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. 2017 Oct 1;46(5):1465-1477.
doi: 10.1093/ije/dyx007.

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

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Free PMC article

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

Nikos Stratakis et al. Int J Epidemiol. .
Free PMC article

Abstract

Background: 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.

Methods: 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.

Results: 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.

Conclusion: 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.

Keywords: Wheezing; allergic rhinitis; asthma; children; fish; pregnancy; seafood.

Figures

Figure 1
Figure 1
Frequency of fish consumption during pregnancy (times/week) in participating cohorts. The line within the box marks the median; the boundaries of the box indicate the 25th and 75th percentiles; horizontal bars denote the variability outside the upper and lower quartiles (i.e., within 1.5 IQR of the lower and upper quartiles); and circles represent outliers.
Figure 2
Figure 2
Adjusted associations of fish consumption during pregnancy (times/week) with offspring wheeze in infancy, preschool age, and school age. Wheeze in infancy was defined as presence of any episode of wheezing or whistling in the chest during the first 2 years of life. Wheeze at preschool age was defined as presence of wheezing or whistling in the chest in the past 12 months at the age of 3-4 years. Wheeze at school age was defined as presence of wheezing or whistling in the chest in the past 12 months at the age of 5-8 years. RRs (95% CIs) by cohort were obtained by using generalized linear models for binary outcomes (modified Poisson) adjusted for maternal age, maternal education, breastfeeding, smoking during pregnancy, parity, parent asthma or hay fever, and child sex. Combined estimates were obtained by using a random-effects meta-analysis. The names of the cohorts and number of participants per each cohort are shown on the left. Cohort-specific RRs (95% CIs), and their weights in meta-analysis are shown on the right. Squares represent the point estimate of each cohort, while the size of the square is proportional to the weight with which each cohort contributed to the overall RR; horizontal lines denote 95% CIs; and diamonds represent overall estimates. RR= relative risk.
Figure 3
Figure 3
Adjusted associations of fish consumption during pregnancy (times/week) with offspring asthma atpreschool age and school age. Asthma at preschool age (3-4 years) and school age (5-8 years) was definedas satisfying at least two of the three following criteria for each time period: (1) ever-reported diagnosis ofasthma, (2) presence of wheezing or whistling in the chest in the past 12 months, or (3) asthma medicationin the past 12 months. RRs (95% CIs) by cohort were obtained by using generalized linear models for binary outcomes (modified Poisson) adjusted for maternal age, maternal education, breastfeeding, smoking duringpregnancy, parity, parent asthma or hay fever, and child sex. Combined estimates were obtained by using arandom-effects meta-analysis. The names of the cohorts and number of participants per each cohort are shown on the left. Cohort-specific RRs (95% CIs), and their weights in meta-analysis are shown on the right. Squares represent the point estimate of each cohort, while the size of the square is proportional to theweight with which each cohort contributed to the overall RR; horizontal lines denote 95% CIs; and diamondsrepresent overall estimates. RR= relative risk.

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