte, Turin, Italy.
Costanza
C
Pizzi
Department of Epidemiology, Lazio Regional Health System, Rome, Italy.
Daniela
D
Porta
Cancer Epidemiology Unit, University of Turin and CPO-Piemonte, Turin, Italy.
Lorenzo
L
Richiardi
Obesity Prevention Program, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA.
Sheryl L
SL
Rifas-Shiman
Medical Research Council (MRC) Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK.|National Institute for Health Research (NIHR), University of Southampton and University Hospital, Southampton, UK.
Sian M
SM
Robinson
Environmental Risk and Health, Flemish Institute for Technological Research (VITO), Mol, Belgium.|Department of BiomedicalSciences, University of Antwerp, Antwerp, Belgium.|Department of Environmental Medicine, University of Southern Denmark, Odense, Denmark.
Greet
G
Schoeters
Centre for Fetal Programming, Statens Serum Institut, Copenhagen, Denmark.|Faculty of Natural and Health Sciences, University of the Faroe Islands, Tórshavn, Faroe Islands.
Marin
M
Strøm
Spanish Consortium for Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain.|ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain.|Department of Preventive Medicine and Public Health, Pompeu Fabra University, Barcelona, Spain.
Jordi
J
Sunyer
CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands.
Carel
C
Thijs
Spanish Consortium for Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain.|ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain.|Department of Preventive Medicine and Public Health, Pompeu Fabra University, Barcelona, Spain.
Martine
M
Vrijheid
Department of Public Health, University of Amsterdam, Amsterdam, The Netherlands.
Tanja G M
TGM
Vrijkotte
Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Bilthoven, The Netherlands.
Alet H
AH
Wijga
Spanish Consortium for Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain.|ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain.|IMIM Hospital del Mar Medicine Research Institute, Barcelona, Spain.
Manolis
M
Kogevinas
NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands.|CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands.
Maurice P
MP
Zeegers
Department of Social Medicine, University of Crete, Heraklion, Greece.|NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands.
Leda
L
Chatzi
D000818:Animals; D001249:Asthma / Q000453:epidemiology*; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005060:Europe / Q000453:epidemiology; D015525:Fatty Acids, Omega-3 / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011247:Pregnancy; D039401:Prenatal Nutritional Physiological Phenomena; D015995:Prevalence; D012044:Regression Analysis; D012135:Respiratory Sounds; D065631:Rhinitis, Allergic / Q000453:epidemiology*; D017747:Seafood; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology
D015525:Fatty Acids, Omega-3
Wheezing; allergic rhinitis; asthma; children; fish; pregnancy; seafood