Low consumption of seafood in early pregnancy as a risk factor for preterm delivery: prospective cohort study

doi:10.1136/bmj.324.7335.447

BMJ 2002;324:447 ( 23 February )

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Low consumption of seafood in early pregnancy as a risk factor for preterm delivery: prospective cohort study

Sjúrur Frói Olsen, associate professor, ^a Niels Jørgen Secher, professor. ^b

^a Maternal Nutrition Group, Danish Epidemiology Science Centre, Statens Serum Institut, Artillerivej 5, DK-2300 Copenhagen S, Denmark, ^b Perinatal Epidemiology Research Unit, Department of Obstetrics and Gynaecology, Skejby University Hospital, DK-8200 Aarhus N, Denmark

Correspondence to: S F Olsen sfo{at}ssi.dk

Objective: To determine the relation between intakeof seafood in pregnancy and risk of preterm delivery and low birthweight.
Design: Prospective cohortstudy.
Setting: Aarhus,Denmark.
Participants: 8729 pregnantwomen.
Main outcome measures: Preterm delivery and low birthweight.
Results: The occurrence of preterm delivery differedsignificantly across four groups of seafood intake, falling progressivelyfrom 7.1% in the group never consuming fish to 1.9% in the groupconsuming fish as a hot meal and an open sandwich with fish atleast once a week. Adjusted odds for preterm delivery were increasedby a factor of 3.6 (95% confidence interval 1.2 to 11.2) in thezero consumption group compared with the highest consumption group.Analyses based on quantified intakes indicated that the workingrange of the dose-response relation is mainly from zero intakeup to a daily intake of 15 g fish or 0.15 g n-3 fatty acids. Estimatesof risk for low birth weight were similar to those for pretermdelivery.
Conclusions: Low consumption of fish was a strong riskfactor for preterm delivery and low birth weight. In women withzero or low intake of fish, small amounts of n-3 fatty acids $---$ providedas fish or fish oil $---$ may confer protection against preterm deliveryand low birthweight.

What is already known on this topic
Long chain n-3 fatty acids in amounts above 2 g a day may delay spontaneous delivery and prevent recurrence of preterm delivery

Large studies have not been carried out to determine to what extent low consumption of n-3 fatty acids is a risk factor for preterm delivery

The dose-response relation has not been described

What this study adds
Low consumption of fish seems to be a strong risk factor for preterm delivery and low birth weight in Danish women

This relation is strongest below an estimated daily intake of 0.15 g long chain n-3 fatty acids or 15 g fish

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