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Ooi KJ, Taylor RM, Fenton S, Hutchesson MJ, Collins CE. Evaluating Validated Diet Quality Indices Used in Pregnant Women in High-Income Countries: A Systematic Review. Nutr Rev 2024:nuae073. [PMID: 38899508 DOI: 10.1093/nutrit/nuae073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/21/2024] Open
Abstract
CONTEXT Diet quality indices (DQIs) assess the level of adherence to dietary recommendations and a specified dietary pattern in populations; however, there is limited evidence regarding the construct criteria and validation methodology of DQIs used in pregnant women. OBJECTIVES The objectives of this study were to (i) identify and describe characteristics of DQIs that have been validated for use in pregnant women in high-income countries, and (ii) evaluate criteria used to develop DQIs and validation methodologies employed. DATA SOURCES CINAHL, Embase, Medline, SCOPUS, and Web of Science were systematically searched for eligible articles published between 1980 and November 2022 that focused on DQIs validated for use in pregnant women from high-income countries. DATA EXTRACTION Characteristics, development criteria, and validation methodologies used in the included articles were extracted by one reviewer and checked by a second reviewer. DATA ANALYSIS A narrative synthesis and descriptive statistics were used to summarize the review findings. Reporting was guided by the Preferred Reporting Items for Systematic Reviews and Meta-analyses statement. RESULTS Six articles with 5 validated DQIs were identified. In total, 3777 participants were included - five articles had pregnant women aged 31-50 years and in their second trimester. Food frequency questionnaires were used as the dietary assessment method in all studies, and 3 DQIs were used to assess dietary intake at 1 time point, using 2 different dietary assessment methods. No indices fulfilled preferred features for the DQI development criteria developed by Burggraf et al (2018). Construct validity was assessed by all DQIs, followed by criterion validity (n = 4) and test-retest reliability (n = 2). CONCLUSION Limited high-quality validated DQIs for use in pregnant women in high-income countries were identified. Scoring for DQI components were not specific to nutrient requirements for pregnant women. Findings from this review may inform the development of DQIs that evaluate specific dietary requirements and specific food safety considerations applicable to pregnancy. SYSTEMATIC REVIEW REGISTRATION https://osf.io/u2hrq.
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Affiliation(s)
- Kee June Ooi
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW 2308, Australia
- Food and Nutrition Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
| | - Rachael M Taylor
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW 2308, Australia
- Food and Nutrition Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
| | - Sasha Fenton
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW 2308, Australia
- Food and Nutrition Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
| | - Melinda J Hutchesson
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW 2308, Australia
- Food and Nutrition Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
| | - Clare E Collins
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW 2308, Australia
- Food and Nutrition Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
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Shine D, Siriwardana H, Minehan M, Takito MY, Jani R, Knight-Agarwal CR. The knowledge, attitudes, and behaviours of pregnant women regarding seafood consumption during the antenatal period: a qualitative study. BMC Pregnancy Childbirth 2024; 24:80. [PMID: 38267938 PMCID: PMC10807157 DOI: 10.1186/s12884-023-06149-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 11/21/2023] [Indexed: 01/26/2024] Open
Abstract
BACKGROUND Maternal nutrition impacts fetal growth and development. The Food Standards Australia New Zealand (FSANZ) guidelines recommend pregnant women consume 2-3 servings (224-336 g) of fish/seafood per week to support intake of long chain omega 3 fatty acids, given adequate consumption supports numerous health benefits including reduced risk of preterm and early preterm birth. Evidence indicates that pregnant women purposely lower their fish/seafood intake, largely due to fears of methylmercury exposure. The aim of this study was to explore pregnant women's knowledge, attitudes, and behaviours regarding their fish/seafood consumption during the antenatal period. METHODS Semi-structured interviews were conducted between October 2018 and December 2020 among a purposive sample of 12 pregnant women from the Australian Capital Territory (ACT). The interviews were recorded, transcribed verbatim, and analysed using an interpretative phenomenological approach. Themes were developed on the women's lived experience related to fish/seafood knowledge, attitudes, and consumption behaviour. RESULTS The most prominent finding was widespread non-adherence to fish/seafood consumption guidelines. This was largely owing to a lack of proactive health promotion related to the health benefits of fish/seafood throughout pregnancy, including the health promoting roles of long chain omega 3 fatty acids for fetal growth and development. Three themes were identified: nutrition knowledge; sources of health promotion; and barriers and enablers to fish/seafood consumption. CONCLUSIONS To support adequate maternal consumption of fish/seafood throughout pregnancy, emphasis should be placed on the benefits of consuming this food group regularly. Additionally, pregnant women should receive education about the health promoting role of long chain omega 3 fatty acids. Dietitians are well placed to provide this information.
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Affiliation(s)
- Danielle Shine
- Department of Nutrition and Dietetics, The University of Canberra, Locked Bag 1, ACT, Bruce, Bruce, Australia
| | - Heshani Siriwardana
- Department of Nutrition and Dietetics, The University of Canberra, Locked Bag 1, ACT, Bruce, Bruce, Australia
| | - Michelle Minehan
- Department of Nutrition and Dietetics, The University of Canberra, Locked Bag 1, ACT, Bruce, Bruce, Australia
| | - Monica Yuri Takito
- Department of Human Movement, The University of São Paulo, São Paulo, Brazil
| | - Rati Jani
- Department of Nutrition and Dietetics, The University of Canberra, Locked Bag 1, ACT, Bruce, Bruce, Australia
| | - Catherine R Knight-Agarwal
- Department of Nutrition and Dietetics, The University of Canberra, Locked Bag 1, ACT, Bruce, Bruce, Australia.
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Gray NL, Stoodley I, Wood LG, Collins CE, Brown LJ, Rae KM, Pringle KG, Schumacher TL. Omega-3 Fatty Acids during Pregnancy in Indigenous Australian Women of the Gomeroi Gaaynggal Cohort. Nutrients 2023; 15:nu15081943. [PMID: 37111163 PMCID: PMC10145055 DOI: 10.3390/nu15081943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 04/06/2023] [Accepted: 04/11/2023] [Indexed: 04/29/2023] Open
Abstract
Higher dietary intakes of Omega-3 long-chain polyunsaturated fatty acids (n-3 LC-PUFAs) have been linked to lower rates of preterm birth and preeclampsia. The aim of this analysis was to describe dietary intake and fractions of red blood cell (RBC) membrane LC-PUFAs during pregnancy in a cohort of Indigenous Australian women. Maternal dietary intake was assessed using two validated dietary assessment tools and quantified using the AUSNUT (Australian Food and Nutrient) 2011-2013 database. Analysis from a 3-month food frequency questionnaire indicated that 83% of this cohort met national n-3 LC-PUFA recommendations, with 59% meeting alpha-linolenic acid (ALA) recommendations. No nutritional supplements used by the women contained n-3 LC-PUFAs. Over 90% of women had no detectable level of ALA in their RBC membranes, and the median Omega-3 Index was 5.5%. This analysis appears to illustrate a decline in concentrations of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) across gestation in women who had preterm birth. However, there was no visible trend in LC-PUFA fractions in women who experienced hypertension during pregnancy. Further research is needed to better understand the link between dietary intake of n-3 LC-PUFA-rich foods and the role of fatty acids in preterm birth and preeclampsia.
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Affiliation(s)
- Natalie L Gray
- School of Health Sciences, University of Newcastle, Callaghan, NSW 2308, Australia
| | - Isobel Stoodley
- School of Biomedical Sciences and Pharmacy, University of Newcastle, Callaghan, NSW 2308, Australia
- Immune Health Program, Hunter Medical Research Institute, New Lambton, NSW 2305, Australia
| | - Lisa G Wood
- School of Biomedical Sciences and Pharmacy, University of Newcastle, Callaghan, NSW 2308, Australia
- Immune Health Program, Hunter Medical Research Institute, New Lambton, NSW 2305, Australia
| | - Clare E Collins
- School of Health Sciences, University of Newcastle, Callaghan, NSW 2308, Australia
- Food and Nutrition Research Program, Hunter Medical Research Institute, New Lambton, NSW 2305, Australia
| | - Leanne J Brown
- Food and Nutrition Research Program, Hunter Medical Research Institute, New Lambton, NSW 2305, Australia
- Department of Rural Health, University of Newcastle, Tamworth, NSW 2340, Australia
| | - Kym M Rae
- Mater Medical Research Institute, South Brisbane, QLD 4101, Australia
- Faculty of Medicine, University of Queensland, Herston, Brisbane, QLD 4072, Australia
| | - Kirsty G Pringle
- School of Biomedical Sciences and Pharmacy, University of Newcastle, Callaghan, NSW 2308, Australia
- Mothers and Babies Research Program, Hunter Medical Research Institute, New Lambton, NSW 2308, Australia
| | - Tracy L Schumacher
- Food and Nutrition Research Program, Hunter Medical Research Institute, New Lambton, NSW 2305, Australia
- Department of Rural Health, University of Newcastle, Tamworth, NSW 2340, Australia
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Chen B, Dong S. Mercury Contamination in Fish and Its Effects on the Health of Pregnant Women and Their Fetuses, and Guidance for Fish Consumption-A Narrative Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15929. [PMID: 36498005 PMCID: PMC9739465 DOI: 10.3390/ijerph192315929] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Revised: 11/25/2022] [Accepted: 11/25/2022] [Indexed: 06/17/2023]
Abstract
As a principal source of long-chain omega-3 fatty acids (3FAs), which provide vital health benefits, fish consumption also comes with the additional benefit of being rich in diverse nutrients (e.g., vitamins and selenium, high in proteins and low in saturated fats, etc.). The consumption of fish and other seafood products has been significantly promoted universally, given that fish is an important part of a healthy diet. However, many documents indicate that fish may also be a potential source of exposure to chemical pollutants, especially mercury (Hg) (one of the top ten chemicals or groups of chemicals of concern worldwide), and this is a grave concern for many consumers, especially pregnant women, as this could affect their fetuses. In this review, the definition of Hg and its forms and mode of entrance into fish are introduced in detail and, moreover, the bio-accumulation of Hg in fish and its toxicity and action mechanisms on fish and humans, especially considering the health of pregnant women and their fetuses after the daily intake of fish, are also reviewed. Finally, some feasible and constructive suggestions and guidelines are recommended for the specific group of pregnant women for the consumption of balanced and appropriate fish diets in a rational manner.
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Affiliation(s)
- Bojian Chen
- Food Science and Engineering, Haide College, Ocean University of China, Qingdao 266100, China
| | - Shiyuan Dong
- College of Food Science and Technology, Ocean University of China, Qingdao 266003, China
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Bahri Khomami M, Walker R, Kilpatrick M, de Jersey S, Skouteris H, Moran LJ. The role of midwives and obstetrical nurses in the promotion of healthy lifestyle during pregnancy. Ther Adv Reprod Health 2021; 15:26334941211031866. [PMID: 34396131 PMCID: PMC8361518 DOI: 10.1177/26334941211031866] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2020] [Accepted: 06/24/2021] [Indexed: 11/17/2022] Open
Abstract
Women with maternal obesity, an unhealthy lifestyle before and during pregnancy
and excess gestational weight gain have an increased risk of adverse pregnancy
and birth outcomes that can also increase the risk of long-term poor health for
them and their children. Pregnant women have frequent medical appointments and
are highly receptive to health advice. Healthcare professionals who interact
with women during pregnancy are in a privileged position to support women to
make lasting healthy lifestyle changes that can improve gestational weight gain
and pregnancy outcomes and halt the intergenerational nature of obesity.
Midwives and obstetrical nurses are key healthcare professionals responsible for
providing antenatal care in most countries. Therefore, it is crucial for them to
build and enhance their ability to promote healthy lifestyles in pregnant women.
Undergraduate midwifery curricula usually lack sufficient lifestyle content to
provide emerging midwives and obstetrical nurses with the knowledge, skills, and
confidence to effectively assess and support healthy lifestyle behaviours in
pregnant women. Consequently, registered midwives and obstetrical nurses may not
recognise their role in healthy lifestyle promotion specific to healthy eating
and physical activity in practice. In addition, practising midwives and
obstetrical nurses do not consistently have access to healthy lifestyle
promotion training in the workplace. Therefore, many midwives and obstetrical
nurses may not have the confidence and/or skills to support pregnant women to
improve their lifestyles. This narrative review summarises the role of midwives
and obstetrical nurses in the promotion of healthy lifestyles relating to
healthy eating and physical activity and optimising weight in pregnancy, the
barriers that they face to deliver optimal care and an overview of what we know
works when supporting midwives and obstetrical nurses in their role to support
women in achieving a healthy lifestyle.
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Affiliation(s)
- Mahnaz Bahri Khomami
- Monash Centre for Health Research and Implementation (MCHRI), Level 1, 43-51 Kanooka Grove, Clayton, VIC, 3168, Australia
| | - Ruth Walker
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Michelle Kilpatrick
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia
| | - Susan de Jersey
- Perinatal Research Centre, Centre for Clinical Research and Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
| | - Helen Skouteris
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Lisa J Moran
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
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de Seymour JV, Simmonds LA, Gould J, Makrides M, Middleton P. Omega-3 fatty acids to prevent preterm birth: Australian pregnant women's preterm birth awareness and intentions to increase omega-3 fatty acid intake. Nutr J 2019; 18:74. [PMID: 31727060 PMCID: PMC6857157 DOI: 10.1186/s12937-019-0499-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Accepted: 10/28/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Preterm birth is the leading cause of death in children under five. A recent Cochrane review found a 42% reduction in early preterm birth (< 34 weeks' gestation) and 11% reduction in preterm birth (< 37 weeks' gestation) with omega-3 fatty acid supplementation. To assist in the development of implementation strategies to increase pregnant women's omega-3 fatty acid intake, we assessed the awareness of Australian pregnant women about preterm birth, their nutrition and supplementation behaviours during pregnancy, and intentions to increase omega-3 fatty acid intake. METHODS A ten-minute survey was conducted online to assess the knowledge, attitudes, behaviours, and intentions of Australian pregnant women across three domains: (1) preterm birth; (2) nutrition and supplementation during pregnancy; and (3) omega-3 fatty acid consumption to prevent preterm birth. Participants were recruited from Survey Sampling International's research panels. RESULTS Of the 763 women who completed the survey, less than two-thirds had heard of preterm birth. Over 55% of respondents had changed their diet during pregnancy and a prenatal dietary supplement was consumed by 82% of the women surveyed. Respondents' main source of information about preterm birth and nutrition during pregnancy was from a health professional. When asked about their intentions to increase their omega-3 fatty acid intake following a health professional's recommendation, the vast majority of participants indicated they would increase their omega-3 fatty acid intake (90%). When a hypothetical scenario was presented of an omega-3 fatty acid supplement being offered from a health service at no cost, the number of respondents who selected they would increase their intake through supplementation increased from 54 to 79%. CONCLUSIONS The main information source for women about preterm birth and dietary supplementation recommendations during pregnancy is their health professional. Therefore, informing women about ways to prevent preterm birth, including the role of omega-3 fatty acids, should occur during antenatal visits. The results from our study are useful for clinicians caring for pregnant women and for the next stage of translation of the Cochrane review findings - the design of implementation strategies to increase the intake of omega-3 fatty acids during pregnancy where needed.
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Affiliation(s)
- Jamie V de Seymour
- SAHMRI Women and Kids, South Australian Health and Medical Research Institute, Adelaide, Australia
| | - Lucy A Simmonds
- SAHMRI Women and Kids, South Australian Health and Medical Research Institute, Adelaide, Australia
| | - Jacqueline Gould
- SAHMRI Women and Kids, South Australian Health and Medical Research Institute, Adelaide, Australia.,Discipline of Paediatrics, University of Adelaide, Adelaide, Australia.,School of Psychology, University of Adelaide, Adelaide, Australia
| | - Maria Makrides
- SAHMRI Women and Kids, South Australian Health and Medical Research Institute, Adelaide, Australia.,Discipline of Paediatrics, University of Adelaide, Adelaide, Australia
| | - Philippa Middleton
- SAHMRI Women and Kids, South Australian Health and Medical Research Institute, Adelaide, Australia. .,Robinson Research Institute, University of Adelaide, Adelaide, Australia.
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Zhou SJ, Greco RL, Grivell R, Louise J, Deussen A, Dodd J, Moran LJ. Awareness of Listeriosis and Methylmercury toxicity public health recommendations and diet during pregnancy. Women Birth 2019; 32:e65-e70. [DOI: 10.1016/j.wombi.2018.04.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2017] [Revised: 02/27/2018] [Accepted: 04/03/2018] [Indexed: 11/24/2022]
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Abstract
OBJECTIVE Public health messages to reduce Hg exposure for pregnant women have focused exclusively on advice on fish consumption to limit Hg exposure, with little account being taken of the positive contribution of fish to nutritional quality. The aim of the present review was to compare and contrast the content and presentation of national guidelines on fish consumption in pregnancy, and comment on their evidence base and impact on consumption. DESIGN We searched for national and international guidelines on fish consumption in pregnancy using Internet search strategies. The detailed content and style of presentation of the guidelines were compared. The evidence base for the guidelines, and evidence for the impact of the guidelines on fish consumption levels, were assessed. RESULTS We identified nineteen national guidelines and three international guidelines. There was great variation in the content, complexity and presentation style. The guidelines were based largely on the Hg content of fish with far less consideration being given to the positive beneficial effects of nutrients provided by fish. The complexity of the guidelines may lead to pregnant women reducing their fish intake, or not eating fish at all. CONCLUSIONS Guidelines on fish consumption in pregnancy should take the beneficial effects of fish into account. Guidelines need to be clear and memorable, and appropriately disseminated, to achieve impact. Guidelines could include visual rather than narrative content. Use of technology, for example apps, could enable women to record their fish consumption in real time and log compliance with guidance over a week or other time period.
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Lucas C, Starling P, McMahon A, Charlton K. Erring on the side of caution: pregnant women's perceptions of consuming fish in a risk averse society. J Hum Nutr Diet 2015; 29:418-26. [PMID: 26693662 DOI: 10.1111/jhn.12353] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Fish and seafood are good sources of several nutrients that are important for foetal growth and development. Despite guidelines encouraging the eating of fish during pregnancy, research indicates that pregnant women may be limiting or avoiding these foods. Possible factors contributing to this include concerns regarding levels of mercury and other contaminants and pregnant women's purported heightened risk consciousness. The present study aimed to explore pregnant women's perceptions of consuming fish and seafood during pregnancy. METHODS Semi-structured telephone interviews were conducted with 15 pregnant women across all three trimesters in New South Wales, Australia. Questions focussed on exploring nutrition information received during pregnancy, dietary changes made during pregnancy and, more specifically, perceptions of fish and seafood, as well as views on information of fish and seafood commonly provided to pregnant women. Data were collected, then transcribed and analysed using an inductive coding process, guided by the qualitative theory grounded approach. RESULTS Multiple inter-related themes were found to shape pregnant women's perceptions related to fish and seafood consumption during pregnancy; namely, the understanding of fish and seafood as part of a healthy diet, external factors such as cost, individual preferences such as taste, and confidence in choosing and preparing fish. The context of a risk adverse society permeated these themes. CONCLUSIONS The present study provides insight into the inter-related factors that influence pregnant women's consumption or avoidance of fish and seafood.
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Affiliation(s)
- C Lucas
- School of Medicine, University of Wollongong, Wollongong, NSW, Australia
| | - P Starling
- School of Medicine, University of Wollongong, Wollongong, NSW, Australia
| | - A McMahon
- School of Medicine, University of Wollongong, Wollongong, NSW, Australia
| | - K Charlton
- School of Medicine, University of Wollongong, Wollongong, NSW, Australia
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Starling P, Charlton K, McMahon AT, Lucas C. Fish intake during pregnancy and foetal neurodevelopment--a systematic review of the evidence. Nutrients 2015; 7:2001-14. [PMID: 25793632 PMCID: PMC4377896 DOI: 10.3390/nu7032001] [Citation(s) in RCA: 85] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2015] [Accepted: 03/10/2015] [Indexed: 11/16/2022] Open
Abstract
Fish is a source of several nutrients that are important for healthy foetal development. Guidelines from Australia, Europe and the USA encourage fish consumption during pregnancy. The potential for contamination by heavy metals, as well as risk of listeriosis requires careful consideration of the shaping of dietary messages related to fish intake during pregnancy. This review critically evaluates literature on fish intake in pregnant women, with a focus on the association between neurodevelopmental outcomes in the offspring and maternal fish intake during pregnancy. Peer-reviewed journal articles published between January 2000 and March 2014 were included. Eligible studies included those of healthy pregnant women who had experienced full term births and those that had measured fish or seafood intake and assessed neurodevelopmental outcomes in offspring. Medline, Scopus, Web of Science, ScienceDirect and the Cochrane Library were searched using the search terms: pregnant, neurodevelopment, cognition, fish and seafood. Of 279 papers sourced, eight were included in the final review. Due to heterogeneity in methodology and measured outcomes, a qualitative comparison of study findings was conducted. This review indicates that the benefits of diets providing moderate amounts of fish during pregnancy outweigh potential detrimental effects in regards to offspring neurodevelopment. It is important that the type of fish consumed is low in mercury.
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Affiliation(s)
- Phoebe Starling
- School of Medicine, University of Wollongong, NSW 2522, Australia.
| | - Karen Charlton
- School of Medicine, University of Wollongong, NSW 2522, Australia.
| | - Anne T McMahon
- School of Medicine, University of Wollongong, NSW 2522, Australia.
| | - Catherine Lucas
- School of Medicine, University of Wollongong, NSW 2522, Australia.
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