Fish consumption during pregnancy, prenatal mercury exposure, and anthropometric measures at birth in a prospective mother-infant cohort study in Spain

Background: Birth size has been shown to be related to maternal fish intake, although the results are inconsistent. Objective: The objective was to assess the association of consumption of different types of fish and prenatal mercury exposure with birth weight, birth length, and classification as small for gestational age (SGA) in newborns. Design: Cord blood total mercury was measured in 554 newborns in a population-based cohort born from 2004 to 2006. Fish consumption was classified in 4 frequency categories (<1 portion/mo, 1-3 portions/mo, 1 portion/wk, and >= 2 portions/wk). Results: When multivariate models were adjusted, newborns in the higher quartile of total mercury weighed 143.7 g less (95% CI: -251.8, -35.6; P for trend = 0.02) and had higher odds of being SGA for length (odds ratio: 5.3; 95% CI: 1.2, 23.9; P from likelihood ratio test = 0.03) without a linear relation (P for trend = 0.13) compared with those in the lowest quartile. Mothers consuming >= 2 portions/wk of canned tuna had newborns who weighed more than those who consumed <1 portion/mo (P for trend = 0.03) and a lower risk of having infants who were SGA for weight (P for trend = 0.01). Consumption of >= 2 portions/wk of large oily fish was associated with a higher risk of being SGA for weight and consumption of lean fish with a lower risk of being SGA for length compared with the consumption of <1 portion/mo, but in neither case was there a linear relation (P for trend >0.05). Conclusions: The role of fish in fetal growth depends on the amount and type of fish consumed. The findings for mercury warrant further investigation in other settings. Am J Clin Nutr 2009; 90: 1047-55.