Maternal fish and shellfish consumption and wheeze, eczema and food allergy at age two: a prospective cohort study in Brittany, France

Abstract

BackgroundEnvironmental exposures, including dietary contaminants, may influence the developing immune system. This study assesses the association between maternal pre-parturition consumption of seafood and wheeze, eczema, and food allergy in preschool children. Fish and shellfish were studied separately as they differ according to their levels of omega-3 polyunsaturated fatty acids (which have anti-allergic properties) and their levels of contaminants.MethodsThe PELAGIE cohort included 3421 women recruited at the beginning of pregnancy. Maternal fish and shellfish intake was measured at inclusion by a food frequency questionnaire. Wheeze, eczema, and food allergy were evaluated by a questionnaire completed by the mother when the child was 2 years old (n = 1500). Examination of the associations between seafood intake and outcomes took major confounders into account. Complementary sensitivity analyses with multiple imputation enabled us to handle missing data, due mostly to attrition.ResultsModerate maternal pre-parturition fish intake (1 to 4 times a month) was, at borderline significance, associated with a lower risk of wheeze (adjusted OR = 0.69 (0.45-1.05)) before age 2, compared with low intake (< once/month). This result was not, however, consistent: after multiple imputation, the adjusted OR was 0.86 (0.63-1.17). Shellfish intake at least once a month was associated with a higher risk of food allergy before age 2 (adjusted OR = 1.62 (1.11-2.37)) compared to low or no intake (< once/month). Multiple imputation confirmed this association (adjusted OR = 1.52 (1.05-2.21)).ConclusionsThis study suggests that maternal pre-parturition shellfish consumption may increase the risk of food allergy. Further large-scale epidemiologic studies are needed to corroborate these results, identify the contaminants or components of shellfish responsible for the effects observed, determine the persistence of the associations seen at age 2, and investigate potential associations with health effects observable at later ages, such as allergic asthma.

Fish intake during pregnancy or infancy and allergic outcomes in children: A systematic review and meta‐analysis

“…In total, 866 records were excluded for duplicates, and 4,133 records were excluded after screening the titles and abstracts. The remaining 29 full‐text articles were assessed for eligibility, four of which were further excluded because of fish intake before pregnancy , retrospective cohort studies , and nested case–control studies . Finally, one RCT and 17 publications from 13 unique prospective cohort studies were included for maternal fish intake during pregnancy, and eight publications from five unique prospective cohort studies for fish intake in infancy.…”

“…In addition, this limited effect of n‐3 LC‐PUFAs may not persist as other components in fish come into play. Contaminants in fish, such as PCBs, PFCs, methylmercury, and lead, could probably counterbalance in part the effect of n‐3 LC‐PUFAs or even increase the risk of allergy .…”

Does maternal diet during pregnancy and lactation affect outcomes in offspring? A systematic review of food-based approaches

“…However some notable examples are possible attenuation of a link between high maternal fish consumption and reduced eczema risk [92]; alongside a potentially stronger association between high fish intake and decreased risk of asthma [93]. Two subsequent studies have reported links between maternal shellfish intake and increased risk of eczema [92], and also food allergy in children [94].…”

Diet and Asthma: Is It Time to Adapt Our Message?

“…No link has been observed between fish intake during pregnancy and wheeze and/or asthma in childhood in most studies, nor in a meta-analysis [ 74 , 77 , 92 , 102 , 103 , 104 , 105 , 106 , 107 , 108 ]. However, fish oil supplementation during pregnancy has been shown to decrease wheeze or asthma in childhood [ 130 , 131 , 132 ].…”